Abdominal Pain, Female

ABDOMINAL PAIN, FEMALE

DEFINITION

  • Pain or discomfort located between the bottom of the rib cage and the groin crease.

General Information

  • There are multiple causes of abdominal pain. In women the range of diagnoses needs to be broadened to include problems related to pregnancy and the female organs.
  • The possibility of pregnancy must be considered in all women of childbearing age.
  • Abdominal pain in the elderly carries with it a higher risk of serious illness.

Top Causes of Abdominal Pain in Women Under 50 Years of Age

  • Appendicitis
  • Ectopic pregnancy
  • Endometriosis
  • Gallbladder disease
  • Nonspecific abdominal pain
  • Ovarian cyst
  • Pelvic Inflammatory Disease
  • Peptic ulcer disease
  • Spontaneous abortion

Top Causes of Abdominal Pain in Women Over 50 Years of Age

  • Appendicitis
  • Bowel obstruction
  • Diverticulitis
  • Gallbladder disease
  • Pancreatitis
  • Peptic ulcer disease

Gastrointestinal Anatomy

See More Appropriate Topic (instead of this one) If

^Back to Top

WHEN TO CALL YOUR DOCTOR

Call 911 (you may need an ambulance) if:

  • Passed out (fainted)
  • Very weak (can't stand)

Call your doctor now (night or day) if:

  • You feel weak or very sick
  • Severe pain
  • Constant abdominal pain for more than 2 hours
  • Vomiting blood or black ("coffee ground" like)material
  • Vomiting bile (bright yellow or green)
  • Vomiting and abdomen is more swollen than usual
  • Blood in bowel movements (black/tarry or red)
  • Recent injury to the abdomen
  • Fever of 103 F (39.4 C) or higher
  • Fever of 100.5 F (38.1 C) or higher and you:
    • Are over 60 years of age OR 
    • Have diabetes mellitus or a weakened immune system (e.g. HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy) OR
    • Are bedridden (e.g. nursing home patient, stroke, chronic illness, recovering from surgery)
  • Whites of the eyes have turned yellow (jaundice)

Call your doctor within 24 hours (between 9am and 4pm) if:

  • You think you need to be seen
  • Moderate or mild pain comes and goes (cramps), but lasts greater than 24 hours
  • Abnormal vaginal discharge (e.g. bad odor; yellow, gray or green in color)
  • Age greater than 60
  • Pregnant or could be pregnant (e.g. missed last menstrual period)
  • Blood in urine

Call your doctor during weekday office hours if:

  • You have other questions or concerns
  • Abdominal pains are a recurrent problem
  • Pain with sexual intercourse

Self care at home if:

  • Mild abdominal pain and you don't think you need to be seen
^Back to Top

HOME CARE ADVICE

  • Reassurance: A mild stomachache can be caused by indigestion, gas pains or overeating. Sometimes a stomachache signals the onset of a vomiting illness due to a viral gastroenteritis ("stomach flu").
  • Rest: Lie down and rest until you feel better.
  • Fluids: Sip clear fluids only (e.g. water, flat soft drinks or ½ strength fruit juice) until the pain has been gone for over 2 hours. Then slowly return to a regular diet.
  • Diet:
    • Slowly advance diet from clear liquids to a bland diet
    • Avoid alcohol or caffeinated beverages
    • Avoid greasy or fatty foods.
  • Pass A BM: Sit on the toilet and try to pass a bowel movement (BM). Do not strain. This may relieve the pain if it is due to constipation or impending diarrhea.
  • Avoid Medicines: Any drug could irritate the stomach lining and make the pain worse, especially an anti-inflammatory medicine such as aspirin and ibuprofen. Do not take any pain medicines, fever medicines or laxatives for stomach cramps.
  • Expected Course: With harmless causes, the pain is usually better or goes away within 2 hours. With viral gastroenteritis ("stomach flu"), belly cramps may precede each bout of vomiting or diarrhea and may last 2-3 days. With serious causes (such as appendicitis) the pain becomes constant and more severe.
  • Pregnancy test, when in doubt:
    • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
    • Follow the instructions included in the package.
  •  Call Your Doctor If:
    • Abdominal pain is constant and present for more than 2 hours
    • Abdominal pains come and go, and are present for more than 24 hours
    • You are pregnant

And remember, contact your doctor if you become worse or develop any of the "Call Your Doctor" symptoms.

^Back to Top

REFERENCES

  1. Cappell MS, Friedel D. Abdominal pain during pregnancy. Gastroenterol Clin North Am. 2003;32(1):1-58.
  2. Condous G. Ectopic pregnancy--risk factors and diagnosis. Aust Fam Physician. 2006;35(11):854-7.
  3. Flasar MH, Cross R, Goldberg E. Acute abdominal pain. Prim Care. 2006; 33(3): 659-84, vi.
  4. Kamin R. Nowicki TA, Courtney DS, Powers RD. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin NA. 2003;21(1):61-72.
  5. Martinez JP, Hogan GJ. Mesenteric ischemia. Emerg Med Clin North Am. 2004;22(4):909-28.
  6. Martinez JP; Mattu A Abdominal pain in the elderly. Emerg Med Clin North Am. 2006; 24(2): 371-88, vii.
  7. McCollough M. Abdominal surgical emergencies in the elderly. Emerg Med Clin North Am. 2003;21(4): 937-69.
  8. Roy S, Weimersheimer P. Nonoperative cause of abdominal pain. Surg Clin North Am. 1997;77(6):1433-1454.
  9. Stewart C, Bosker G. Pelvic inflammatory disease. Emerg Med Reports. 1999;20(16).
  10. Yamamoto W, Kono H, Maekawa M, Fukui T. The relationship between abdominal pain regions and specific diseases: an epidemiologic approach to clinical practice. J Epidemiol. 1997; 7(1): 27-32.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

See Other Topics:

View Anatomic Index of Topics