Why Does My Lower Stomach Hurt? Understanding Causes and When to Seek Help

Lower stomach pain, medically referred to as lower abdominal pain, is a common complaint with a wide range of potential causes. This area, located between your belly button and pelvic bone, can experience discomfort for various reasons, from simple indigestion to more serious medical conditions.

It’s crucial to understand that lower abdominal pain is a symptom, not a disease itself. If you’re experiencing this pain, paying attention to accompanying symptoms is vital for determining the potential cause and when to seek medical attention. Symptoms like blood in your stool or vomit, alongside lower abdominal pain, are red flags that warrant immediate medical evaluation.

:max_bytes(150000):strip_icc()/VWH_Illustration_RedFlagDIgestiveSymtpoms_Illustrator_JessicaOlah_Final-c5b501ebe287456496277b7f90dc7878.jpg)

Verywell / Jessica Olah

When Should You Consult a Healthcare Provider for Lower Stomach Pain?

While occasional mild lower stomach pain might be due to temporary issues like gas, it’s important to know when to seek professional medical advice. Consult a healthcare provider if your lower stomach pain:

Persists or Worsens: If the pain doesn’t subside or intensifies over time.
Is Severe: Intense pain that significantly impacts your daily activities.
Is Accompanied by Red Flag Symptoms:
- Blood in the stool: This could indicate bleeding in the digestive tract.
- High fever: Suggests infection.
- Vomiting blood: A serious symptom requiring immediate attention.
- Lightheadedness or dizziness: Could indicate internal bleeding or dehydration.
- Unexplained weight loss: May point to an underlying medical issue.
- Changes in bowel habits: Significant constipation or diarrhea that is new or worsening.

These symptoms could be indicative of conditions that require prompt diagnosis and treatment. Let’s explore some of the potential causes of lower stomach pain.

Potential Causes of Lower Stomach Pain

Lower abdominal pain can stem from various organs and systems in your body. Here are some common and significant causes:

Appendicitis: A Surgical Emergency

Appendicitis is a serious condition requiring immediate medical intervention. It occurs when the appendix, a small pouch attached to your large intestine, becomes inflamed and infected. If left untreated, the appendix can rupture, leading to severe complications.

Appendicitis is most prevalent in individuals between 10 and 30 years old, but it can occur at any age.

Symptoms of Appendicitis:

Pain Progression: Pain often starts gradually around the navel and then shifts to the lower right side of the abdomen. This pain typically worsens over time. It’s a hallmark symptom to differentiate appendicitis pain.
Rebound Tenderness: Pain that intensifies when pressure is released from the abdomen, particularly in the lower right quadrant.
Aggravated Pain: Pain that is exacerbated by movement, deep breathing, coughing, or sneezing.
Gastrointestinal Distress: Nausea and vomiting are common.
Abdominal Swelling: The abdomen may become distended and tender to the touch.
Changes in Bowel Habits: Diarrhea or constipation can occur.
Low-Grade Fever: A mild fever may develop.
Loss of Appetite: Feeling less hungry than usual.
Inability to Pass Gas: Difficulty or inability to relieve gas.

It’s crucial to note that if the appendix ruptures, there might be a temporary decrease in pain, followed by a rapid worsening as infection spreads throughout the abdomen, potentially leading to sepsis, a life-threatening condition.

Causes of Appendicitis:

Infections: Viral, bacterial, or parasitic infections within the digestive tract can trigger appendicitis.
Blockage: A blockage in the appendix, often due to hardened stool (fecalith), can lead to inflammation.
Tumors: Although rare, tumors in the appendix or intestines can contribute to appendicitis.

Treatment for Appendicitis:

The standard treatment for appendicitis, especially in cases without rupture, is a laparoscopic appendectomy, a minimally invasive surgical procedure to remove the appendix. Antibiotics may be used in very mild cases without complications, but surgery is often recommended due to the risk of recurrence.

In cases of a ruptured appendix or complications, an open appendectomy (traditional surgery) may be necessary. Post-surgery, antibiotics and drainage tubes might be required to manage infection.

Seek Immediate Emergency Care:

If you suspect appendicitis, especially with sudden, worsening lower right abdominal pain, seek emergency medical attention immediately. Appendicitis is a medical emergency requiring prompt surgical intervention to prevent serious and potentially fatal complications.

Colitis: Inflammation of the Colon

Colitis refers to chronic inflammation of the large intestine, or colon. It’s classified as a type of inflammatory bowel disease (IBD).

Symptoms of Colitis:

Abdominal Pain: Colitis pain can develop gradually or suddenly and may be constant or intermittent. It’s often described as cramping, typically located in the lower left abdomen. Flare-ups, periods of worsened symptoms, are common, followed by periods of remission with milder pain.
Blood in Stool: A frequent symptom, indicating inflammation and potential ulceration in the colon.
Bloating: A feeling of fullness and distention in the abdomen.
Frequent Urge to Defecate (Tenesmus): A persistent feeling of needing to have a bowel movement, even after having one.
Diarrhea: Loose, frequent stools are common.
Dehydration: Due to diarrhea, dehydration can be a concern.
Fever: May occur during flare-ups.

Causes of Colitis:

Infections: Viral or parasitic infections in the colon.
Food Poisoning: Bacterial food poisoning.
Inflammatory Bowel Diseases: Crohn’s disease and ulcerative colitis are major causes.
Ischemic Colitis: Reduced blood flow to the colon.
Radiation Colitis: Damage to the colon from radiation therapy.
Necrotizing Enterocolitis: Primarily in newborns.

In a significant percentage of cases, the exact cause of colitis remains unknown, suggesting a combination of genetic, environmental, and dietary factors.

Treatment for Colitis:

Treatment strategies for colitis vary depending on the severity and type. Mild to moderate colitis is often managed with aminosalicylates, medications that reduce inflammation in the colon. Other treatment options include:

Corticosteroids: Short-term oral corticosteroids to reduce inflammation and induce remission.
Immunomodulators: Medications to suppress the immune system and reduce inflammation.
Biologic Therapies: Newer medications that target specific proteins involved in inflammation.
Surgery: In severe cases, surgery like total proctocolectomy with Brooke ileostomy (removal of the colon and rectum with an ostomy bag) or proctocolectomy with ileal pouch-anal anastomosis (creation of an internal pouch) may be necessary.

Diverticular Disease: Pouches in the Colon

Diverticular disease encompasses diverticulosis and diverticulitis. Diverticulosis is the presence of small, bulging pouches (diverticula) in the colon wall. Diverticulitis occurs when these pouches become inflamed or infected. Diverticular disease is more common with age, affecting over half of adults over 60.

Symptoms of Diverticular Disease:

Diverticulosis: Many individuals with diverticulosis experience no symptoms. However, some may have bloating, cramping, and constipation.
Diverticulitis: Symptoms often arise suddenly and can be severe, including:
- Sharp Abdominal Pain: Typically located in the lower left abdomen, accompanied by tenderness.
- Nausea and Vomiting: Common gastrointestinal symptoms.
- Loss of Appetite: Reduced desire to eat.
- Fever and Chills: Indicating infection.

While less common, blood in the stool can occur in diverticulitis and requires prompt medical attention.

Causes of Diverticular Disease:

The precise cause isn’t fully understood, but a low-fiber diet is considered a major contributing factor. Lack of fiber can lead to harder stools, straining during bowel movements, and increased pressure in the colon, potentially causing diverticula to form. Once formed, these pouches are permanent, and diverticulitis can recur.

Treatment for Diverticular Disease:

Treatment for diverticulitis depends on symptom severity. Mild cases may be managed with:

Rest: Bed rest to reduce strain on the digestive system.
Heat Therapy: Heating pad on the abdomen to soothe pain.
Pain Medication: Over-the-counter or prescription pain relievers as recommended by a doctor.
Dietary Changes: Initially, clear liquids, then progression to thicker fluids and solid foods.
Antibiotics: Prescribed if infection is present.

Kidney Infection (Pyelonephritis): Infection of the Kidneys

A kidney infection, or pyelonephritis, is a type of urinary tract infection (UTI) where one or both kidneys become infected, usually by bacteria but sometimes by viruses or fungi.

Symptoms of Kidney Infection:

Severe Pain: Kidney infection pain can be intense and felt in the back, side, abdomen, and groin.
Painful Urination (Dysuria): Burning or pain during urination.
Frequent Urge to Urinate (Urgency): Feeling the need to urinate often.
High Fever with Chills: Indicating a systemic infection.
Nausea and Vomiting: Gastrointestinal symptoms.

Causes of Kidney Infection:

Kidney infections typically start as bladder infections (cystitis). If the infection spreads upwards from the bladder to the kidneys, it can cause pyelonephritis.

Treatment for Kidney Infection:

Kidney infections caused by bacteria are treated with antibiotics. Antifungal or antiviral medications are used for infections caused by fungi or viruses. Pain relievers like acetaminophen can help manage pain. Prompt treatment is essential to prevent kidney damage and complications.

Acute Urinary Retention: Inability to Urinate

Acute urinary retention is the sudden inability to urinate. It’s more common in men, especially after age 60, and requires immediate medical attention.

Symptoms of Acute Urinary Retention:

Inability to Urinate: Complete or partial inability to pass urine.
Difficulty Starting Urination (Hesitancy): Trouble initiating urine flow.
Severe Lower Abdominal Pain: Often intense pain due to bladder distention.
Urgent Need to Urinate (Urgency): Feeling a strong urge to urinate without success.
Urinary Leakage (Overflow Incontinence): Leaking urine without warning.
Lower Abdominal Swelling: Distention of the lower abdomen.

Causes of Acute Urinary Retention:

Urinary retention often results from a blockage preventing urine outflow from the bladder or urethra. Common causes include:

Prostate Issues: Enlarged prostate (benign prostatic hyperplasia – BPH) or prostate inflammation (prostatitis).
Obstruction: Bladder obstruction from scar tissue or stones.
Tumors: Pelvic tumors, fibroids, polyps, or clots.
Pelvic Floor Muscle Issues: Tight pelvic floor muscles.
Infections: UTIs or sexually transmitted infections (STIs).
Trauma: Injury to the pelvis, urethra, or penis.
Neurological Conditions: Parkinson’s disease, multiple sclerosis, or stroke.
Medications: Certain antidepressants, opioids, and decongestants.
Weak Bladder Muscles: Due to aging, trauma, pregnancy, or childbirth.

Treatment for Acute Urinary Retention:

Acute urinary retention is an emergency. Immediate treatment in an emergency room involves bladder drainage using a catheter to relieve pain and prevent bladder and kidney damage. Treating the underlying cause is crucial for long-term resolution.

Cystitis: Bladder Inflammation

Cystitis refers to inflammation of the bladder, commonly caused by a lower urinary tract infection (UTI). It’s far more frequent in women than men. Menopause increases cystitis risk in women due to hormonal changes.

Symptoms of Cystitis:

Painful Urination (Dysuria): Pain or burning sensation during urination.
Lower Abdominal or Back Cramps/Pressure: Discomfort in the lower abdomen or back.
Frequent Urge to Urinate (Urgency): Feeling the need to urinate often.
Urinary Incontinence: Involuntary urine leakage.
Cloudy or Dark Urine: Changes in urine appearance.
Blood in Urine (Hematuria): Blood in the urine.
Foul-Smelling Urine: Unusual urine odor.
Pain During Intercourse (Dyspareunia): Pain during sexual activity.
Genital Pain: Discomfort in the genital area.
Low-Grade Fever: Mild fever.
Fatigue: Feeling unusually tired.

Older adults may experience cystitis with atypical symptoms like fever, confusion, or delirium.

Causes of Cystitis:

Bacterial infection is the most common cause. Bacteria from the rectal area or during sexual activity can enter the urethra and reach the bladder. Women are more susceptible due to shorter urethras. Non-bacterial causes include medications, radiation, foreign objects, interstitial cystitis, and underlying medical conditions.

Treatment for Cystitis:

Antibiotics are typically prescribed for bacterial cystitis. Pain relievers like phenazopyridine can manage urinary tract pain. Warm sitz baths can also provide relief. Cystitis caused by blockages may require surgical intervention.

Nephrolithiasis (Kidney Stones): Mineral Deposits in the Kidneys

Kidney stones are hard masses that form in the kidneys from mineral and acid buildup in urine, such as calcium, oxalate, phosphorus, and uric acid.

Symptoms of Kidney Stones:

Sharp Pain: Intense, sharp pain in the back, side, lower abdomen, or groin. Pain can be constant or come and go in waves.
Blood in Urine (Hematuria): Pink, red, or brown urine.
Persistent Urge to Urinate (Urgency): Feeling a constant need to urinate.
Painful Urination (Dysuria): Pain or burning during urination.
Difficulty Urinating (Hesitancy): Trouble starting urine flow.
Cloudy or Foul-Smelling Urine: Changes in urine appearance and odor.
Nausea and Vomiting: Gastrointestinal symptoms.
Fever and Chills: May occur if infection is present.

Causes of Kidney Stones:

Kidney stones are common and often have a familial tendency. Dehydration, obesity, weight loss surgery, high salt or sugar intake, and high fructose consumption are risk factors.

Treatment for Kidney Stones:

Small kidney stones may pass on their own with increased fluid intake. Pain relievers can help manage discomfort. Other treatments include:

Medications: Diuretics, allopurinol, sodium bicarbonate or citrate, and tamsulosin to aid stone passage.
Lithotripsy: Non-invasive procedure using sound or shock waves to break up stones.
Surgery: In rare cases, surgery is needed to remove large stones.

Trapped Gas: Air in the Digestive Tract

Trapped gas in the digestive tract is a frequent cause of abdominal discomfort. The average person produces a significant amount of gas daily.

Symptoms of Trapped Gas:

Burping: Releasing air from the stomach.
Bloating: Feeling of abdominal fullness and distention.
Abdominal Pain: Can vary depending on gas location. Left-side gas may mimic heart pain, while right-side gas can resemble appendicitis pain.
Flatulence: Passing gas.

Causes of Trapped Gas:

Swallowing air and consuming certain gas-producing foods are common causes. These foods include:

High Fiber Foods: Soluble fiber (beans) and insoluble fiber (vegetables).
Fructose: Onions, bananas.
Raffinose: Cabbage, cruciferous vegetables.
Starch: Potatoes, noodles.
Lactose: Dairy products.

Individuals with lactose intolerance or digestive disorders are more prone to gas.

Treatment for Trapped Gas:

Trapped gas is usually not serious and resolves on its own. Burping and passing gas provide relief. Home remedies include:

Herbal Teas: Peppermint or chamomile tea to relax the bowel.
Apple Cider Vinegar: Diluted in water to aid digestion.
Deep Breathing: Relaxation techniques.
Light Physical Activity: Walking, yoga.

If gas symptoms persist despite home remedies, consult a healthcare provider to rule out food sensitivities or digestive issues.

Twisted Bowel (Volvulus): Intestinal Obstruction

A twisted bowel, or volvulus, occurs when part of the intestine twists, potentially cutting off blood supply (bowel obstruction). It’s a serious condition requiring immediate medical care.

Symptoms of Twisted Bowel:

Cramping Abdominal Pain: Pain that may be constant or intermittent.
Bloating: Abdominal distention.
Constipation: Difficulty passing stool.
Nausea and Vomiting: Gastrointestinal distress.

Emergency Symptoms:

Seek immediate medical attention if you experience:

Infection Symptoms: Fever.
Shock Symptoms: Confusion, loss of consciousness, rapid heart rate, sweating, pale skin.

Causes of Twisted Bowel:

Twisted bowel can be caused by congenital abnormalities in intestinal structure or surrounding tissues, such as a longer-than-average sigmoid colon or loose tissues allowing excessive colon movement. Sigmoid volvulus is more common in older adults in long-term care facilities due to prolonged bed rest.

Treatment for Twisted Bowel:

Twisted bowel is a medical emergency. Treatment usually involves emergency surgery. In some cases without colon damage, a flexible sigmoidoscopy may untwist the bowel. Surgery to remove the affected colon segment may be necessary if sigmoidoscopy fails or if there’s colon damage.

Menstrual Cramps (Dysmenorrhea): Uterine Contractions

Menstrual cramps are common lower abdominal pain experienced by menstruating individuals due to uterine contractions.

Symptoms of Menstrual Cramps:

Lower Abdominal Pain: Mild to severe, dull or throbbing, continuous pain for a few days.
Lower Back Pain: Pain radiating to the lower back.
Fatigue: Feeling tired.
Weakness: General body weakness.
Diarrhea: Loose stools.
Nausea and Vomiting: Gastrointestinal symptoms.
Headaches: Head pain.

Causes of Menstrual Cramps:

Mild to moderate cramps are normal during menstruation. Secondary dysmenorrhea refers to abnormal cramps due to underlying conditions like endometriosis or fibroids.

Treatment for Menstrual Cramps:

Over-the-counter pain relievers (NSAIDs like ibuprofen, naproxen, or acetaminophen) are first-line treatments. Other options include:

Oral Contraceptives: To suppress ovulation.
Progesterone Therapy: Hormone treatment.
Regular Exercise: Physical activity.
Heat Therapy: Heating pad on the abdomen.
Warm Baths/Showers: Heat application for pain relief.

Constipation: Infrequent Bowel Movements

Constipation is characterized by infrequent bowel movements and difficulty passing stool.

Symptoms of Constipation:

Inability to Poop: Difficulty or inability to have a bowel movement.
Painful Bowel Movements: Straining and discomfort during defecation.
Bloating and Discomfort: Abdominal distention and unease.
Sluggishness: Feeling tired and low energy.
Abdominal Pain: Discomfort in the abdomen.

Causes of Constipation:

Constipation occurs when the colon absorbs too much water, leading to hard, dry stools. Common causes include:

Lack of Exercise: Sedentary lifestyle.
Dehydration: Insufficient fluid intake.
Low-Fiber Diet: Inadequate dietary fiber.
Pregnancy: Hormonal changes and physical pressure.
Old Age: Age-related changes in bowel function.
Laxative Abuse: Overuse of laxatives.
Underlying Conditions: Irritable bowel syndrome (IBS) or intestinal function problems.
Medications: Certain antidepressants and opioids.

Treatment for Constipation:

Increasing fiber intake and fluid consumption are often effective. Prunes or figs can help. Laxatives or magnesium supplements may be used in more severe cases. Prevention strategies include a high-fiber diet and adequate hydration.

Irritable Bowel Syndrome (IBS): Functional Bowel Disorder

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by gastrointestinal symptoms without structural abnormalities.

Symptoms of Irritable Bowel Syndrome (IBS):

Abdominal Pain: Varying types and locations of pain.
Changes in Bowel Habits: Diarrhea, constipation, or alternating patterns.
Bloating: Abdominal distention.
Mucus in Stool: Presence of mucus in bowel movements.
Incomplete Evacuation: Feeling like the bowel movement is not fully finished.

Symptoms occur at least three days per month for three months or more to be considered IBS.

Causes of Irritable Bowel Syndrome (IBS):

The exact cause is often unclear. Post-infectious IBS can develop after bacterial or parasitic infections. Stress is also a common trigger.

Treatment for Irritable Bowel Syndrome (IBS):

Diet and lifestyle changes, such as avoiding trigger foods, eating slowly, smaller meals, and increasing fiber, are initial recommendations. Medications for severe cases include:

Antispasmodics: To control intestinal muscle spasms.
Loperamide: For IBS with diarrhea (IBS-D).
Lubiprostone: For IBS with constipation (IBS-C).
Low-Dose Tricyclic Antidepressants: For intestinal pain relief.
Psychological Therapies: For stress-related IBS.

Diagnosing Lower Abdominal Pain

If your lower abdominal pain persists, worsens, or is not relieved by simple measures, seeking medical attention is essential. Diagnosis involves:

Medical History and Physical Exam: The healthcare provider will ask detailed questions about your symptoms, medical history, and perform a physical examination, including abdominal palpation.
Gynecological or Rectal Exam: May be performed depending on the suspected cause and patient demographics.
Blood Tests: Complete blood count to check for infection or anemia. Pregnancy test for women of childbearing age.
Imaging Tests:
- CT Scan: Computed tomography scan to visualize abdominal organs.
- Ultrasound: Preferred imaging method for unexplained abdominal pain, especially in pregnant women.

Pelvic Pain vs. Lower Abdominal Pain

Sometimes, pelvic pain can be mistaken for lower abdominal pain. Conditions causing pelvic pain include:

Pelvic Inflammatory Disease (PID)
Ruptured Ovarian Cyst
Leiomyomas (Fibroids)
Endometriosis
Ovarian Torsion
Ectopic Pregnancy
Ovarian Hyperstimulation Syndrome
Ovarian Cancer

In Summary: Understanding Your Lower Stomach Pain

Lower abdominal pain is a common symptom with diverse causes, ranging from mild and temporary to serious medical conditions. It can originate from the digestive system, urinary tract, reproductive organs, or musculoskeletal system.

Common causes include trapped gas, indigestion, constipation, and menstrual cramps. More serious causes include appendicitis, colitis, diverticular disease, kidney infections, and twisted bowel.

Treatment depends entirely on the underlying cause. It may range from over-the-counter remedies to emergency surgery. It’s crucial to pay attention to your symptoms and seek medical advice if your lower stomach pain is persistent, severe, or accompanied by red flag symptoms. Early diagnosis and appropriate treatment are key to managing lower abdominal pain effectively and preventing complications.