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Lower abdominal pain can range from mild to severe, occurring anywhere from your belly button to your pelvis. Sometimes, it’s no more than a dull, aching sensation that’s easy to ignore. Other times, it presents as sharp, stabbing pain that can stop you in your tracks. And it’s common—according to a study published in Clinical Pathways in Emergency Medicine, abdominal pain accounts for 10% to 12% of visits to the emergency room globally[1]Mehta H. Abdominal Pain. Clinical Pathways in Emergency Medicine. 2016;22:32945. .

Less serious causes of abdominal pain include gas, indigestion or constipation. While these conditions don’t typically require urgent medical attention, it can be difficult to pinpoint the exact cause of abdominal discomfort. Furthermore, the severity of your stomach pain doesn’t necessarily correlate with the seriousness of the condition that’s causing it. For example, a viral stomach bug can cause intense pain, while more serious conditions, like colon cancer, may cause minimal or no pain.

Imagine a horizontal line drawn at the level of your belly button. Any significant discomfort located below that line is considered lower abdominal pain, says Carl V. Crawford, M.D., a gastroenterologist at Weill Cornell Medicine in New York City. At times, the pain can be confined to a very specific area that can be pointed to with one finger, says Dr. Crawford. But other times, it can be more difficult to determine its source.

This is because the region is home to so many home to many internal organs, including the stomach, liver, gallbladder, pancreas, small intestine and large intestine, says Vanessa Méndez, M.D., a triple board-certified gastroenterologist, internist and lifestyle medicine physician and founder of the telemedicine practice Planted Forward. “Each of these organs has a different role in your digestion and will generally express distress a bit differently,” explains Dr. Méndez.

Additionally, lower abdominal pain can be acute or chronic. Acute pain refers to a new issue with a sudden onset, explains Dr. Mendez, whereas pain that you’ve experienced for an extended period of time–either ongoing or intermittently– is considered chronic. Acute pain is typically related to illness or injury, and usually goes away when treated. Chronic pain can last for months or even years.

Identifying whether the source of your lower abdominal pain is acute or chronic can help your health care provider narrow down the cause and determine the best treatment, says Dr. Méndez.

The location is important, too. Doctors often view the abdomen in four quadrants, plus the epigastrium, or midline between the sternum and belly button, says Elena Ivanina, D.O., director of neuro-integrative gastroenterology at Lenox Hill Hospital in New York City. “The small intestines are usually in the middle around the belly button and the large intestine is in an upside-down “U” on the edges of the abdomen and across the top,” she continues. The quadrants and their corresponding symptoms, according to Dr. Ivanina, include:

When it comes to lower abdominal pain, there is a plethora of possible causes. Some of the more common causes include the following.

Trapped gas often occurs as part of the process of digestion, says Dr. Crawford. As we eat, we swallow air, and as food travels through the digestive tract, bacteria work to break down carbohydrates, producing gas as a byproduct. The result of this process are gasses that can cause uncomfortable symptoms.

Symptoms: Pain from trapped gas is acute and can occur anywhere in the abdomen, causing belching, bloating, a distended stomach and flatulence. Typically, people feel better once they’ve passed the gas, says Dr. Crawford. Gentle movements like walking, yoga stretches, light abdominal massaging, lots of water and calming teas may all help to soothe gas-related abdominal pain, advises Dr. Méndez.

Approximately 10% to 15% of adults in the U.S. may be living with Irritable Bowel Syndrome (IBS), according to the American College of Gastroenterology)[2]Irritable Bowel Syndrome. American College of Gastroenterology. Accessed 9/10/2022. . A disorder of the gastrointestinal (GI) tract, IBS is characterized by chronic abdominal pain and altered bowel habits, says Aniruddh Setya, M.D., a board-certified pediatric gastroenterologist at Joe DiMaggio Children’s Hospital and Kidz Medical Services in Hollywood, Florida.

Because other GI conditions need to be ruled out by a gastroenterologist before a true diagnosis of IBS can be made, IBS is called a diagnosis of exclusion, explains Dr. Méndez. While the true cause is unknown, IBS is thought to arise from a dysregulated gut-brain communication, which results in hypersensitivity in the intestinal organs and altered muscle contraction in the GI tract, she adds.

Symptoms: Pain from IBS is chronic and occurs in the lower abdomen. Symptoms of IBS often include abdominal pain, gas, bloating, and bowel changes including constipation, diarrhea and loose stool. Common triggers are stress and certain foods, like dairy and fermentable sugars, says Dr. Seyta. Treatments range from dietary control to medications designed to control the altered bowel pattern or the pain, adds Dr. Crawford.

Inflammatory bowel disease (IBD) is a term that describes two disorders involving chronic inflammation of the intestinal tract, says Dr. Méndez. The Centers for Disease Control and Prevention report that these two conditions—Crohn’s disease and ulcerative colitis— may impact as many as 3 million people in the U.S.[3]Inflammatory Bowel Disease . Centers for Disease Control and Prevention. Accessed 9/10/2022.

Symptoms: Common symptoms of ulcerative colitis and Crohn’s disease, which are chronic conditions, are similar and include frequent diarrhea, lower abdominal cramping and pain, bloody stools, fever, weight loss, fatigue and night sweats, says Dr. Méndez. Treatment for these chronic conditions may include medication, bowel rest or surgery.

If you have infrequent bowel movements that are difficult or painful to pass, you’re likely experiencing constipation, says Dr. Seyta. The condition, which is usually brought on by dietary triggers, insufficient hydration and stress, often occurs in individuals without an identifiable underlying cause, he continues. And it’s common—Dr. Méndez says constipation is the most frequent digestive complaint among her patients.

Symptoms: Constipation can be either acute or chronic, and usually causes pain and discomfort in the lower abdominal region. Symptoms of acute constipation include having three or less bowel movements in a week, hard, lumpy stools that can be difficult to pass and feeling like not all of your stool has passed. Bleeding may occur if the delicate anal tissue tears, says Dr. Seyta. Lifestyle changes like drinking more water, eating more fiber and getting more exercise often help resolve constipation, but if constipation persists or becomes chronic, it’s important to be evaluated by a doctor.

Chronic constipation from a diet low in fiber is believed to cause diverticula, or small, sac-like structures, to form inside of the colon. This condition is known as diverticulosis. When these pouches become inflamed or infected, it’s called diverticulitis and is most commonly seen in adults over the age of 60, says Dr. Méndez. You May Also Be Interested In Products For Digestion From Our Featured Partner Pique Sun Goddess Matcha Buy Now On Pique's Website Price $2.07 per serving Features Organic, Non-GMO, Vegan-friendly, Gluten free Ingredients 100% organic ceremonial grade matcha from Japan Hibiscus Beauty Elixir Buy Now On Pique's Website Price $1.14 per serving Features Zero preservatives, refined sugar, or additives Ingredients Hibiscus, mint, licorice root Jasmine Green Tea Buy Now On Pique's Website Price $1.14 per serving Features Zero preservatives, refined sugar, or additives Ingredients Organic jasmine green tea only Ginger Digestion Elixir Buy Now On Pique's Website Price $1.14 per serving Features Zero preservatives, refined sugar, or additives Ingredients Ginger, mint, licorice root, lemon peel, orange peel Passion Fruit Green Tea Buy Now On Pique's Website Price $1.14 per serving Features Zero preservatives, refined sugar, or additives Ingredients Organic green tea, natural passion fruit flavor Mint Sencha Green Tea Buy Now On Pique's Website Price $1.14 per serving Features Zero preservatives, refined sugar, or additives Ingredients Organic green tea, organic spearmint

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Symptoms: Acute diverticulitis is commonly felt on the left lower abdomen and may be ongoing and present for several days, says Dr. Méndez, and it may be accompanied by nausea, vomiting, fever and constipation.

When bacteria accidentally enters the urethra, this can cause an infection of the urinary tract, or UTI.

Symptoms: Urinary tract infection symptoms include a strong need to urinate, pain or burning in the lower pelvis, and burning while passing only small amounts of urine, says Dr. Méndez. “The urine may also be foul-smelling and appear oldly colored (cloudy or reddish-pink if blood is present),” she continues. These acute infections are treated with a course of antibiotics.

A kidney infection, or pyelonephritis, is a type of UTI that can become serious, requiring IV antibiotics, says Dr. Ivanina. It starts in the bladder and travels upward, infecting one or both of the kidneys.

Symptoms: Symptoms of this acute infection may include flank (side) pain, back pain, fever with chills (bad enough to cause shaking), nausea and vomiting, says Dr. Ivanina.

Concentrated deposits of salts and minerals that form in your kidneys and pass through the urinary system are called kidney stones, says Dr. Ivanina. These stones can get lodged in the urinary tract and cause a backup of urine in the kidney, bladder or urethra, which can cause infection and pain.

Symptoms: Symptoms of this acute condition may cause sharp, severe pain in the back, side, abdomen, and groin that comes in waves as well as discolored, foul-smelling urine and a change in urinary frequency, says Dr. Ivanina. Nausea, vomiting, fever and chills can also occur, she adds.

The appendix is a small, tubular-like structure that extends into the cecum of the colon, explains Dr. Crawford. Normally, mucus, cells and bacteria travel freely from the appendix into the cecum, but when a blockage occurs, inflammation of the appendix can result. Appendicitis is serious. It’s important to get to the ER if you think you are experiencing symptoms, as it often requires surgery, says Dr. Seyta

Symptoms: Acute appendicitis symptoms include right lower abdominal pain, nausea, vomiting, loss of appetite and fever, says Dr. Seyta. At first, the pain may be centered near the belly button, but as the inflammation progresses, it will migrate to the right lower quadrant of the abdomen, he says. Severe pain can come on suddenly.

Pelvic pain is also considered lower abdominal pain, but it specifically refers to issues affecting the genitourinary tract and the uterus, fallopian tubes and ovaries, explains Dr. Carpenter. Common causes of pelvic pain may include:

The root cause of lower abdominal pain will depend on each individual, says Dr. Méndez. Most of the time, it’s something innocuous like trapped gas or indigestion, but sometimes, lower abdominal pain can be a symptom of a more serious issue, she continues.

A diagnosis starts with a thorough history and physical exam. Your doctor may perform urine, blood and stool tests, enemas, a colonoscopy (a procedure where a doctor uses a scope to look inside your colon or rectum) or an endoscopy (a procedure in which a scope is used to view different organs in the body—for example, an upper endoscopy looks at the esophagus and stomach), says Dr. Méndez, adding that they may also order x-rays, ultrasounds or CT scans. “A gastroenterologist will do a full workup to determine the root cause including reviewing dietary and lifestyle habits,” continues Dr. Méndezs. You may be referred to other specialists, such as a urologist, gynecologist or even a surgeon, adds Dr. Carpenter.

A multidisciplinary approach is key to properly diagnosing lower abdominal pain, says Dr. Ivanina. The tests will vary depending on what specialist you are referred to. “A gastroenterologist may order a CT [of the] abdomen/pelvis and a colonoscopy. A gynecologist may do an internal examination and order a pelvic ultrasound. A urologist may do urine tests and evaluate the bladder with imaging,” she explains. Ritual Synbiotic+ 3-in-1 clinically-studied prebiotic, probiotic and postbiotic can help to support a balanced gut microbiome. Learn More

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It’s normal to experience a mild upset stomach or indigestion from time to time, but if your abdominal pain is persistent, worsening and associated with other symptoms, it’s time to see a doctor, advises Dr. Ivanina. Some of the more concerning symptoms include:

As innocuous as many instances of lower abdominal pain may be, if you start to experience symptoms of any kind that concern you, it’s always a good idea to speak with your doctor.

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Heidi Borst is a freelance journalist, healthcare content writer and certified nutrition coach with a love of all things health and wellness. Her work has appeared in The New York Times, The Washington Post, National Geographic, Good Housekeeping, MSN, Yahoo and more. Based in Wilmington, North Carolina, Borst is a lifelong runner and general fitness enthusiast who is passionate about the physical and mental benefits of sleep and self-care.

Dr. Rafael Sepulveda Acosta is a board-certified physician with experience in internal medicine, pediatric and adult sleep medicine, and obesity medicine in Northern California. He practices as a sleep medicine specialist and weight management physician in the North Bay of the San Francisco Bay and Sonoma County. His focus and skills include the evaluation and treatment of obesity, weight-related disorders, obstructive sleep apnea, central sleep apnea, restless legs syndrome, narcolepsy, insomnia, parasomnias, behavioral insomnia of childhood and other sleep-related disorders.