Male lower abdominal pain below belly button right side

Both men and women get abdominal pain and many of the causes are the same but there are conditions that are more common in men and those that only men get. So here’s a guide to working out what’s causing your abdominal pain if you’re a man.

What is lower abdominal pain?

Lower abdominal pain generally means pain that you feel below the level of your belly button. It can come from any of the tissues and organ systems in that area and there are many, which is why it can be hard to work out exactly what’s causing it. Pain which is very low down is termed pelvic pain but we’ll be including it as lower abdominal pain for this guide.

Safety first

Rather than trying to diagnose your own pain, if you have any of the following symptoms then see your doctor as soon as possible:

• Severe pain
• Pain that continues to get worse
• A high temperature
• Blood in your poo – either fresh or black and smelly
• Inability to walk around due to the pain
• Recurrent vomiting especially if there is blood in your vomit
• A persistent change in your bowel habit

Describe your pain

When a doctor asks you about your pain they will want to know where exactly you are feeling the pain. This can be a useful indicator of what the cause might be. They’ll also want to know how long you’ve had the pain, the severity and the nature of the pain; is it coming or going or is it continuous? They will ask you to describe how the pain feels, is it sharp, dull, crampy or burning for example?

Associated symptoms such as diarrhoea, vomiting and urinary symptoms can all help to distinguish the cause so your doctor will question you about these as well.

Where is your pain?

We’ll explore the causes of lower abdominal pain by their location to make it easier to work out what is causing your pain.

Pain around the belly button

If you experience pain around the belly button (peri-umbilical) it could be one of the following:

• Early appendicitis

Inflammation of the appendix is often initially felt around the belly button. It may come and go and gradually move to the right side. It gets more severe over 24 hours and is worse on movement. You may feel nauseated, have slight loose stools and a temperature. Surgery is often required to remove an inflamed appendix so don’t wait at home if you think this may be the diagnosis.

• Stomach ulcers

Conditions of the stomach lining such as inflammation (gastritis) or ulcers may be felt in the centre of your abdomen. The pain is often burning in nature. Nausea, indigestion, belching and even vomiting are common. Blood in the vomit or black, tar-like stools are worrying signs and need urgent assessment. Treatment to stop acid production and ease pain are required so see your doctor.

Pain just above the pubic bone

If you experience pain just above the pubic bone (supra-pubic) it could be one of the following:

• Bladder pain

Bladder pain is generally a low central pain. Cramping and burning during or after passing urine might indicate an infection. With a urine infection you might need to go for a wee more often, notice blood in your urine and feel tired and sick. If your symptoms aren’t settling with plenty of fluids, then you need to see your doctor for possible antibiotics. Bladder stones can cause pain in this area too with a sharper, more severe pain and difficulty passing urine.

• Testicular pain

It’s common for conditions of the testicles to be felt low in the abdomen, either centrally or to one side. This includes inflammation or infections such as sexually transmitted infections. Trauma to the testicles might be felt in the abdomen too. If you’re experiencing abdominal pain and notice any lumps or bumps in your testicles, skin changes or any discharge from the penis then see your doctor.

• Prostatitis

The prostate is a small gland that sits between the bladder and the penis. It makes the fluid part of semen. If it becomes inflamed or infected it can produce pain that’s felt in the genitals but also in the lower abdomen. It can make it difficult or painful to pass urine or to ejaculate. If prostatitis comes on quickly (acute) then it’s usually caused by a bacterial infection and antibiotics need to be prescribed. If it takes a more gradual course coming and going over weeks or months (chronic) then the cause is often harder to find and treatment can be challenging.

Pain on one side

Sometimes low abdominal pain is felt on one side. It can be anywhere from just beside of your belly button, right down to your groin:

• Appendicitis

As mentioned above, the pain from appendicitis can start centrally but usually settles low down on the right hand side of the abdomen where the appendix is located. It hurts to press in this area and is also worse when you cough, sneeze or move.

• Pyelonephritis

Infection in a kidney gives pain on one side which may originate from or spread through to your back. You may have urinary symptoms such as pain on weeing, have blood in your urine and feel generally unwell. It’s common to feel nauseated, vomit and have a high temperature. These infections are usually bacterial and require antibiotics so don’t delay seeing your doctor.

• Kidney stones

Sudden, very severe pain in the back, abdomen and groin could be due to kidney stones. The pain tends to come in waves as the body tries to push the stone from the kidney and along the ureters (tube from kidney to bladder). Pain from stones is often associated with nausea or vomiting. People who don’t drink enough fluids are more likely to get kidney stones. Small stones will usually pass and be excreted in the urine but if the pain is severe and not settling, you may need hospital treatment. Tests are needed to find out why you’re making stones and to check your kidney function.

• Muscular pain

It’s easy to forget that a simple muscle strain can cause pain in the abdomen. The pain can be quite severe when the muscle is moved so consider it if you have been working out or the pain has a muscular feel to it. Warm baths and pain killers will usually settle muscular pains.

• Hernias

Inguinal hernias (groin hernias) can cause abdominal pain. Hernias form when there’s a weakness in the abdominal muscle wall and fatty tissue or part of the bowel pokes through. You may feel an aching pain and notice a soft lump or swelling in your groin. The lumps tend to appear when you strain, cough or lift something heavy.

It’s important to avoid constipation if you have a hernia and troublesome hernias need to be repaired surgically to push the bowel back inside and repair the weak abdominal wall. They only need urgent treatment if bowel in the hernia gets stuck or ‘strangulated’ and pain is intense.

Generalised abdominal pain

Lots of conditions produce more of an all over pain which doesn’t seem to focus on one location:

• Constipation

A common cause of abdominal pain and often associated with nausea, loss of appetite and bloating. The pain is often all over but may be felt on the left hand side where the large bowel descends to the rectum. Treatment involves drinking plenty of fluids, taking exercise and eating fibrous foods. Speak to your pharmacist about laxatives if you are struggling to get your bowels working.

• Irritable bowel syndrome (IBS)

Pain from IBS can be anywhere in your abdomen and is often associated with bloating, constipation or diarrhoea. It can be constant or colicky (in waves). IBS is a long term condition and treatment focuses on spotting triggers such as stress and learning to manage the condition through diet and a healthy lifestyle.

• Gastroenteritis

Infections of the bowel such as viruses and food poisoning can cause generalised abdominal pain. It can be a dull ache but often crescendos and cramps up prior to episodes of diarrhoea, vomiting or both. Most bouts settle in a few days and the priority for treatment is to avoid dehydration so small amounts of fluids often is advised. If you are concerned you are getting dehydrated or your symptoms are getting worse or not settling after a week then see your doctor.

• Back pain

It’s worth knowing that pain originating from the back can often be felt in the abdomen. This is called ‘referred pain’ and can catch you out as you assume pain is coming directly from the place you are feeling it. Pain would be worse when moving around, bending and lifting. It’s often a case of excluding abdominal causes of pain first.

Abdominal pain examination and investigations

Your doctor will have a good idea as to what might be causing your pain after listening to your description and asking questions. They will usually examine your abdomen too to see if there is any pain on pressing on certain areas of your tummy and to check for any lumps.

They may be able to give you a diagnosis and recommend treatment but if any further clarification is needed then further tests will be arranged. These will vary according to what condition is suspected but may involve taking urine, stool or blood samples, arranging a scan of your abdomen or possibly referring you to a specialist.

It can be a tricky business figuring out exactly what the cause of lower abdominal pain is so do make an appointment if you are concerned and always go back to your doctor if your symptoms aren’t resolving.

Last updated: 02-01-2020

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