Abdominal pain is pain that occurs between the chest and pelvic regions. It can be crampy, achy, dull, intermittent, constant, or sharp and can be associated with other symptoms such as nausea, vomiting, diarrhea, fever, chills, and pain with urination. There are so many possible causes of this pain and many will often assume that it's our uterus or ovaries but that is not always the case. 

Evaluating abdominal pain requires an approach that relies on patient history, physical examination, blood tests, and imaging studies. The location of pain is a useful starting point and will guide further evaluation. This can sometimes be difficult because there are so many organs in your abdomen that can cause pain. Here are some possible causes of abdominal pain besides the uterus, fallopian tubes, and ovaries:

Muscle

Musculoskeletal pain is usually hard to diagnose and pain that is discovered after everything has been ruled out. Muscle pain can be caused by a trigger point. This is a tight area within the muscle that causes pain in other parts of the body. The area of pain is located no more than a few centimeters in from the point of tenderness and can be reproduced by tensing the abdominal wall. Stretching, massage, heat, and injection with a numbing medicine (lidocaine) can help provide relief.

Urinary System

The kidneys are located in the middle of the back but there are tubes called ureters that connect the kidney to the bladder in your lower abdomen. Depending on the location, the urinary system can be a cause of your pain. If your pain is in your back, you could have kidney stones or a kidney infection called pyelonephritis. Kidney stones usually cause colicky back that may radiate to your lower belly and cause nausea, vomiting, and blood in your urine. Pyelonephritis will cause constant back pain, fever, nausea, vomiting, frequent and burning with urination. If you have symptoms such as frequent urge to urinate, burning, and pain with urination then you may have a simple bladder infection. Your doctor will do blood work, check your urine, and possibly get imaging or picture of your kidneys if they suspect something more serious than a bladder infection.

Bowel

This type of pain is often caused by a particular organ depending on the area. You can localize pain by dividing your abdomen into 4 quadrants, right and left upper quadrant and right and left lower quadrant. 

  1. Right upper quadrant. If you have pain in the right upper quadrant, then it could be your gallbladder. Your gallbladder is a small sac that sits on top of your liver. Gallbladder disease is common in women in their 40s and is usually made worse after eating fatty foods. The pain will have a sudden onset and can be associated with gas, bloating, nausea, and pain after eating. 
  2. Epigastric Pain is located right under your breastbone. This can be due to regurgitation of food or sour liquid called acid reflux. Symptoms are worse after eating and at night when you lay down. Epigastric pain associated with shortness of breath may be symptoms of a heart attack.  
  3. Left upper quadrant pain can be due to pancreatitis. This is commonly caused by gallstones or alcohol. The pain is dull and constant and often radiates to your back.  Pancreatitis is usually worse after eating and can also cause nausea, vomiting, and fever.
  4. Left lower quadrant pain is usually caused by the large bowel. Diverticulitis is the inflammation or infection of small bulging pouches called diverticula. This is caused by a chronic low-fiber diet and constipation. Symptoms include nausea, fever and chills.  
  5. Right lower quadrant pain can be caused by appendicitis. You may experience fever, chills, nausea, vomiting and poor appetite. The appendix is a 3-4 in long tube between your small and large bowel.  Appendicitis is usually caused because the appendix gets blocked and then becomes infected. If you suspect you have appendicitis, see immediate medical attention. 

Keeping track of your symptoms and location always helps narrow down what the possible causes are. Just because you are a woman does not mean the uterus, fallopian tubes, or ovaries are always the cause. I hope this helps the next time you are experiencing abdominal pain.

With love, 

Dr. Jodie Horton