Stomach & Abdominal Pain



Stomach & Abdominal Pain

Abdominal pain is the pain felt in the area between the chest and pelvis. Pain can arise from the tissues of the abdominal wall, or originate from organs of the abdomen including the stomach, liver, pancreas, colon, gallbladder and small intestine.  

There are different types of abdominal pain: The pain that is felt in the center of the upper abdomen is called epigastric pain (some refer to this as “gastric”). The pain that is felt around the umbilicus is called paraumbilical pain. The pain that is felt in the center lower abdomen is called suprapubic pain.

Sometimes people call it stomach pain. Strictly, the stomach is an organ in the abdomen and the disease of the stomach normally give rise to pain in the upper abdomen, which is an epigastric pain.

Belly pain is another non-specific term that often used interchangeably with abdominal pain.

Abdominal pain is one of the common health complaints in Singapore. The abdomen is home to many vital organs, muscles, connective tissues and blood vessels that may be affected, hence there are many various contributing causes to abdominal pain. While most cases of abdominal pain are mild and can be easily treated, it can also be a sign of a serious illness.

Causes Of Abdominal Pain

 In general, pain in the epigastric area points towards organs like the stomach, duodenum, pancreas, gallbladder and the liver. Diseases such as stomach ulcer, stomach cancer, duodenal ulcer, pancreatitis, pancreas cancer, cholecystitis or biliary colic would present as pain in this area.

Pain around the umbilicus point towards the small bowel, appendix and the right side of the colon. Early appendicitis would be felt in this area.  Diseases of the small bowel like Crohn’s disease would also be felt here. 

Pain in the lower abdomen would point towards diseases involving the colon, the female reproductive system, and the urinary bladder. Cancer of the colon, ulcerative colitis, pelvic inflammatory disease, and ovarian mass would sometimes present as pain in this area.

 Symptoms Of Abdominal Pain

The tempo and duration of pain give important information. Persistent pain, even when not severe, point towards a problem that does not go away such as cancer or chronic inflammation. On the other hand, pain that comes in waves usually is associated with contraction of a hollow organ such as the colon or the gallbladder.

Associated symptoms are important as well. Loss of weight, loss of appetite, difficulty swallowing, change in bowel habit, recurrent vomiting, blood in stool and black stool all point towards serious disease such as cancer. The presence of any of these symptoms warrants urgent evaluation by a trained gastroenterologist. Fever, lethargy, generalized weakness and blood in stool points towards an inflammatory process and inflammatory bowel disease or infection needs to be excluded.

Some of the pain has clear precipitating factors and some do not. Some of the pain may worsen with stress. Some of the abdominal pain is more complex and may not conform to any particular pattern. The journey to discover the cause of these pain can be challenging. Some abdominal pain may even have a psychological component.

 Diagnosing Abdominal Pain

Correct diagnosis of the abdominal pain is important. Correct diagnosis leads to correct treatment and resolution of the symptoms.

The diagnosis of abdominal pain often requires careful and detailed history taking, paying attention to the site, duration, severity of the pain as well as the associated symptoms. Physical examination may sometimes be helpful. Specialists in gastroenterology can also conduct further investigations such as blood test, CT scan, gastroscopy and colonoscopy which may be necessary.

If you experience abdominal pain that could not be resolved with treatment with your family doctor, you probably would benefit from an expert evaluation from a specialist. You should not delay the evaluation for more than 2-3 weeks to ensure that there is no delay in diagnosis.


If you have persistent abdominal pain, do not just ignore it. Get a proper diagnosis to ensure that there is no serious illness. The medical cost is often fully covered by the majority of medical insurance and most clinics and government hospitals in Singapore do offer very affordable care. 

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