Abdominal Pain, Age 12 and Older
Abdominal Pain, Age 12 and OlderSkip to the navigationTopic OverviewThe cause of abdominal problems can be hard
to pinpoint. Sometimes minor and serious abdominal problems start with the same
symptoms. Fortunately, most abdominal problems are minor, and home treatment is
all that is needed. Many times the exact
cause of abdominal pain is hard to find. The severity of your pain, its
location, and other symptoms you have may help determine what is causing the
pain. - Generalized pain occurs in half of the
abdomen or more. Generalized pain can occur with many different illnesses and
will usually go away without medical treatment.
Indigestion and
an upset stomach are common problems that can cause
generalized pain. Home treatment may help relieve some of the discomfort.
Generalized mild pain or crampy pain that becomes more severe over several
hours may be a symptom of a blockage of the intestines (bowel obstruction).
- Localized pain is located in one area
of the abdomen. Localized pain that comes on suddenly and gets worse is more
likely to be a symptom of a serious problem. The pain of
appendicitis may start as generalized pain, but it
often moves (localizes) to one area of the abdomen. The pain from gallbladder
disease or
peptic ulcer disease often starts in one area of the
abdomen and stays in that same location. Localized pain that gradually becomes
more severe may be a symptom of inflammation of an abdominal
organ.
- Cramping is a type of pain that comes and goes (intermittent) or
that changes in position or severity. Cramping is rarely serious
if it is relieved by passing gas or a stool. Many women have cramping pain with
their menstrual periods. Generalized cramping pain is usually not a cause for
concern unless it gets worse, lasts for longer than 24 hours, or localizes.
Cramping that starts suddenly with diarrhea or other minor health problems can
be quite painful but is usually not serious.
Occasionally, severe pain that comes on suddenly may be a
symptom of a rupture of the stomach or intestines (perforation),
torsion of the testicle or
ovary, a
kidney stone,
gallbladder disease, or blood vessel problems, such as
an
aortic aneurysm. The pain caused by appendicitis or
gallbladder disease may increase when you move or cough. Pain that increases
with movement or coughing and does not appear to be caused by strained muscles
is more likely to be a symptom of a serious problem. A visit to a doctor is usually needed when
severe abdominal pain comes on suddenly, or when new and
different mild pain slowly becomes more severe over several hours or
days. After a minor
abdominal injury, pain, nausea, or vomiting may occur
but often gets better in a few minutes. Pain and other symptoms that continue,
increase, or develop following an injury may mean an abdominal organ has been
damaged. Many
medicines can cause abdominal pain. Some medicines
also cause side effects, such as constipation, that can make abdominal pain
worse. Abdominal symptoms can also occur from an infection passed on by animals or while traveling to a foreign country. Specific abdominal symptoms have been linked to ovarian cancer. These symptoms include abdominal or
pelvic pain, increased abdominal size or bloating, and trouble eating or
feeling full quickly. If you have one or more of these symptoms, and it occurs almost daily for more than 2 or 3 weeks, talk with your doctor. Check
your symptoms to decide if and when you should see a doctor. Check Your SymptomsDo you have pain or cramping in your belly? This also includes injuries to the belly. How old are you? 11 years or younger 11 years or younger 12 to 55 years 12 to 55 years 56 years or older 56 years or older Have you had surgery on your chest, belly, or pelvic area in the past 2 weeks? Yes Recent abdominal surgery No Recent abdominal surgery Are you pregnant? Yes, you know that you're pregnant. Pregnancy No, you're not pregnant, or you're not sure if you're pregnant. Pregnancy Have you had a baby in the past 3 months? Yes Had baby within past 3 months No Had baby within past 3 months Moderate Moderate dehydration Are you having trouble drinking enough to replace the fluids you've lost? Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids. Yes Unable to maintain fluid intake No Able to maintain fluid intake Do you have pain in your belly? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Has the pain: Gotten worse? Pain is getting worse Stayed about the same (not better or worse)? Pain is unchanged Gotten better? Pain is getting better How long have you had pain? Less than 4 hours Pain for less than 4 hours At least 4 hours but less than 1 full day (24 hours) Pain for 4 to 24 hours At least 1 full day but less than 2 days (48 hours) Pain for more than 24 hours At least 2 days but less than 1 week Pain for more than 48 hours 1 week or more Pain for more than 1 week Does the belly hurt all over or mostly in one area? Pain that is most intense in just one area is likely to be more serious than a bellyache that hurts all over. Mostly in one area Localized pain Yes Pain in lower right part of belly No Pain in lower right part of belly Do you have pain with a new bulge in your belly button or groin? Yes Pain with bulge at the navel or groin No Pain with bulge at the navel or groin Is there any chance that you could be pregnant? Yes Possibility of pregnancy No Possibility of pregnancy Within the past week, have you had an injury to the abdomen, like a blow to the belly or a hard fall? Yes Abdominal injury within past week No Abdominal injury within past week Since the injury, have you had any new bleeding from the rectum, urethra, or vagina? Yes Bleeding from rectum, vagina, or urethra since injury No Bleeding from rectum, vagina, or urethra since injury Is there a belly wound that is deeper than a scratch? Have you vomited since the injury? Yes Has vomited since the injury No Has vomited since the injury Is there pain just below the ribs? Pain just below the ribs after an injury can be a symptom of serious damage to the liver or spleen. Have you had any new shoulder pain since the injury? A belly injury sometimes can cause pain in the shoulder. Yes Shoulder pain since injury No Shoulder pain since injury Did you hurt your shoulder in the injury? Do you think that the injury may have been caused by abuse? Yes Injury may have been caused by abuse No Injury may have been caused by abuse Have you had: At least 1 stool that is mostly black or bloody? At least 1 stool mostly black or bloody At least 1 stool that is partly black or bloody? At least 1 stool partly black or bloody Streaks of blood in your stool? Streaks of blood in stool Do you think you may have a fever? Did you take your temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long have you had a fever? Less than 2 days (48 hours) Fever for less than 2 days At least 2 days but less than 1 week Fever for at least 2 days but less than 1 week 1 week or more Fever for 1 week or more Do you have a health problem or take medicine that weakens your immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Do you have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Are you nauseated or vomiting? Nauseated means you feel sick to your stomach, like you are going to vomit. Have you vomited blood or what looks like coffee grounds? If there is only a streak or two of blood that you are sure came from your nose or mouth, you are not vomiting blood. Yes Has vomited blood or what looks like coffee grounds No Has vomited blood or what looks like coffee grounds How much blood have you vomited? Two or more streaks of blood, or any amount of material that looks like coffee grounds Has vomited material that looks like coffee grounds or at least 2 streaks of blood One streak of blood or less Has vomited 1 streak of blood or less Have you felt nauseated for more than 2 full days (48 hours)? Yes Nausea for more than 2 days No Nausea for no more than 2 days Is your diabetes getting out of control because you are sick? Yes Diabetes is affected by illness No Diabetes is affected by illness Is the plan helping get your blood sugar under control? Yes Diabetes illness plan working No Diabetes illness plan not working How fast is it getting out of control? Quickly (over several hours) Blood sugar quickly worsening Slowly (over days) Blood sugar slowly worsening Did the pain start after you took a new medicine? Yes Abdominal pain started after taking a medicine No Abdominal pain started after taking a medicine In the past few weeks, have you been losing weight without trying? Yes Has been losing weight without trying No Has been losing weight without trying Have your symptoms lasted longer than 1 week? Yes Symptoms have lasted longer than 1 week No Symptoms have lasted longer than 1 week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
With cramping pain in the belly: - The pain may hurt a little or a lot.
- The amount of pain may change from minute to minute. Cramps often get better when you pass gas or have a bowel movement.
- The pain may feel like a tightness or pinching in your belly.
- The pain may be in one specific area or be over a larger area. It may move around.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury. Symptoms of shock (most of which will be present) include: - Passing out (losing consciousness).
- Feeling very dizzy or
lightheaded, like you may pass out.
- Feeling very weak or having
trouble standing.
- Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
If you're not sure if a fever is high, moderate, or mild,
think about these issues: With a high fever: - You feel very hot.
- It is likely one of
the highest fevers you've ever had. High fevers are not that common, especially
in adults.
With a moderate fever: - You feel warm or hot.
- You know you have
a fever.
With a mild fever: - You may feel a little warm.
- You think
you might have a fever, but you're not sure.
Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature. Oral (by mouth) temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Ear or rectal temperature - High:
105°F (40.6°C) and
higher
- Moderate:
101.4°F (38.6°C) to
104.9°F (40.5°C)
- Mild:
101.3°F (38.5°C) and
lower
Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
It is easy for your diabetes to become out of control when
you are sick. Because of an illness: - Your blood sugar may be too high or too
low.
- You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
- You may
not know how to adjust the timing or dose of your diabetes
medicine.
- You may not be eating enough or drinking enough
fluids.
An illness plan for people with diabetes usually covers things like: - How often to test blood sugar and what the target
range is.
- Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
- What to do if you have trouble keeping
food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems. You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - Your mouth and eyes may be extremely
dry.
- You may pass little or no urine for 12 or more
hours.
- You may not feel alert or be able to think
clearly.
- You may be too weak or dizzy to stand.
- You may
pass out.
Moderate dehydration means: - You may be a lot more thirsty than
usual.
- Your mouth and eyes may be drier than usual.
- You may
pass little or no urine for 8 or more hours.
- You may feel dizzy
when you stand or sit up.
Mild dehydration means: - You may be more thirsty than usual.
- You may pass less urine than usual.
Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar. A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid. Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black. If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms. Symptoms of a heart attack may
include: - Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of
breath.
- Nausea or vomiting.
- Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. Many prescription and nonprescription medicines can cause
belly pain or cramping. A few examples are: - Aspirin, ibuprofen (such as Advil or Motrin), and
naproxen (such as
Aleve).
- Antibiotics.
- Antidiarrheals.
- Laxatives.
- Iron
supplements.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself. Postoperative Problems Pregnancy-Related Problems Abdominal Pain, Age 11 and Younger Problems After Delivery of Your Baby Home TreatmentMost of the time, abdominal pain
improves with home treatment and you do not need a visit to a doctor. Specific home treatment for abdominal pain often depends on the
symptoms you have along with the pain, such as diarrhea or nausea and
vomiting. If you have mild abdominal pain without other symptoms,
try the following: - Rest until you are feeling
better.
- Drink plenty of fluids to prevent
dehydration. You may find that taking small, frequent
sips of a beverage is easier on your stomach than trying to drink a whole glass
at once. Do not drink carbonated or caffeinated drinks, such as soda pop, tea,
or coffee.
- Try eating several small meals instead of 2 or 3 large
ones. Eat mild foods, such as rice, dry toast or crackers, bananas, and
applesauce. Do not eat spicy foods, other fruits, alcohol, and drinks that have
caffeine until 48 hours after all symptoms have gone away.
- Do not
eat foods that are high in fat. Foods high in fat may increase your abdominal
pain.
- Do not use aspirin or other nonsteroidal anti-inflammatory
medicines, such as ibuprofen and naproxen. These medicines may irritate your
stomach and increase your pain.
Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home treatment: - Pain increases, does not improve, or
localizes to one specific area of the
abdomen.
- Other
symptoms develop, such as diarrhea, nausea, vomiting, or a fever.
- Symptoms become more severe or frequent.
PreventionAbdominal pain can often be
prevented. - Develop regular bowel habits to prevent
abdominal pain caused by constipation. For more information, see the topic
Constipation, Age 12 and Older.
- Develop
regular eating habits. Overeating is a common cause of abdominal discomfort.
Eat slowly and stop when you feel full.
- To prevent abdominal pain
caused by swallowing air (aerophagia), do not chew gum or drink carbonated
beverages.
- Prevent abdominal injuries by wearing your seat belt
safely and correctly every time you drive or are a passenger in a car.
- Wear both your lap and shoulder belts. The
shoulder strap should cross the collarbone, and the lap belt should fit low and
tight.
- Do not wear your shoulder strap slipped behind the back or
under the arm. This dangerous habit can cause severe injury, especially in cars
with air bags.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to
answer the following questions: - How long have you had the pain?
- What
were you doing when the pain started?
- Did the pain start suddenly
or develop gradually?
- How
severe is your pain? Rate your pain on a scale of 1 to
10.
- Is your pain generalized or
localized? If you have localized pain, where is it
located?
- Is your pain
cramping, a steady ache, burning, or a tearing
sensation?
- Is your pain changing? If so, how?
- Is the
pain constant, or does it come and go?
- Have you had other symptoms,
such as nausea, vomiting, constipation, diarrhea, a change in urination, or
fever?
- Have you had this type of pain before? If so, did you see a
doctor? How was the pain treated?
- What makes the pain
better? What makes the pain worse?
- Have you recently traveled
outside of the country?
- Have you drunk any untreated well, stream,
or lake water?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerKathleen Romito, MD - Family Medicine Current as of:
May 3, 2017 Last modified on: 8 September 2017
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