Pain in the abdomen can have a variety of causes – depending on whether they are acute or chronic, in women or men

For many people, abdominal pain is still synonymous with women’s ailments, i.e. complaints that primarily affect the female genital organs. Pain in the lower third of the abdominal region, i.e. in the lower abdomen, is not just a woman’s concern. Men can also experience abdominal pain.

First and foremost, it is about the organs in the lower pelvic space, including the small pelvis. These are the (internal) genital organs, the urinary bladder with the urethra and the ureters that open at the sides, the appendix and the lower intestinal parts, vessels, nerves and lymph nodes.

Abdominal pain in women: Often before and during your period

Typical abdominal pain includes period pain that many women feel before and during their period: as pulling in the abdomen or in the lower back or as cramp-like pain. They are individually very different, mostly not pathological and change many times, depending on the life situation and phase.

Some women also experience drawing pains for a day or two between menstrual bleeds, often on one side or over the pubic hair area. This middle pain often marks ovulation. Even if there are no other symptoms, it is advisable to speak to your gynecologist about such pain to make sure that no other problems are the cause. Because acute or chronic complaints can conceal, for example, inflammations and diseases of the genital organs or the urinary tract.

If a woman starts to have spotting and abdominal pain, especially if she did not have periods before, the gynecologist will conduct targeted examinations to check whether there is an ectopic pregnancy.

In the case of abdominal pain during pregnancy, greater caution should be exercised if something changes in the abdomen. The complaints in expectant mothers can have special reasons, harmless but also alarming, which the gynecologist will clarify immediately. This article does not deal with this.

In men and women: Acute abdominal pain …

Discomfort in the lower abdomen can be acute. They then either indicate a temporary, rather harmless disorder or they represent alarm signals that a practitioner should investigate immediately. This is especially true if they are very violent and there are also symptoms such as fever, nausea, indigestion such as diarrhea or constipation, pain when emptying the bladder and/or bleeding.

The causes of sudden onset of severe pain are often acute inflammation, such as of the appendix or intestine, fallopian tubes, ovaries or urinary tract. Urinary stones, twisting and breakthroughs in tumours or parts of the intestine can also trigger threatening abdominal pain.

… or: chronic abdominal pain

Doctors speak of chronic pelvic pain if the symptoms persist for six months. They can appear again and again in certain situations or nestle more or less permanently.

There are many causes of chronic pain. Problems are often caused by chronic inflammation and diseases of the genital organs, the urinary tract, the digestive tract, especially the large intestine. Tumor diseases of the individual organs should also be considered. In addition, disorders in the nerves, muscles or spine can be responsible for pelvic pain.

It is not uncommon for psychological problems and illnesses such as depression to be associated with physical symptoms. This can include chronic abdominal pain. On the contrary, possible consequences of the operation such as scarring can only aggravate the pain.

Lower abdominal pain: when to see a doctor?

Pain in the lower abdomen should always be clarified by a doctor, in particular, if the pain starts suddenly and violently, fever and/or bleeding is added. In addition to the family doctor, the first point of contact is the gynecologist and, for men, the urologist. In addition, a specialist in gastrointestinal diseases (gastroenterologist) is often in demand, possibly also an orthopedist or neurologist.

Abdominal pain: important causes, possible accompanying symptoms

Gynecological diseases, venous diseases

• Chlamydia infections (discharge, problems with urination and bowel movements are possible; however, the majority of the infection is chronic and insidious for a long time without causing symptoms)
• Inflammation of the uterus (discharge, bleeding outside of the norm)
• Inflammation of the fallopian tubes and ovaries (often fever, discharge, intermenstrual bleeding)
• Purulent tissue meltdown (abscess)
• Rotation of the stem, rupture of cysts on the ovary or tumors (acute pain)
• Fibroids, polyps in the uterus (often bleeding disorders)
• Endometriosis (often bleeding between periods, severe menstrual pain)
• Ectopic pregnancy (no menstruation, followed by abdominal pain, spotting)
• Miscarriage, discharge (heavy bleeding)
• Cervical cancer, uterine cancer (strong-smelling discharge, bleeding outside of normal periods, after menopause)
• Ovarian cancer
• Surgical consequences
• Malformations
• Narrowing of the vagina
• Backward tilted uterus, uterine sagging Venous diseases:
• Varicose veins, thrombosis of the leg and/or pelvic veins (possible warning signs: in addition to heaviness and pain, swelling in the leg , groin, sensation of warmth, bluish discoloration)

Intestinal disorders, intestinal diseases

• constipation
• Appendicitis (pain often in the right groin, but also not exactly localizable, diffuse, possibly fever, weakness, nausea, vomiting)
• Acute intestinal infections (often diarrhea, fever, nausea)
• Chronic bowel diseases: Crohn’s disease, ulcerative colitis (also diarrhea)
• Twisting of intestinal parts
• Inflammation of the diverticulum (colic-like pain, constipation or diarrhea, mild fever) and complications such as abscesses
• Bleeding into the abdominal cavity
• Irritable bowel syndrome (often gas, constipation, or diarrhea)
• Inguinal hernia, hernias (warning signs: severe pain in the groin area, nausea, vomiting, circulatory problems)
• Colon cancer ( blood in the stool, constipation and diarrhea, weight loss )

Urinary tract problems

• Bladder infections (pain and difficulty urinating)
• Bladder stones
• Ureteral stones, colic, blockages (violent, cramp-like pain, nausea, bloody urine possible)
• Kidney stones
• Inflammation of the kidney pelvis (pain in the flank, chills, fever, pronounced malaise)
• Irritable bladder, urethral syndrome (urge to urinate, painful urination)

Problems in men

• Testicular torsion (pain in the testicles, groin, testicle discolouration)
• Chronic prostate inflammation (especially young men; mostly urination disorders)
• Inflammation of the seminal vesicles (problems urinating)
• Vein problems (rare in the small pelvis; see above: Women’s diseases)

Other causes

• Stress, burn-out (typical stress or burn-out symptoms such as exhaustion, tiredness, sleep disorders, headaches, digestive problems)
• Sexual problems
• Trauma (for example after abuse)
• Depression, personality disorders (each with typical psychological symptoms)
• Chronic pelvic pain syndrome as a psychosomatic disorder (fears, depressive moods, tiredness, headache and back pain)Other causes:
• Herniated disc ( pulling pain in the lower back that can radiate into the leg, symptoms of paralysis)
• Spine damage (pain radiating to the lower abdomen)
• Fibromyalgia (pain in muscles and joints)

Pain in the abdomen, especially in combination with other digestive symptoms like constipation or diarrhea can be helped with Colon Hydrotherapy.