Abdominal Pain

Abdominal pain appears in the abdomen (stomach, belly) and can arise from abdominal organs like the gallbladder or appendix, or other organs like the spine or heart.

Severity of abdominal pain does not always correlate with severity of an underlying disorder: constipation or gas, built in the bowel, may cause debilitating pain, while developed pancreatic cancer may not cause any symptoms. Check for causes of severe abdominal pain.

Abdominal Quadrants

One vertical and one horizontal line flowing through the navel (umbilicus) divide abdomen on four abdominal quadrants: right upper (RUQ), right lower (RLQ), left upper (LUQ) and left lower (LLQ).

Abdominal quadrants: RUQ, LUQ, RLQ, LLQ

Picture 1. Four abdominal quadrants
(source: Wikimedia)

Abdominal pain can be denoted according to abdominal quadrant in which it appears:

  • Right Upper Quadrant or RUQ pain may arise from the liver, gallbladder, main bile duct, upper part of the ascending colon, right part of the transverse colon, stomach, duodenum, right kidney, ureter or adrenal gland, right lung membrane (pleura), lower right ribs, abdominal muscles, skin or spinal nerves.
  • Left Upper Quadrant or LUQ pain may arise from the pancreas, stomach, left part of the transverse colon, upper part of the descendent colon, second part of the small intestine (jejunum), left kidney, ureter or adrenal gland, spleen, heart, left lung membrane, lower left ribs, abdominal muscles, skin or spinal nerves.
  • Right Lower Quadrant or RLQ pain may arise from the lower part of ascending colon, last part of the small intestine (ileum), appendix, right ureter, right spermatic cord, right ovary and uterine tube, abdominal muscles, skin or spinal nerves
  • Left Lower Quadrant or LLQ pain may arise from lower part of the descending colon, sigmoid colon, small intestine, left ureter, left spermatic cord, left ovary and uterine tube, abdominal muscles, skin or spinal nerves

Pain in the middle upper abdomen is called epigastric pain and may arise from the stomach, lower part of esophagus, pancreas, heart, spine or aorta.

Pain in the middle lower abdomen is called hypogastric or suprapubic pain and may arise from the bladder, spine or uterus.

Causes of abdominal pain that can appear in any abdominal quadrant: abscess, endometriosis, adhesions, benign and malign abdominal tumors, metastases.


Article reviewed by Dr. Greg. Last updated on December 22, 2011