Sore Abdomen – Location and Causes of Abdominal Soreness

Soreness denotes very mild pain which is often also described as an ache. Sometimes discomfort that cannot be classified as pain or a sense of uneasiness may also be referred to as soreness. A sore abdomen may occur from a host of different diseases and disorder of the organs within the abdominal cavity. Therefore the same causes of abdominal pain need to be considered in a sore abdomen as well as abdominal tenderness.

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Abdominal pain is common and the cause cannot always be identified. In some cases, like abdominal migraines which tend to affect children, there is recurrent episodes of abdominal pain despite there not being any detectable disease. In other instances, abdominal pain can be psychogenic. However, when abdominal pain is accompanied by other symptoms like nausea, vomiting or diarrhea then it needs to be medically investigated.

Location of Abdominal Soreness

The abdomen can be divided into 9 regions or 4 quadrants demarcated by imaginary lines. The latter is often easier to isolate abnormalities like abdominal soreness. The organs that may be the source of the pain can be identified by locating the quadrant where the soreness arises.

  • Right upper quadrant (RUQ): Liver, gallbaldder, bile ducts, right kidney, right ureter, colon (ascending, transverse, right hepatic flexure), stomach (pylorus) and small intestine.
  • Left upper quadrant (LUQ): Stomach, spleen, left kidney, left ureter, liver (left lobe), colon (transverse, descending, left hepatic flexure) and small intestine.
  • Right lower quadrant (RLQ): Small intestine, large intestine (cecum with appendix, ascending colon) and right ureter. In women the right ovary and fallopian tube may also be considered in this quadrant.
  • Left lower quadrant (LLQ): Small intestine, large intestine (descending colon, sigmoid colon) and left ureter. In women the left ovary and fallopian tube may also be considered in this quadrant.

Causes of Sore Abdomen

Some of the more common causes of abdominal pain related to diseases or disorders of the abdominal organs has been discussed below. There are many other causes that may also give rise to soreness in the abdomen. It is difficult to identify the exact cause of abdominal soreness or pain without considering accompanying symptoms and diagnostic investigations. Therefore medical advice should always be sought. Gynecological conditions also need to be considered as a possible cause of abdominal soreness.

Read more on causes of abdominal pain.

Abdomen and Abdominal Wall

The following conditions may cause generalized abdominal pain (soreness throughout the abdomen) or superficial abdominal pain (due to the abdominal wall).

  • Peritonitis is inflammation of the peritoneum (abdominal lining) due to an infection or injury caused by trauma or toxic chemicals.
  • Trauma to the abdominal wall may arise with a host of different causes such as a blow to the abdomen or following surgery.
  • Muscle strain can arise with overuse of the abdominal muscles or an inury to the muscles.

Liver and Gallbladder

Jaundice (yellowing of the skin and eyes), nausea, vomiting and diarrhea are some of the other symptoms that may accompany soreness in the right upper abdominal quadrant due to liver and gallbladder diseases.

  • Hepatitis is inflammation of the liver that may be caused by infection, alcohol and other toxins.
  • Fatty liver disease is where excess fat occurs in the liver tissue and is not related to alcohol consumption.
  • Liver cancer (hepatocellular carcinoma) is a malignant growth arising from the liver.
  • Gallstones where stones that form from bile in the gallbladder become stuck in the the ducts.
  • Cholecystitis is inflammation of the gallbladder usually associated with gallstones.


Nausea, vomiting and upper middle abdominal pain with pain that radiates to the back are some of the symptoms that are present in pancreatic conditions.

  • Pancreatitis is inflammation of the pancreas often associated with alcohol abuse, drugs, infection and injury.
  • Pancreatic cancer is a malignant tumor that arises from the pancreatic tissue.

Kidney and Ureter

Blood in the urine, frequent urination or no urination, large volume or no urine production are some of the symptoms that may accompany flank soreness and pain due to kidney and ureter conditions.

  • Pyelonephritis is inflammation of the kidney due to an infection which is often due to bacteria.
  • Kidney stones are masses that form from the substances in urine and can block urine outflow.
  • Ureteral stones are stones that form in the kidney and may become stuck the ureter.
  • Kidney cancer (renal carcinoma) is a malignant tumor that arises from cells in the kidney.


Nausea, vomiting, heartburn, bloating and changes in appetite along with soreness in the upper left abdominal quadrant are some of the symptoms that may occur with stomach diseases and disorders.

  • Gastritis is inflammation of the stomach mainly caused by H.pylori bacteria or excessive use of NSAIDs.
  • Gastroenteritis is due to an infection of the stomach and small intestines, often associated with viruses and food poisoning.
  • Hiatal hernia is where a portion of the stomach pushes through into the chest cavity through the esophageal opening.
  • Stomach tumors may be benign (non-cancerous) like gastric polyps or malignant (cancerous) such as gastric adenocarcinoma.

Small Intestine

Nausea, vomiting, nutritional deficiencies, fatty stool (steatorrhea), diarrhea or constipation and abnormal bowel sounds along with abdominal soreness/pain are some of the symptoms that occur with small intestine disorders.

  • Peptic ulcers are open sores that form in the stomach or duodenum. Duodenal ulcers are more common.
  • Enteritis is inflammation of the small intestine that is often associated with the bacterial infections.
  • Small bowel obstruction may occur when a mass or foreign body blocks the lumen of the small intestine. Paralysis of small intestine muscles can cause a pseudo-obstruction.

Large Intestine

Excessive flatulence, diarrhea or constipation, mucus or blood in the stool and abnormal bowel sounds are some of the symptoms that may accompany abdominal soreness or pain in large intestine diseases.

  • Appendicitis is inflammation of the vermiform appendix due to an infection. There is a risk of the appendix rupturing and it is therefore considered a medical emergency.
  • Colitis is inflammation of the colon that may arise with an infection or interruption in blood supply to the colon.
  • Diverticulitis is an infection of abnormal pouches that form in the colon (diverticula).
  • Inflammatory bowel disease (IBD) is an immune-mediated condition leading to inflammation of the bowels and ulcer formation.
  • Irritable bowel syndrome (IBS) is a functional bowel disorder where there are episodes of abdominal pain with alterations in bowel habit, such as constipation or diarrhea.
  • Colorectal cancer is a malignancy that forms in the colon or rectum and is one of the most common and deadly cancers.

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