Symptoms and when to see a doctor
Lower abdominal pain: common causes and the warning signs to act on
By Dr Wong Nan-Yaw, MBBS (NUS), FRCS (Edinburgh). Published . 6 min read.
Lower abdominal pain is often caused by trapped wind, constipation, a stomach bug or period pain, and these usually settle. Pain that starts suddenly and is severe, moves to the lower right side, or comes with fever, vomiting, blood in the stool or fainting needs urgent care (NHS). Dr Wong Nan-Yaw is a general and colorectal surgeon.
What are the common causes of lower abdominal pain?
Most lower abdominal pain comes from the bowel and is short-lived. The NHS lists trapped wind, indigestion, constipation and stomach bugs as common causes, and irritable bowel syndrome, period pain and urinary infections among other causes. Other symptoms that come with the pain are often more helpful than the pain itself in pointing to the cause.
| Pain and other symptoms | Possible cause |
|---|---|
| Bloating and passing a lot of wind | Trapped wind |
| Hard stools or going less often | Constipation |
| Watery stools, nausea or vomiting | Stomach bug or food poisoning |
| Ongoing cramps, bloating, diarrhoea or constipation | Irritable bowel syndrome |
| Cramps with your period | Period pain |
| Burning when passing urine, needing to go often, cloudy urine | Urinary tract infection |
| Pain starting near the belly button that moves to the lower right | Appendicitis |
| Pain in the lower left, sometimes with fever or a change in bowel habit | Diverticular disease or diverticulitis |
| Severe pain from the side or back spreading to the groin, coming in waves | Kidney stone |
Sources for this table: NHS pages on stomach ache, appendicitis, diverticular disease, urinary tract infections and kidney stones. The table is a guide to what doctors consider, not a way to diagnose yourself.
Some of these causes need prompt treatment. The NHS describes appendicitis as needing urgent hospital treatment, and advises urgent help for kidney stones causing severe pain or a high temperature. Small pouches in the bowel wall, called diverticula, are very common with age and usually cause no symptoms at all; pain arises when they become inflamed or infected.
Does the side of the pain matter?
The site of the pain gives clues but is not reliable on its own. Appendicitis usually starts around the belly button and moves to the lower right. Diverticular pain is usually on the lower left. Kidney stone pain starts in the side or back and can spread to the groin. Urinary infections can cause lower tummy pain.
The NHS points out that appendicitis does not always behave typically. Pain may be milder, develop more slowly or sit in a different place, which is more likely in pregnancy, in young children and in older people. A small number of people with diverticular disease feel the pain on the right rather than the left.
A lump in the groin that gets bigger when you cough or sneeze and smaller when you lie down may be a hernia. Pain in or around a hernia, a bloated tummy or vomiting needs urgent advice, because pain can be a sign that the hernia is being squeezed and its blood supply is at risk (NHS).
What causes of lower abdominal pain are specific to women?
Period pain, endometriosis, ovarian cysts, pelvic infection and pregnancy problems can all cause lower abdominal pain. The most urgent to recognise is an ectopic pregnancy, which can cause pain low down on one side, vaginal bleeding or brown discharge, and pain in the tip of the shoulder, usually between the 4th and 12th week of pregnancy (NHS).
Endometriosis typically causes intense pain around the time of a period, and possibly pain during and after sex and when passing stool (NHS). Pelvic inflammatory disease and a ruptured ovarian cyst are among the conditions the NHS lists that can be mistaken for appendicitis.
Seek help promptly for lower tummy pain if you might be pregnant, even without a positive pregnancy test. Sudden, sharp, intense pain with dizziness or fainting is an emergency, because an ectopic pregnancy can be serious (NHS).
Which warning signs mean I should go to the emergency department?
Go to the emergency department or call 995 if the pain started suddenly and is severe, or if it comes with vomiting blood or green vomit, heavy bleeding from the bottom or black sticky stools, being unable to pass urine, stool or wind, a rash that does not fade when pressed, or difficulty breathing (NHS, SCDF).
The last point matters because, if appendicitis is not treated quickly, the appendix can burst. The NHS notes the pain may briefly improve before becoming severe and spreading across the abdomen. Do not drive yourself; ask someone to take you or call an ambulance.
- Severe pain that came on suddenly
- Vomiting blood, or vomit that is green or looks like coffee grounds
- A lot of blood from the bottom, or black and sticky stools
- Not being able to pass urine, or stool and wind
- Pain with fainting or feeling very dizzy, especially if you might be pregnant
- Pain that spreads across the whole abdomen after a period of lower right pain
When should I see a doctor for pain that is not an emergency?
See a doctor if pain keeps returning or does not go away, if you notice a lump in your tummy, or if pain comes with blood in the stool, bloating or a change in how you pass stool. Get an urgent same-day review if pain is steadily getting worse, you have a high temperature, or you cannot keep fluids down.
Lower abdominal pain with a change in bowel habit or bleeding can have bowel causes that need investigation, such as diverticular disease, which the NHS notes can cause blood in the stool, constipation or diarrhoea. Its symptoms overlap with those of irritable bowel syndrome, so tests may be needed to tell them apart. A doctor will examine your abdomen and may arrange blood and urine tests, a scan, or a colonoscopy depending on the findings.
Sources
Medically reviewed by Dr Wong Nan-Yaw
MBBS (NUS), FRCS (Edinburgh). 33 years in medicine (since 1993), 23 years as an accredited specialist (since 2003) and 18 years in private practice at Mount Elizabeth (since 2008). Last reviewed 6 November 2026.
How this article is prepared
Statements are checked against the sources listed above. This article is general education and does not replace a consultation. It is reviewed and updated when guidance changes. In an emergency, call 995.