saudigastro.com/patients/acute-abdomen
Category
Serious
Red flags
6
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
An "acute abdomen" means sudden, severe abdominal pain that may need urgent medical or surgical care. It is not one disease but a warning sign. Causes include appendicitis (inflamed appendix), gallbladder inflammation or stones, pancreatitis (inflamed pancreas), bowel blockage, a hole in the bowel (perforation), poor blood supply to the bowel, kidney stones, and in women problems with the ovaries or a pregnancy outside the womb.
How common is it?
Abdominal pain is one of the most frequent reasons for emergency visits. Many causes are mild, but some are dangerous and cannot be separated from mild ones without examination and tests.
Why does it happen?
Pain arises when an organ is inflamed, blocked, stretched, twisted, or loses its blood supply, or when the bowel wall tears and leaks contents into the abdomen, irritating its lining (peritonitis). Older adults, people with diabetes, those on steroids or immune-lowering medicines, and pregnant women may have milder pain even when the problem is serious.
Symptoms
- Sudden, severe or rapidly worsening abdominal pain
- Pain that stays in one spot, or pain that moves, for example to the lower right abdomen
- Nausea and vomiting
- Fever or chills
- Swollen or tight abdomen, or being unable to pass stool or gas
- Pain that makes you not want to move, or worse with coughing and bumps
Red flags — seek urgent medical care
Severe pain that does not ease within a short time, or is getting worse
Go to the emergency department now.
A rigid, hard belly or pain that is worse with any movement
May mean peritonitis from a perforation. Call emergency services.
Vomiting blood, black stool, or repeated vomiting that you cannot stop
Bleeding or blockage. Emergency care needed.
Fever with pain, fast heartbeat, fainting or confusion
Possible serious infection or shock. Call emergency services.
Abdominal pain in pregnancy, or in a woman with a missed period and vaginal bleeding
Could be an ectopic pregnancy, which is life-threatening. Go to the ER immediately.
A baby or child with severe pain, repeated vomiting (especially green), a swollen belly, or blood in the stool
A baby or child needing urgent care must be seen immediately in an emergency department.
How is it diagnosed?
The emergency team asks about the pain, examines your abdomen, and checks pulse, blood pressure and temperature. They take blood and urine tests, and for women of childbearing age a pregnancy test. Ultrasound or CT scan shows the cause in many cases, and X-rays may be used for blockage or free air. Sometimes the diagnosis is made during an operation.
Outlook — what to expect
The outlook depends on the cause and how soon it is treated. Many causes, such as appendicitis and gallstones, are treated very successfully when they are caught early. Delay raises the risk of complications.
Treatment
Habits & Lifestyle
Do not treat severe sudden pain at home. Get emergency help.
- Go to the ER or call emergency services if the pain is severe, constant, or comes with the red-flag signs.
- Do not drive yourself if the pain is severe or you feel faint.
- Do not use heating pads, enemas or laxatives, as they can make some conditions worse.
- Tell the team about your medicines, previous operations and any pregnancy.
Diet
Do not eat or drink while you have severe pain, as you may need an operation or sedation.
- In hospital you may be asked to stay nil by mouth and receive fluids through a drip.
- Food is restarted gradually according to the cause and your recovery.
Medications
Medicines are given by the emergency team after assessment.
- Pain relief is given in hospital; modern practice is that effective pain relief does not hide the diagnosis.
- Intravenous fluids and anti-sickness medicine.
- Antibiotics if infection is suspected.
- Avoid taking anti-inflammatory painkillers (like ibuprofen) or opioids at home before being assessed.
Procedures & Surgery
Many causes need an operation or a procedure.
- Surgery, often by keyhole (laparoscopy), for conditions such as appendicitis, gallbladder inflammation, perforation or bowel ischemia.
- Drainage of an abscess or a collection by a radiologist.
- Endoscopic procedures for some bile duct or bleeding problems.
- Some causes are managed without surgery, with close observation.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- What was the cause of my pain?
- Do I need an operation, and what are the risks and recovery time?
- Can I go back to eating and my usual medicines?
- What symptoms should make me return urgently?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide