Gutbliss - Dr. Robynne Chutkan

Abdominal Pain


Abdominal pain is a symptom with many different causes and while most abdominal pain is caused by minor digestive distress, pain that is persistent and/or severe could be caused by something more serious and usually requires the help of your healthcare practitioner.


Different types of abdominal pain include:

  • Generalized pain: an all over feeling of discomfort or pain in the abdomen
  • Localized pain: pain experienced in a specific area of the abdomen, which we usually divide up into four quadrants: left upper, left lower, right upper, and right lower, plus the central area around the umbilicus (peri-umbilical). Different abdominal organs are in different parts of the abdomen, so locating where the pain is occurring can help pinpoint the source.
  • Cramping: intermittent, oftentimes sharp pain


Causes of abdominal pain include:

  • Acid reflux/GERD
  • Bowel obstruction
  • Celiac disease
  • Diverticulitis
  • Dysbiosis
  • Food allergies/intolerance
  • Gas
  • Gastroparesis
  • Gastritis
  • Gallbladder dysfunction
  • Gallstones
  • Gluten sensitivity
  • H. pylori infection
  • Hepatitis
  • Inflammatory bowel disease (IBD)
  • Irritable bowel syndrome (IBS)
  • Lactose intolerance
  • Pancreatic cancer 
  • Pancreatitis
  • Small intestinal bacterial overgrowth (SIBO)
  • Stomach cancer
  • Stomach ulcers


When diagnosing abdominal pain, it’s helpful to know what kind of pain you’re experiencing where it’s located, as well as whether there are any accompanying symptoms. Here are some examples:

  • Gastroparesis: Abdominal pain is usually accompanied by nausea, bloating, and feeling abnormally full after eating – particularly after eating high-fat foods
  • Pancreatic insufficiency: Abdominal cramping in the left upper quadrant accompanied by bloating, fatigue, nausea, and oily-looking, foul-smelling stools that float
  • Parasites: Abdominal cramping often accompanied by diarrhea that persists for several weeks, bloating, low-grade fever, poor appetite, weight loss, increased flatulence, and sometimes fat malabsorption that results in oily, floating stools
  • Gluten related disorders: Abdominal pain is usually accompanied by a variety of other symptoms including bloating, diarrhea, a change in weight, constipation, fatigue, anemia, rashes, joint pain, neurological symptoms, a “foggy brain”, or sometimes no other symptoms at all
  • Irritable Bowel Syndrome: Abdominal pain or discomfort is usually associated with constipation, diarrhea, or both, and virtually everyone complains of bloating
  • Bowel obstruction: Sudden and severe abdominal pain and bloating often accompanied by nausea and vomiting
  • Pancreatic cancer: Abdominal pain that radiates to the back and is associated with bloating and weight loss. A significant percentage of people with pancreatic cancer will develop diabetes a few months before their cancer is diagnosed, and blood clots in the veins may also occur. Bloating associated with painless jaundice, weight loss, and loss of appetite is also common
  • Stomach cancer: Feeling of fullness in the upper abdomen associated with bloating and indigestion or heartburn, although stomach cancer is often asymptomatic early on. Once the cancer reaches an advanced stage, there will likely be additional symptoms of weight loss, nausea, and abdominal pain. 
  • Diverticulitis: Abdominal pain with a combination of bloating and fever, usually accompanied by either diarrhea or constipation. The abdomen is usually tender, especially in the left lower quadrant
  • IBD (Crohn’s and ulcerative colitis): Abdominal pain with additional symptoms like weight loss, diarrhea, or blood in the stool. With Crohn’s disease, additional symptoms of a partial bowel obstruction may occur, and constipation rather than diarrhea may be present.


Because so many different things cause abdominal pain, there is no one mode of treatment. If your abdominal pain is persistent or chronic, it’s important to find out the cause so you can identify the best treatment. If your pain is chronic but you haven’t found the cause through conventional exams, tests, and procedures, exploring conditions such as IBS, leaky gut, dysbiosis, and gluten related disorders may be helpful. If you suspect your pain is a result of what you are eating or due to IBS, trying an elimination diet or eating low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) foods reduces hydrogen and methane production, which can improve bloating and lessen abdominal pain. For people with IBS or chronic abdominal pain who are experiencing a lot of bowel spasms, abdominal massage or acupuncture can be helpful.

Because so many different things cause abdominal pain, there is no one mode of treatment. If your abdominal pain is persistent or chronic, it’s important to find out the cause so you can identify the best treatment.


Dr Robynne Chutkan
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