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Aching pains in the abdominal area: below, near the navel, left and right side of the body
Last reviewed: 12.07.2025
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Without a doubt, spasmodic, cramping or cramping abdominal pains occur in pathological conditions. The exception is painful sensations during contractions in women in labor.
In ICD-10, pain arising in the abdominal region is classified in class XVIII – symptoms, signs and deviations from the norm, and pain associated with the digestive system and abdominal cavity is coded R10-R19.
[ Causes of cramping abdominal pain
So, cramping abdominal pain is a symptom of a disease. And, given the prevalence of this symptom, the causes of spasmodic abdominal pain can be divided into several groups.
Firstly, nausea, cramping abdominal pain and vomiting with diarrhea are the first signs of food poisoning. In some cases, certain foods are to blame (especially fatty ones, which lead to bile stagnation) or systematic overeating, which slows down the digestion process and can often lead to functional disorders that cause cramping pain in the stomach and intestines.
Periodic cramping pain in the abdomen may not only be physiologically caused (overeating, constipation, in women - menstruation), but may also appear due to pathologies that the patient is not even aware of, for example, with prolapse of the stomach or intestines.
More common causes rightfully include the whole spectrum of intestinal infections that cause severe nausea with vomiting, cramping abdominal pain and diarrhea. In particular, dehydrating vomiting and diarrhea in a child are very often signs of rotavirus infection in children.
It should be remembered that in many ways similar symptoms appear when infected with parasitic worms (helminths).
In most situations, frequent cramping abdominal pain is a symptom of pathologies of the digestive system and gastrointestinal tract dysfunction, i.e., it reflects problems of a gastroenterological nature. For example, diverticulitis is characterized by cramping abdominal pain and vomiting, and spastic gastroenterocolitis and pancreatitis are characterized by nausea, vomiting, and diarrhea.
A separate group is made up of genetically determined enzymopathies, primarily the inability to digest gluten from grains – celiac disease, when, due to damage to the well-innervated mucous membrane of the small intestine, frequent abdominal spasmodic painful sensations and intestinal disorders are observed. And people with lactose intolerance – intolerance to milk sugar – in addition to nausea, diarrhea and increased gas formation in the intestine (flatulence), also complain of frequent cramping pains in the abdomen above the navel.
Sometimes the etiology cannot be explained for a long time, even when cramping pains in the stomach and intestines occur constantly, as happens with congenital anomalies - dolichosigma, intestinal atresia, Ladd's syndrome; gastroenterological neurosis (painful sensations in the abdomen of psychogenic genesis) or abdominal epilepsy.
Almost all of these reasons can provoke spasmodic abdominal pain in a child or teenager.
In addition, the organs of the urinary and female reproductive systems have abdominal localization. And in a significant number of patients, the appearance of this pain syndrome is associated with damage or inflammation of these visceral organs - with certain urological and gynecological diseases.
But in any case, the pathogenesis of abdominalgia is caused by the excitation of nociceptors and affector endings of nerve fibers that provide innervation of the abdominal organs (hollow and parenchymal), mesentery and parietal peritoneum.
Localization of painful sensations
The range of diseases in which one of the leading symptoms is cramping abdominal pain is extremely wide, therefore specialists highlight such important diagnostic factors as the specific localization of pain and the dominant nature of painful sensations.
And although both factors, as well as the accompanying symptoms, are considered in a complex, the place where the patient feels pain, that is, its localization, serves as an anatomical landmark for determining its etiology:
- in the upper abdomen most often indicates inflammation of the esophagus, gastritis, gastric ulcer and/or duodenal ulcer, giardiasis, but can also occur with inflammation of the mesenteric lymph nodes, lobar pneumonia, and even myocardial infarction;
- on the right side of the abdomen are associated with dyskinesia or inflammation of the gallbladder, cholelithiasis, chronic appendicitis, inflammation of the liver parenchyma;
- in the right side of the lower abdomen are observed with inflammation of the appendix, granulomatous enteritis (Crohn's disease);
- on the left side of the abdomen (top) – an indicator of problems with the pancreas, below – diverticulitis, ulcerative colitis, and in women – left-sided inflammation of the appendages;
- in the lower abdomen are caused by problems with the large intestine (the same ulcerative colitis), bladder (most often interstitial cystitis) and pelvic organs (in gynecological diseases);
- in the abdomen in the navel area - the first sign of appendicitis, as well as intestinal spasms during gastrointestinal infections, helminthiasis and abdominal aortic aneurysm;
- in the abdomen above the navel are characteristic of many gastropathies, including gastric neurosis (nervous dyspepsia); may be with a pancreatic cyst;
- in the middle of the abdomen may be caused by inflammation, or irritable bowel syndrome, or strangulation of the small intestinal loops. In cases of intense pain, nausea and fever, acute appendicitis with an abscess should be suspected; the consequences and complications of its perforation are rapidly developing inflammation of the peritoneum (peritonitis). This urgent condition often leads to sepsis and is fatal.
Equally urgent is the dissection and perforation of an abdominal aortic aneurysm, which can result in significant blood loss.
Nature of pain
The nature of painful sensations – depending on pathophysiological characteristics – can have significant differences in duration, intensity and its subjective sensory assessment.
For example, with intestinal adhesions, a slight pulling or aching pain may be felt, and with the same pathology, after eating or physical exertion, there may be severe cramping pain in the abdomen.
Sharp cramping pains in the abdomen that occur as a result of intestinal infections, poisoning and other causes are called intestinal colic. In cases of perforation of a stomach ulcer or intestinal obstruction, patients experience cutting pains; similar painful sensations are well known to those who often have cystitis, as well as to those who have encountered an inguinal hernia.
Acute inflammation of the appendix, pancreas, gall bladder or urinary bladder also causes acute pain. Symptoms of inflammatory processes and general infectious intoxication – temperature – are often observed in gynecology (more on that later).
And cramping pain in the abdomen after eating corresponds to the clinical picture of a dietary error, irritable stomach syndrome, gastritis, gastroesophageal reflux and gastroduodenitis, gastroenteritis of viral etiology, celiac disease, dyskinesia of the gallbladder and the presence of stones in it.
Cramping abdominal pain in women
You understand why cramping abdominal pain in women is highlighted in a separate section, although all the above reasons are relevant regardless of gender.
First of all, physiological (caused by the functioning of the female reproductive system) include pain in the lower abdomen before menstruation, when painful sensations occur before the onset of each menstruation due to ovulation syndrome. But in a significant number of women, cramping pain during menstruation is associated with algomenorrhea.
Cramping pains in the lower abdomen may occur in the middle of the cycle.
Gynecologists note pain in the lower abdomen in women with inflammation of the uterine appendages (adnexitis or salpingo-oophoritis); inflammation of the ovaries (oophoritis), ovarian cysts or malignant tumors; pelvic peritoneal and uterine adhesions.
Cramping pains in the uterus can be caused by polyps that have formed on its inner walls, endometriosis, or submucous uterine fibroids.
What causes cramping abdominal pain during pregnancy?
Physiological reasons:
- contractions of the uterus during implantation of the fertilized egg into its endometrium (in the first two weeks);
- constipation and flatulence due to increased estrogen levels, which slow down gastrointestinal motility (during the entire period).
Pathological causes:
- intense spasmodic pain in the abdomen (often one-sided) is a sign of an ectopic, that is, extrauterine pregnancy;
- severe cramps in the lower abdomen with bloody vaginal discharge up to 20 weeks - threat of spontaneous abortion;
- recurring several times per hour, periodic cramping pains in the abdomen with irradiation to the lower back and a feeling of increasing pressure in the pelvic region (Braxton-Hicks contractions) at up to 37 weeks are a signal of the onset of premature labor.
Cramping pains in the abdomen after childbirth are explained by the fact that the overstretched muscle fibers of the uterine wall - thanks to the action of the hormone oxytocin - begin to contract in order to return the organ to its previous size.
Diagnostics
The entire range of diagnostic procedures is covered in detail in the publication – Diagnosis of abdominal pain
Also learn how food poisoning is diagnosed.
What to do, treatment
Symptomatic treatment is aimed at relieving painful sensations. It is strictly not recommended to take any painkillers on your own in case of acute pain syndromes of the category of urgent conditions - acute appendicitis, ulcer perforation, intestinal obstruction, ectopic pregnancy, ruptured ovarian cyst or twisting of its stalk - when surgical treatment in the form of an emergency operation is required.
Doctors pay special attention to:
In other cases, help with cramping abdominal pain is provided by medications with analgesic and antispasmodic effects - No-shpa, Meverin, Spazmalgon, etc.
Since spastic abdominal pain is a symptom of various diseases, it is necessary to conduct appropriate therapy for the etiologically related disease, in which physiotherapeutic treatment can be used: electrical and thermal procedures for diseases of the gastrointestinal tract, in gynecology - for inflammatory diseases of the pelvic organs
Some people find folk remedies helpful, see – How to relieve cystitis pain at home?
Herbal treatment helps with diarrhea (decoction of oak bark, birch buds, plantain leaves, fireweed, orchis, cinquefoil, couch grass roots); for inflammation, water infusions of centaury, knotweed, betony, hernia, chamomile flowers or calendula are recommended; for gastrointestinal spasms, decoctions of valerian roots, lemon balm leaves, mint, lady's mantle or barberry berries have a positive effect.
Homeopathy – preparations Gelmintox, Bryonia Alba, Sulfur, Colocynthis – helps with helminthiasis. Although there are also official means for this, such as Pirantel, Vormil, Mebex, etc.
Prevention
It is not possible to prevent all the causes of cramping pain, but preventing food poisoning, intestinal infections and helminthic invasions is quite possible for everyone if you adhere to the principle: cleanliness is the key to health.
Forecast
In this case, everything depends on the disease that causes it, and only its successful treatment makes the prognosis favorable.