Acute Severe Abdominal (Stomach) Pain

Severe abdominal (stomach) pain is a debilitating pain preventing someone to continue with his/her daily activities. Abdominal cramps (spasms) are painful contractions of the hollow abdominal organs or muscles in abdominal wall lasting from few seconds to several hours. The cause of the pain or cramp can be usually suspected from its location and accompanying symptoms. Severe abdominal pain often requires urgent hospitalization but not always.

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Severe Abdominal Pain Requiring Immediate Hospitalization

A person with:

  • Severe stomach pain, forcing him/her to sit or lie down
  • Pain, lasting over 10 minutes
  • Restlessness or unusual calmness
  • Pale face and lips
  • Shallow breathing and weak heart beat
  • Fever, chills, nausea or vomiting..

..should be admited to hospital immediately to treat a possible life threatening disorder, like:

1. Acute Appendicitis

Sudden right lower abdominal pain, which usually starts near the navel and gradually moves few inches toward left and down, tenderness at this spot, nausea, vomiting and fever are main symptoms of acute appendicitis,which can affect a person of any age. Inflamed appendix has to be surgically removed as soon as possible to prevent its perforation and life threatening abdominal inflammation.

Diagnosis in typical cases can be made from history and physical examination; in non-typical cases a CT is the main investigation. Appendix is removed through an inch wide incision in the abdominal wall. Prognosis is excellent; death from appendicitis is rare.

2. Acute Poisoning

Severe upper middle abdominal pain and cramps, vomiting and altered consciousness are main symptoms of acute poisoning due to ingesting of corrosive liquids (e.g. petrol, acids), excessive amount of medications or illegal drugs, inhaling of poisonous gases like war gases or pesticides.

Inducing vomiting with fingers pushed into the throat or drinking a glass of salted water may be tried only in conscious person but not if corrosive substances like petrol or acids were ingested. Stomach pumping, injecting antidots, hemodialysis, and intravenous fluid infusion are some of possible treatments measures.

More about chemical poisoning.

3. Infections

In the western world, food poisoning by bacteria or parasites in a previously healthy person is rarely serious despite possible dramatic vomiting, abdominal cramps and diarrhea. Food poisoning often heals on its own in few days, and if not, a doctor may prescribe oral antibiotics.

Rotavirus infection causing stomach flu with fever, stomach cramps, vomiting and diarrhea is also usually not a serious disease in the western world, but it is still a major cause of children deaths in Africa, South Asia and South America. Therapy is with replacing lost fluids by oral rehydration solutions or intravenous infusion.

4. Injuries with Internal Abdominal Bleeding

A hit to the stomach (often in car accidents), shot and knife injuries may cause bleeding into abdominal cavity. Abdominal pain, paleness, thirst and feeling of coolness are main symptoms.

Therapy. An urgent surgery is required.

5. Perforation of the Stomach or Intestine

Perforation of the stomach is a complication of advanced stomach ulcer or cancer. Perforation of the small intestine is rare. Perforation of the colon may occur in advanced Crohn’sor ulcerative colitis, diverticulitis, Clostridium difficile infection, colorectal cancer and during colonoscopy or surgery.

Therapy is with an urgent surgery.

6. Dissection or Rupture of Abdominal Aorta

In persons after 50 with advanced atherosclerosis, layers in the wall of abdominal part of the aorta may be split what may cause a sudden severe abdominal pain. Therapy is with an urgent surgery; many patients die before treatment starts, though.

About Jan Modric (249 Articles)
Health writer

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  • Hi Debra. That’s difficult to possibly diagnose. You really should see a doctor ASAP if it is severe. Vomiting, diarrhea and related symptoms would point to a digestive problem so it is possible that this has nothing to do with the digestive tract. However, some digestive conditions can only present with abdominal pain in the early stages and nothing else. It may also be worth considering a UTI. Even though you may not have urinary symptoms as yet it could be due to a urinary tract infection. Your doctor will advise you accordingly.

  • Eva

    Hello, my 12 year old daughter is going through the same thing. Have you found any answers? We have been to the ER, our regular doctor, a GI doctor and nothing has been found. Your description above describes ours to the T. We did the miralax and that seemed to make it worse. We also tried fish oil pills and were give a break for 3 months were everything was going great. And this week all of a sudden it has come back. I haven’t noticed any change in what she has been eating.

  • chrid

    Hello I’m 26 on Monday morning I woke up feeling sick to my stomach and about an hour after I got a sharp pain in my lower right side of stomach that felt like a sharp stabbing pain. It was gone by the end of day but when the pain was there it was really painful. The next day the pain was gone and then randomly at one point during the day I got the same exact pain for around 10-20 minutes but on my left side then went away. Is this anything I should be worried about?

  • Albert Smith

    Since i was about 9 years old I’ve had times where i get extreme abdominal pain followed by fainting. There have been times where im not sure how long i was out. I’ve also injured myself while fainting. Never knowing if I have experienced a concussion. Anyone know of any illnesses or reasonings for my symptoms?

  • Hi Chrid. The recurring pain should always be treated as cause for concern until medical investigations can prove that it is nothing serious. Pain on its own without other symptoms is difficult to diagnose so your doctor will very likely want to run further tests if there is no clearly obvious cause.For example pain with diarrhea would point towards a digestive condition as the more likely cause. However, you do not mention any such symptoms. It may not be anything to worry about just yet but you should be concerned enough to see a doctor.

  • Hi Albert. Some children do suffer with a condition known as abdominal migraines. It could possibly be related to this. It is uncommon in adults as compared to migraine headaches but can still occur. It is difficult to say with any certainty. There is often a family history of migraines in these children. Assuming that you are now an adult it would be difficult to accurately identify the condition that was occurring in childhood. However, if you are suffering with migraines now then it is worth discussing your childhood symptoms with your doctor.

  • katy

    i have severe abdominal and kidney pain for a minute or two. abdominal pain usually last for a few seconds

  • gaby

    I was at work earlier today and had to leave early cause I experienced some of the symptoms. I had breakfast and about 2 hours later, I get this horrible stomach pain in the upper center of my stomach, it hurt when I touched it, felt bloated, was sweating a lot and felt really cold,y face and lips went pale and was disoriented, although when I felt the need to throw up nothing would come out. When ever I tried to do the restroom, again nothing would come out

  • Sophie

    Hi I’m an 18 year old female. I have been suffering with severe lower abdominal pain in the night which starts when I’m asleep and wakes me up. It starts very suddenly every few weeks. It makes me feel sick and sometimes I am sick, I can’t stay still when the paid starts and I start sweating a lot. Then the pain goes after around 20 minutes and it is like nothing ever happened. I do get the pain during the day too but it is never as severe as in the night. It is starting to happen more and more often in the night. No doctors can figure it out!!

  • Hi Sophie. Episodic pain in this manner can be difficult to diagnose especially when it comes to the abdominal area where there are so many organs. It could also be gynecological. It would be advisable that you consult with a gynecologist and if everything is clear then your family doctor may consider sending you to a gastroenterologist for further investigations like a colonoscopy. Since you don’t have other symptoms apart from the pain, a gynecological examination would be the next logical step.

  • dee

    I have severe ab problems and recently went to Emergency. The Doctor walked into the room and without even having my vitals done or even trying to examine me he said, “We are discharging you, went don’t treat your problems here”.
    My guess is I had a bout of chemical/poison exposure including Hydrogen Cyanide but nobody believed me. One of the Doctor’s was new to the hospital and had just left VA. After examining me he excused himself and after about 15 minutes returned and said he was diagnosing me with Anxiety. I do suffer from PTSD but don’t make up illnesses. I believe he still had access to my medical records at VA and he looked at the records and seen my anxiety issue. Since then all Doctor’s do very few tests and give me the Anxiety diagnosis.
    I believe this is due to the fact I put down every single problem I have to help them make an easier diagnosis and they see it as I’m a basket case or one of those people that needs attention so goes to the hospital to get it.
    I have “irritable bowel syndrome” (to me that’s a diagnosis for when they can’t find the problem). My syndrome is constipation and when they gave up they had me start taking Milk of Magnesia every 3 days—-normally on the 3rd day I have physical problems until my bowel is empty.
    The problem I went in with was pain in the ab constantly, increased on left side after eating and after about an hour it moves to the right side, I have pain near my belly button and I have joit and muscle pain all over. I get rashes and I explained these things as the Doctor was trying to escape and he said, it sound as if you might want to check with you FP and get tested for Lupus but we don’t do that here. I have general fatigue and constant pain but I also have a Testosterone reading of 120.85. My Doctor says it’s low but they don’t treat it unless it goes under 120.
    Can anyone help?

  • Kasey Isaacs

    Hello, I am 15. About every six months I get this severe pain in my middle abdomen. It hurts so bad I cannot stand up. I curl up in a ball and cry in pain for about 20 to 40 minutes. And then nothing. Like it never happened. I get nausea. I also feel cold, but my body is warm. This has been happening for about the last 3 years. I went to the doctors and they told they don’t see anything wrong, it is just your basic stomach cramps. But I know it isn’t. The pains are to great to be a basic stomach cramp.

  • MandyNblake Hilton

    Hi I’m 23 year old female I have had several severe lower abdomen pain that is sharp and will shoot in my pelvis I recently had surgery in Feb to remove a 9cm cysts but when my doctor went in through my c-section scar it was fluid pockets on my large intestine and scar lining it went away for a month and has been back scence new symptoms have occurred with feeling like I’m going to pass out and blood when I get sick and been feeling really cold but no fever

  • Kristen Terre

    Hi there, I have been having some crazy stomach pain accompanied by temporary stomach hardening…so my stomach will hurt either when I’m hungry or shortly after I eat a smoothy, at the same time my stomach, right where my my belly button is hardens .I do t know I’d this is trapped gas or what but if I lay on my stomach it usually only last 5-10 mins or may go away with food intake. Thanks for your time.