The abdomen contains many organs between the chest and the groin. It is no surprise that abdominal pain has many causes. Fortunately, doctors can narrow the origin by paying attention to various features of the pain, such as the timing and location.
The location of abdominal pain is such a useful detail that the symptom can be classified by region. The abdomen can be divided into four quadrants or nine sections like a tic-tac-toe grid. The following overview categorizes the major causes of abdominal pain by quadrant and some regions of the nine-section schemata.
Upper Abdominal Pain
The upper abdomen, located above the belly button (umbilicus), can be divided into a right upper quadrant and a left upper quadrant. Sometimes, one may consider a middle region between the two upper quadrants called the epigastrium, or epigastric region.
- Right Upper Quadrant (RUQ):The RUQ of the abdomen is the location for the liver and gallbladder. Therefore, RUQ pain can result from conditions affecting these organs, including but not limited to inflammation of the gallbladder (cholecystitis), inflammation of the liver (hepatitis), and obstruction of the bile duct. Less commonly, RUQ pain results from disease processes in organs outside the gastrointestinal system, such as pneumonia in the right lower lobe of the lung.
- Left Upper Quadrant (LUQ): The LUQ of the abdomen is where the stomach and spleen are found. Conditions involving these organs, such as gastritis and rupture of the spleen, can cause LUQ pain. Like RUQ pain, LUQ pain can result from lower lobe pneumonia or other non-gastrointestinal causes.
- Epigastrium: Pain in the epigastrium can sometimes occur because of conditions that usually manifest as RUQ or LUQ pain. Otherwise, epigastric pain can originate from inflammation of the pancreas (pancreatitis), gastroesophageal reflux disease, or even a heart attack (myocardial infarction).
Lower Abdominal Pain
The lower abdomen below the umbilicus consists of a right lower quadrant and a left lower quadrant. One may also look at the hypogastrium, or hypogastric region, between the two lower quadrants.
- Right Lower Quadrant (RLQ): One of the most notable causes of RLQ pain is appendicitis, or inflammation of the appendix. Other causes of RLQ pain include but are not limited to a descended kidney stone, inflammatory bowel disease, and inflammation of intestinal pockets called diverticuli (diverticulitis). In women, RLQ pain can also result from ovarian torsion, endometriosis, or pregnancy in the fallopian tube.
- Left Lower Quadrant (LLQ): Pain in the LLQ shares many of the same causes as RLQ pain, aside from appendicitis. Of these, diverticulitis involving the last part of the colon is a common cause of LLQ pain.
- Hypogastrium: Hypogastric pain can sometimes occur with conditions that produce RLQ or LLQ pain. It can also result from conditions such as inflammation of the urinary bladder (cystitis) and pelvic inflammatory disease.
Diffuse Abdominal Pain
Abdominal pain can sometimes be diffuse, not localized to one region. This can occur with gastroenteritis, intestinal obstruction, early-stage appendicitis, pancreatitis, and diabetic ketoacidosis. A worrisome cause of diffuse abdominal pain is inflammation of the membrane lining the abdominal cavity (peritonitis), because it often results from perforation of the gastrointestinal tract that introduces gut bacteria into the sterile abdominal cavity.
Consult Your Physician
The preceding overview is only a partial list and intended to educate, not help self-diagnose. Issues with one's own abdominal pain should always be discussed with a physician.
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