Abdominal pain: how to describe it and when it is urgent

In short

• Where the pain is gives a first clue, but pain can start in one place and show up in another.
• Sudden, severe pain or a stiff, hard, tender abdomen needs emergency care.
• Pain that moves to the lower right side may be appendicitis, which is a medical emergency.
• Pain spreading to the chest, neck or shoulder needs immediate medical help.
• Severe pain does not always mean something serious, and mild pain does not rule it out.

Why the belly hurts

The abdomen runs from below the chest to the groin, and pain can come from any organ in it. Pain can also start elsewhere, for example in the chest. Common causes are trapped wind, indigestion, constipation, and a stomach bug or food poisoning. Others include period pain, endometriosis, appendicitis, irritable bowel syndrome, kidney stones and gallstones.

Because so many conditions overlap, it is hard to decode abdominal pain on your own. You can describe it precisely, though, and that is half of a clinician's work.

Location as a first clue

• Lower right side: appendicitis is a possibility, particularly when the pain began near the belly button and moved here.
• Upper right side or under the right ribs: gallstones can cause severe pain here, sometimes after eating.
• Pain in the side or back that comes and goes: kidney stones are one possible cause.
• Pain with diarrhea or vomiting: often a stomach bug or food poisoning.
• Pain spreading to the chest, neck or shoulder: needs urgent assessment.

Pain often begins as vague and widespread and only later settles in one spot, so a location can shift over hours.

How to describe your pain

Try to answer these questions before a visit, and write the answers in your phone.

1. WherePoint to the most painful spot with one finger and outline the area it spreads to.
2. When it startedThe time, and what you were doing. Sudden onset differs from pain that builds over a day.
3. What it feels likeCramping, constant ache, burning, sharp or pressure.
4. Where it spreadsTo the back, shoulder, groin or leg.
5. What changes itEating, hunger, movement, position, a bowel movement, urinating or coughing.
6. What comes with itFever, vomiting, diarrhea or inability to pass stool or wind, changes in your urine, bleeding or rash.
7. How strongRate it from 0 to 10 now and at its worst, and say how it limits what you do.

A pattern worth knowing: appendicitis

Appendicitis pain usually starts around the belly button, then moves to the lower right abdomen and gets worse. Movement, coughing or pressure can make it worse, and drawing the knees up may ease it. Nausea, vomiting, loss of appetite and a low fever are common. Not everyone has all of these, and pregnant women, young children and older adults can have milder or differently located pain.

MedlinePlus calls appendicitis a medical emergency, because an untreated blockage can burst and cause peritonitis, a serious abdominal infection. If the appendix bursts, the pain may briefly ease and then become severe across the abdomen. Surgery to remove the appendix is the usual treatment.

Mild pain: what you can do

If the pain is mild and you otherwise feel well, a pharmacist can help you work out the likely cause and suggest treatments, for example for constipation or indigestion. Note when it started and how it changes. Follow it over a day or so, along with how it relates to meals and bowel movements.

If it keeps coming back, does not go away, or you can feel a lump in your belly, book an appointment. If a diarrhea or vomiting illness has not gone away after a few days, get urgent advice.

Pregnancy and other special situations

If you are pregnant and have belly pain, get urgent advice from your provider, as NHS guidance puts it. The same applies to unusual vaginal bleeding or discharge with belly pain. Older adults, people with diabetes and people taking steroid medicines can have serious illness with only mild symptoms, so their threshold for seeking care should be lower. Tell your clinician about every medicine you take.

Red flags: call 911

Call 911 or go to an emergency department for pain that started suddenly and is severe, a stiff, hard, tender abdomen, vomiting blood or vomit that is green or looks like coffee grounds, a lot of blood from the rectum or black, sticky stools, being unable to pass urine at all, being unable to pass stool or wind at all, especially with vomiting, a rash that does not fade when pressed, trouble breathing, confusion or pale, blotchy skin. Pain spreading to the chest, neck or shoulder also needs immediate help. Do not drive yourself, and bring your medicines.

Get an urgent appointment the same day if pain suddenly gets much worse, there is blood in your stool, or you are pregnant. Do not rely on home measures once the pain is severe or getting worse.

How a clinician finds the cause

Expect questions about your pain, a physical examination and sometimes blood and urine tests. Imaging such as an abdominal ultrasound or a CT scan is used when needed, and some conditions call for endoscopy. Bring notes on your pain, a list of medicines and supplements and earlier test results.

Make a routine appointment if you have repeated episodes, pain tied to certain foods, a lasting change in bowel habits or mild pain lasting a week or longer. MedlinePlus advises contacting a provider if mild pain lasts a week or longer or comes with other symptoms.

Questions for your provider

• What are the most likely causes of my pain?
• Do I need blood tests, imaging or other tests now?
• What can I take for the pain until we know more?
• Which symptoms mean I should come back at once?
• Do I need to change what I eat for the next few days?

Questions and answers

Sources

1. NHS — Stomach ache
2. MedlinePlus — Abdominal Pain
3. MedlinePlus — Appendicitis
4. NHS — Appendicitis
5. NHS — Gallstones

Sources checked on 29 October 2026.