Lower Abdominal Pain: Causes, Types & Treatments
By Miss Louise Hayes MBBS (Lond.) FRCOG
Consultant in Gynaecology & Women’s Health
Published April 24th 2023
We’ve all been there. Groaning, wincing, shifting to ease the pain, then here comes another wave… Lower abdominal pain is a drag, but it rarely lasts long and it hardly ever means anything serious. But how can you tell? And when should you ask? And is there anything you can you do to ease the misery?
Why is my tummy hurting?
There could be all sorts of reasons. The good news is, hardly any of them are any real cause for concern. Mostly they’ll do no damage, go away soon, and that’ll be that.
Most abdominal pain comes under the broad heading ‘just one of those things’, can hit men just as much as women, and is due to some boring everyday explanation like something you ate, a strained muscle or a bit of trapped wind.
Women suffer various additional causes of abdominal pain, from urinary infections to period pains, but again the vast majority are normal, non-threatening, and temporary.
In short, most of the time there’s nothing to worry about and not a great deal you can do beyond having a bath, hugging a hot water bottle, taking some paracetamol or ibuprofen, and hanging out on the sofa till it all goes away.
What if it’s really bad?
If the pain:
- Starts suddenly and for no apparent reason
- Is unusually bad – particularly if it’s in one place, and
- Just feels to you like there could be something seriously wrong
…you need to speak to someone now.
You should also seek immediate help and advice if:
- You’re being treated for cancer
- You’re pregnant – or think you may be
- You’re unable to poo – particularly if you’re also throwing up
- You’re vomiting blood, or see blood in your poo
- You get sudden/severe/unusual chest, neck, or shoulder pain
- Your belly feels unusually tender and/or tight, rigid, hard to the touch
- You’ve had a recent abdominal injury
- You’re having difficulty breathing
Any such symptoms could indicate an underlying problem, possibly serious, and/or require immediate treatment.
In the case of less severe symptoms (which may still be really unpleasant!) you should call your doctor if:
- The pain lasts a week or more
- After 24-48 hours your pain is getting worse rather than better, or combines with nausea and/or vomiting
- Bloating hasn’t gone away after two or three days
- You have diarrhoea that lasts more than five days
What is my ‘lower abdomen’?
When we say lower abdomen, we’re talking about the bit of your tummy below the belly button. This is where most of the pains that are just for women tend to be located.
When you’re trying to decide whether what you’re suffering is bad enough to need medical attention, it can be helpful to think in terms of three broad areas of your lower abdomen – middle, left and right.
Pains in the middle part of your lower abdomen could mean:
- Period pain – usually a crampy, dull or tight pain, sometimes extending to the lower back. Often uncomfortable or worse, but many women find they can cope with the help of a hot water bottle and basic painkillers like paracetamol and ibuprofen.
- Urinary tract infection – cystitis or some other UTI, causing pain along with urinary symptoms like burning, stinging, or needing to pee urgently. Drink lots of fluids, and wait. If your symptoms don’t go away, or get worse, speak to your doctor, who may prescribe a short course of antibiotics.
- Pelvic inflammatory disease – infections of your uterus, fallopian tubes and ovaries are common and again, for the most part, will go away of their own accord. But if they don’t – and particularly if symptoms get worse – you need to speak to a doctor.
- Pain during sex – and/or discoloured or smelly discharges: again, suggest infection. Look after yourself, refrain from sex, and wait. And if your symptoms persist after a week or so, talk to your doctor.
Pains in the left of your lower abdomen could be due to any of the above, but could also be:
- Gas (flatulence) – gas built up in your guts from swallowing air or generated by your body’s digestive processes. Any ‘abnormal’ farting/burping that doesn’t stop within a day or two may suggest issues, and should be checked out.
- Polyps or diverticular disease – small bumps or pockets on the bowel, either of which can cause diarrhoea and sometimes bleeding. Symptoms may be tolerable, but if you notice blood in your poo, or it looks black and tarry, call for advice immediately.
Again, as for ‘middle’, but if you have a sudden, sharp, stabbing pain on the right, you need to get advice, because it could be a sign of appendicitis: swelling or inflammation of the appendix due to infection. Appendicitis can be serious, and if it’s suspected, you need to talk to someone straightaway – or if the pains are really bad, call 111 or go straight to A&E.
What else might cause lower abdominal pain?
- Muscle strains – due to exercise or injury can affect any part of your lower abdomen, and can be painful and persistent. Be brave, grit your teeth, take painkillers.
- Pregnancy – pregnancy imposes all sorts of new strains on your organs and muscles. Hardly surprising if they protest a bit! Some women also suffer from Braxton Hicks contractions approaching their due date, as the muscles prepare for childbirth.
- Ectopic pregnancy – affecting around 11,000 women in the UK every year, many cause no symptoms, but they can lead to lower abdominal pain in one side, or both sides, or generally – often severe. Need to seek medical review urgently.
As ever, the general rule is, if you feel out of sorts, uncomfortable, sore and in need of chocolate, that’s just normal. But anything that feels ‘unusual’ – so sudden, sharp or stabbing pains, discharges, bleeding, vomiting – get help straightaway. In extreme cases, go straight to A&E.
Is there anything I can do about lower abdominal pain?
Mostly it’s a case of keeping safe, comfortable and warm, avoiding stress, and biding your time. Some women find it helpful to:
- Sip water or other clear fluids
- Avoid solid foodfor a few hours
- Eat less, more frequently, favouring bland foods like rice, pasta or plain biscuits, and avoiding dairy
- Use antacids to control heartburn or indigestion
- Avoid ‘high-risk’ foods, like citrus fruits, high-fat, fried or greasy foods, tomatoey foods, caffeine, alcohol, and fizzy drinks, and foods that you know give you gas
- Eat well, with balanced, high-fibre foods including plenty of fresh fruit and veg
- Exercise – just a walk can be a great remedy. Or a swim, yoga, gentle gymnastics…whatever works for you