Nausea and abdominal pain are two common symptoms that occur together. Both are non-specific meaning that it does not clearly indicate the cause or even site of the problem. Although nausea and abdominal pain are mainly due to abdominal and digestive problems, it may sometimes originate from other causes that do not involve the abdomen or gastrointestinal tract. Therefore the presence of other signs and symptoms, as well as the events preceding the onset of the nausea and abdominal pain, may provide a better indication to a possible cause. Both symptoms are often not taken seriously as it is common in life to experience nausea and abdominal pain, but sometimes it can be associated with serious or life threatening disorders. The terms nausea and abdominal pain are sometimes used loosely and it is therefore important to understand the meaning of these terms and differentiate it among other symptoms.

Nausea Definition

Nausea is a sensation that one feels like vomiting. It is commonly referred to as an upset stomach or feeling bilious. Vomiting does not always occur with the feeling of nausea (nauseous) and the likelihood of vomiting may be associated with the intensity of the nausea. In other words, severe nausea is more likely to lead to vomiting. However, vomiting can at times occur on its own with no preceding nausea.

Abdominal Pain Definition

Abdominal pain is any soreness, discomfort or pain within the abdominal region. It is sometimes commonly described as a tummy ache, stomachache or painful belly. The abdominal cavity is thought to start at the bottom of the last ribs but actually starts above this region. Therefore the organs of the upper abdominal cavity are partially or completely tucked under the ribcage. The abdominal cavity may be divided into different anatomical quadrants in order to localize any abnormality. The four basic abdominal quadrants  (clockwise) are the right upper quadrant (RUQ), left upper quadrant (LUQ), left lower quadrant (LLQ) and right lower quadrant (RLQ).

Common Causes of Nausea

The common causes of nausea usually cannot be separated from vomiting, although there are many instances where vomiting will not follow nausea. Therefore the causes listed below are relevant to nausea and vomiting.

  • Acid reflux
  • Appendicitis
  • Cystitis
  • Excessive alcohol intake
  • Gallstones
  • Gastritis
  • Gastroenteritis (stomach flu)
  • Delayed gastric emptying
  • Drugs particularly chemotherapy and anesthesia.
  • Motion sickness
  • Migraine
  • Other substances – narcotics and poisons
  • Overeating
  • Pancreatitis
  • Peptic ulcers
  • Pregnancy
  • Starvation
  • Vertigo

Common Causes of Abdominal Pain

  • Abdominal injury
  • Appendicitis
  • Diverticulitis
  • Kidney stones
  • Gallstones
  • Gastritis
  • Inflammatory bowel disease (IBD)
  • Irritable bowel syndrome (IBS)
  • Menstrual pain
  • Pancreatitis
  • Peptic ulcers
  • Peritonitis
  • Pregnancy
  • Starvation
  • Urinary tract infection (UTI)

Other Symptoms

Nausea and abdominal pain may be accompanied by other signs and symptoms. The most common additional symptom is vomiting which tends to follow nausea. A person with nausea and abdominal pain may also experience :

  • Abdominal tenderness
  • Constipation or diarrhea
  • Excessive belching
  • Bloating
  • Abdominal distension
  • Urinary symptoms
  • Menstrual disturbances in women
  • Malaise
  • Fever
  • Dizziness

Causes of Nausea and Abdominal Pain

There is a significant degree of overlapping of the causes of nausea or abdominal pain on its own. The major causes of nausea with abdominal pain are discussed further. It is important to remember that almost every one of these conditions may be asymptomatic for long periods of time or there may be symptomatic episodes followed by periods of no symptoms.

Appendicitis is the inflammation of the vermiform appendix, a small outpouching of the colon. The pain and tenderness is most prominent in the lower right quadrant. There may also be changes in bowel habit like constipation and diarrhea, low-grade fever and abdominal swelling.

Cystitis is an inflammation of the urinary bladder most commonly due to a bacterial infection. The lower parts of the urinary tract may also be involved but nausea and lower abdominal pain is most prominent when the bladder is affected. There may also be urinary frequency, burning upon urination, changes in the color and smell of urine and a fever.

Gallstones are sediments within the gallbladder that may pass out into the bile ducts. There are episodes of intense upper right abdominal pain worse after eating. The pain radiates to the back and right shoulder. Sometimes there may be jaundice (yellowing discoloration of the skin) and loss of appetite.

Gastritis is the inflammation of the stomach lining most often caused by H.pylori infection or excessive use of medication like NSAIDs. There is a burning or gnawing ache in the right upper abdominal quadrant with bloating. Sometimes the pain goes away for long periods of time and then return again. Eating may ease or worsen the pain.

Gastroenteritis is an infection of the stomach and intestines usually caused by viruses or bacteria. There is intense nausea and repeated vomiting with an inability to keep down any solid foods. It is usually accompanied by a watery diarrhea and sometimes there is a fever.

Kidney stones are crystallized masses that develop within the kidney and may pass out into the ureters. Most stones are small and expelled with urine but some may become lodged in the urinary tract. The pain is felt on the flanks and extends downwards to the lower abdomen. It typically worsens with urination. There may be signs of blood in the urine and a fever may sometimes be present.

Pancreatitis is inflammation of the pancreas, an important gland responsible for digestion and controlling the blood glucose levels. Pancreatitis may be acute or chronic. The pain is usually in the upper abdomen, radiates to the back and is worse after eating. There may be fatty stools and in chronic cases there is weight loss.

Peptic ulcers are open sores that form in the stomach and first part of the small intestine known as the duodenum. It may also occur in the esophagus. The pain is worse at night, usually felt in the upper abdomen and eases with eating. Sometimes there may be bleeding from the ulcers which causes blood in the vomit or dark blood in the stool.

Nausea and Abdominal Pain in Children

Although many of the common causes of nausea, abdominal or both together may occur in children and adults, there is one condition that is more frequent in children. This is known as abdominal migraines. These are episodes of abdominal pain that occur for no known reason. It is often accompanied by nausea and sometimes even leads to vomiting. In more severe cases there may paleness, loss of appetite and excessive bloating. Abdominal migraines are more likely to occur in a child with a family history of migraines (head pain). Most of these children will grow up to suffer with migraines as adults. Although the exact cause is unknown, it tends to be aggravated by stress and anxiety.

Nausea and Abdominal Pain in Women

Some of the common causes of nausea and abdominal pain in women is menstruation and pregnancy. In both cases these symptoms are usually not indicative of any disease and will pass once the period ends or after the first trimester, or sometimes only after childbirth. Various gynecological disorders, however, can also cause nausea and abdominal pain. The most prominent of these includes :

  • Pelvic inflammatory disease (PID) where there is an infection of the female reproductive organs.
  • Endometriosis is a condition where the tissue lining the inner part of the uterus grows outside of the uterus.
  • Polycystic ovarian syndrome (PCOS) is an excess of male hormones (androgens) associated with the development of cysts in the ovaries.
  • Ectopic pregnancy is where the embryo grows within the fallopian tube.

Article reviewed by Dr. Greg. Last updated on December 1, 2011