Why is my lower stomach tender to touch

Lower abdominal pain has a lot of causes and can feel significantly different depending on the cause. Most of the time, it’s something innocuous like trapped gas or indigestion.

Sometimes, though, lower abdominal pain can be a symptom of a more serious issue. Pay attention to any other symptoms you have, as they may be clues as to what's going on.

This article looks at many causes of lower abdominal pain, their symptoms, what causes them, and how they're diagnosed and treated.

Lower abdominal pain can feel different depending on the underlying cause. Some types of pain are spread throughout the lower abdomen. Others may feel specific and pointed. 

Symptoms may differ depending on the reason for the pain. Lower abdominal pain is a symptom in and of itself. It’s not a condition.

Red Flag Digestive Symptoms

Get immediate medical help for:

• Fever with abdominal pain
• Severe pain that doesn't go away
• Vomiting blood
• Signs of shock or low blood pressure that may signal internal bleeding
• Bloody or dark tarry stools

Causes of Lower Abdominal Pain

Lower abdominal pain can be either acute or chronic. Acute pain comes on suddenly and may go away on its own. Chronic pain lasts longer than six months.

Both types of pain may result from something benign, like an upset stomach, or more serious, like appendicitis.

Appendicitis

Appendicitis is a serious condition that requires emergency attention. When the appendix becomes infected and inflamed, prompt treatment is necessary to prevent the organ from rupturing.

People between the ages of 10 and 30 are most likely to get appendicitis. It can happen at any age, though.

Most people with appendicitis have pain that:

• Starts suddenly on the right side of the lower abdomen
• Starts suddenly around the navel, then shifts to the lower right abdomen
• Is relieved by putting pressure on the site but comes back when the pressure is removed
• Gets worse when you move, breathe deeply, cough, or sneeze
• Comes on before other symptoms and gets worse over the next few hours
• Is severe and may have a different quality than you've felt before

Other possible symptoms include:

• Nausea and vomiting
• Abdominal swelling
• Diarrhea or constipation
• Mild fever
• Loss of appetite
• Being unable to pass gas 

When the appendix ruptures, it usually alleviates the pain for a while. However, the burst organ spills infection out into your abdomen, where it can spread throughout your body. That leads to sepsis, which is life-threatening.

Get Emergency Treatment

If you think you have appendicitis or a ruptured appendix, call 911 or go to an emergency room. The condition almost always requires immediate surgery to avoid potentially fatal complications.

Colitis

Colitis is an inflammatory condition that causes swelling in the large intestine and may cause lower abdominal pain. The pain can come and go or remain constant.

Other symptoms include:

• Blood in the stool
• Bloating
• Frequent urge to have a bowel movement
• Diarrhea
• Dehydration 
• Fever 

Colitis can happen due to:

• An infection
• Food poisoning
• Crohn's disease
• Ulcerative colitis
• Ischemic colitis

Inflammatory Bowel Disease

Crohn's disease and ulcerative colitis are classified as inflammatory bowel diseases (IBD).

Diverticular Disease

Diverticular disease includes diverticulosis and diverticulitis.

Diverticulosis

People with diverticulosis have bulging pouches that protrude from the large intestine or colon. Older adults are more likely to have this condition.

Some people have no symptoms at all. But the bulging can cause abdominal bloating, cramping, and constipation. 

Diverticulitis

When the pouches become irritated in some way, the condition is called diverticulitis. Left-sided abdominal pain is the most common symptom of this type of inflammation or infection. Other symptoms of diverticulitis include:

• Nausea and vomiting
• Fever
• Chills
• Constipation
• Cramping

Kidney Infection

A kidney infection (pyelonephritis) is a serious infection that often starts with an infection of the bladder (also called infectious cystitis). When cystitis due to bacteria or fungi travels to the kidneys, it can cause a kidney infection.

While you're likely to feel some back pain, you may also feel pain under your ribs, around the abdomen, and around your groin. Kidney infection pain is typically very severe.

Symptoms may include:

• Pain when urinating
• Frequent urge to urinate
• High fever with chills
• Nausea
• Vomiting

If you suspect you have a kidney infection, get immediate medical attention.

Acute Urinary Retention

If you have acute urinary retention, you're suddenly unable to pass urine. Urinary retention can also be chronic. Chronic urinary retention is more likely in males and may not cause symptoms.

If you suddenly can't pass urine, you'll likely experience severe pain, which can radiate to your abdomen. However, the inability to urinate is the most obvious sign of this condition.

Acute urinary retention requires an emergency room visit.

Cystitis

Females are more likely than males to develop cystitis—inflammation of the bladder. It's typically caused by bacteria, but it can be due to other causes.

Cystitis symptoms include:

• A cramping-like pain in the lower middle abdomen
• Pain in the back
• Cloudy urine
• Blood in the urine
• Foul-smelling urine
• Low-grade fever
• Burning or painful urination
• Frequent need to urinate, even after you've just urinated
  

Nephrolithiasis (Kidney Stones)

Kidney stones often cause extremely severe back pain, but the pain can also creep forward to the side of your abdomen.

Other symptoms of kidney stones include:

• Blood in the urine
• Fever
• Vomiting
• Foul-smelling urine
• Burning pain when urinating

While small kidney stones may pass on their own, larger ones may require treatment. They can cause urinary tract infections, which cause aching pain in the lower abdomen and make urination painful.

Trapped Gas

Gas can end up in the digestive tract when you swallow air or eat certain foods that cause gas. Some foods contain substances that can make you feel gassy, such as:

• Soluble fiber, like beans
• Insoluble fiber, like vegetables
• Fructose, like onions or bananas
• Raffinose, in cabbage and other cruciferous vegetables
• Starch, like potatoes and noodles
• Lactose, found in dairy products

Some people are more likely to have gas in the digestive tract, including people who are lactose intolerant or have digestive disorders.

Symptoms of trapped gas may include:

• Burping
• Bloating
• Abdominal pain
• Flatulence

The abdominal pain from trapped gas depends on where it is. Left-side gas may feel like heart-related pain, while right-side gas may feel similar to appendicitis.

Menstrual Cramps

Cramping during menstruation happens due to uterine contractions. The pain can be mild or severe. You may experience lower back pain in addition to lower abdominal pain. 

Other symptoms that may accompany menstrual cramps include:

• Fatigue
• Diarrhea
• Nausea and vomiting 

Some people experience menstrual cramps due to another disorder or infection. This is called secondary dysmenorrhea. This abnormal cramping can happen for several reasons, including:

• Pelvic inflammatory disease (PID)
• Fibroids 
• Endometriosis
• Adenomyosis

Constipation

Constipation is an uncomfortable condition in which it is difficult to make a bowel movement. You can become constipated if you lack fiber in your diet or suddenly change your eating habits. 

Symptoms of constipation include:

• Dry, hard stools
• Not passing stools at all
• Bloating
• If there's trapped gas or a blockage, lower abdominal pain

Constipation is sometimes due to an underlying condition.

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a condition that causes various gastrointestinal symptoms, including:

• Abdominal pain
• Changes in bowel movements, including diarrhea, constipation, or a mix of both
• Bloating
• Mucus in stool
• A sensation of an unfinished bowel movement

Causes of Pelvic Pain

Sometimes people mistake pelvic pain for lower abdominal pain. Conditions that can cause pain in this area include:

• Pelvic inflammatory disease (PID)
• Ruptured ovarian cyst
• Leiomyomas (fibroids)
• Endometriosis
• Ovarian torsion
• Ectopic pregnancy
• Ovarian hyperstimulation
• Ovarian cancer

Diagnosis of Lower Abdominal Pain

If your abdominal pain doesn’t seem to be the result of indigestion and is getting worse or not going away, you should see a healthcare provider. 

They will likely perform a physical exam and ask about your symptoms in detail. They may also request tests to rule out possible causes of your abdominal pain.

Expect your provider to ask you about the exact location of the pain and to describe the sensation you’re feeling. They may perform a gynecological or rectal exam if you have lower abdominal pain.

Testing may include:

• Blood tests such as a complete blood count to check for infection or blood loss
• A pregnancy test
• Imaging tests such as a computed tomography (CT) scan to look at your abdominal organs

If you could be pregnant, an ultrasound is the preferred imaging method for evaluating unexplained abdominal pain.

Treatment of Lower Abdominal Pain

Treatment depends on the cause of the lower abdominal pain. 

For mild abdominal pain that's the result of trapped gas or indigestion, you may have relief with:

• Over-the-counter (OTC) medications including calcium carbonate
• Adjusting your diet by eliminating foods that cause indigestion or gas
• Probiotics
• Complementary and alternative medicine (CAM) such as acupuncture or massage

If you have a bacterial infection that's causing abdominal pain, you may need prescription medication. Those with severe indigestion may also require prescription drugs. A urinary tract infection is usually treated with antibiotics.

Some digestive disorders, such as colitis or irritable bowel syndrome, have no cure. Treatment involves a combination of lifestyle changes and prescription medications in order to manage symptoms.

Treatment may also depend on the severity of the condition. People with moderate to severe ulcerative colitis may need to take prescription drugs such as:

• Corticosteroids
• Aminosalicylates
• Biologics
• Immunomodulators
• Janus kinase (JAK) inhibitors

Some causes of lower abdominal pain may require surgery. For example, people with severe ulcerative colitis may need surgery to avoid complications of the disease. The need for surgery is decided on a case-by-case basis.

Appendicitis is considered an emergency condition that almost always requires surgery as soon as possible. Without surgery, the appendix could burst and cause peritonitis, a life-threatening infection.

Summary

Lower abdominal pain can be acute or chronic. It can be a symptom of minor or major digestive system conditions such as gas, indigestion, constipation, colitis, diverticular disease, or appendicitis.

Gynecologic conditions such as menstrual cramps or pregnancy may also be causes, as can kidney stones and urinary tract infections.

Treatment depends on the underlying cause. It may include anything from over-the-counter antacids to emergency surgery.

A Word From Verywell 

Most of the time, lower abdominal pain is nothing to worry about. Often, the pain may be the result of something you ate. 

See a healthcare provider if your symptoms aren't going away or are getting worse, or if you have other potentially serious symptoms, such as:

• Blood in the stool
• High fever
• Vomiting blood
• Lightheadedness
• Severe pain that doesn't go away

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