Abdominal Pain: Surgical Causes, When to Worry, and How We Help
Abdominal pain is common — and in most cases, it isn’t caused by anything serious. But some causes do require urgent surgical assessment.
This page explains the surgical causes of abdominal pain, the warning signs that mean you should seek urgent help, how doctors work out the cause, and what treatment might involve.
At RCG Health — a multidisciplinary team led by consultant surgeon Mr Ricardo Camprodon — patients receive rapid assessment for acute abdominal pain and minimally invasive treatment whenever it’s safe to do so.
When is Abdominal Pain an Emergency?
Call 999 or go straight to A&E if you develop:
- Sudden, severe, or worsening pain — especially if your abdomen feels stiff or rigid
- Fever, persistent vomiting, or inability to keep fluids down
- Jaundice (yellowing of the skin/eyes) with abdominal pain
- Blood in vomit or stool, or black, tarry stools
- Chest pain, fainting, or marked weakness alongside abdominal pain
- Severe lower abdominal pain in pregnancy (ectopic pregnancy must be excluded)
- Severe testicular pain with abdominal pain (possible torsion)
If in doubt, err on the side of caution and seek urgent medical help.
Where Is the Pain? Location Can Offer Clues
Doctors often use the location and type of pain to guide the diagnosis:
- Right upper abdomen (under ribs): gallstones, cholecystitis, biliary colic, sometimes hepatitis
- Upper middle (epigastrium): pancreatitis, stomach/duodenal ulcer, reflux
- Right lower abdomen: appendicitis, ovarian causes
- Left lower abdomen: diverticulitis, ovarian causes
- Central/colicky pain with bloating: bowel obstruction, early appendicitis, gastroenteritis
- Groin or near scars: incarcerated/strangulated hernia
Location isn’t perfect on its own, but it provides valuable clues.
Common Surgical Causes of Abdominal Pain
Appendicitis
Often starts around the belly button, then shifts to the lower right side. Nausea, loss of appetite, and fever are common. Treatment is usually a laparoscopic appendicectomy, with a short hospital stay.
Gallstones & Acute Cholecystitis
Gallstones may cause waves of pain after fatty meals (biliary colic) or persistent, tender pain with fever (cholecystitis). Options range from pain relief and antibiotics to laparoscopic gallbladder removal.
Pancreatitis
Causes severe, steady pain in the upper abdomen (often radiating to the back), worse after alcohol or heavy meals, and usually with vomiting. Most patients need hospital admission, fluids, and pain control. Gallstones are a frequent trigger; some later benefit from gallbladder surgery.
Bowel Obstruction
Crampy pain, bloating, vomiting, and inability to pass wind or stool. Causes include adhesions (scar tissue), hernias, or tumours. Some cases settle with conservative treatment; others require urgent surgery.
Diverticulitis
Inflamed pouches in the colon typically cause left lower abdominal pain, fever, and tenderness. Usually treated without surgery, but recurrent or complicated cases may need an operation.
Perforated Ulcer
Sudden, severe upper abdominal pain with a rigid abdomen suggests a perforated stomach or duodenal ulcer — a surgical emergency.
Strangulated or Incarcerated Hernia
A lump that becomes painful, hard, or irreducible, often with nausea or vomiting. This needs urgent surgical treatment to prevent loss of blood supply to the bowel.
⚠️ Note: Some gynaecological (e.g. ectopic pregnancy, ovarian torsion) and urological (e.g. kidney stones) conditions can mimic surgical abdominal pain. If needed, we involve the right specialists promptly.
How We Find the Cause: Tests & Scans
Your doctor will look for “red flags” and choose investigations based on your symptoms:
- History & examination — where it hurts, what worsens or eases it, past operations, medicines
- Blood tests — for infection, liver and pancreas function, kidney function, pregnancy test if relevant
- Urine tests — to rule out infection or kidney stones
- Ultrasound — excellent for gallbladder, pelvic problems, and hernias
- CT scan — very helpful for appendicitis, obstruction, diverticulitis, or complications
All results are explained clearly in plain language, with treatment options discussed openly.
Treatment: From Watchful Waiting to Minimally Invasive Surgery
Your treatment depends on the cause and how unwell you are:
- Observation & medication — pain relief, fluids, anti-sickness medicines, antibiotics if needed
- Day-case or inpatient surgery — many procedures can be completed laparoscopically, meaning more minor scars, less pain, and faster recovery
- Open surgery — reserved for specific situations (e.g. severe inflammation, prior complex surgery)
Aftercare typically includes hydration, gentle movement, and a gradual return to regular eating habits. Written instructions are always provided.
What You Can Do Now
- Don’t keep masking severe pain with repeated painkillers — get checked instead
- Note any triggers (fatty meals, alcohol) and related symptoms (fever, vomiting, jaundice, constipation)
- Keep a list of regular medicines and allergies ready
- If pain is severe, new, or worsening, seek urgent medical attention
Why Choose RCG Health?
- Rapid surgical assessment for abdominal pain
- Minimally invasive techniques wherever possible (gallbladder, appendix, hernia)
- Clear diagnosis and communication — you’ll always understand your options and plan
- Joined-up multidisciplinary care, including imaging, anaesthetics, physiotherapy, and dietetics as needed
FAQs
Is my abdominal pain surgical or “just a bug”?
Short-lived, crampy pain with diarrhoea or vomiting is often viral and settles in 24–48 hours. Severe, constant, localised pain — especially with fever, vomiting, jaundice, or a rigid abdomen — needs urgent assessment.
Can gallstones cause pain without fever?
Yes. Biliary colic causes waves of right-upper pain, often after fatty meals, but without fever. Persistent pain with fever suggests infection (cholecystitis) and should be checked urgently.
How quickly does appendicitis progress?
It varies, but many patients worsen over 24–48 hours. Early review is safer. Modern imaging allows us to confirm the diagnosis and treat quickly with laparoscopic surgery if needed.
What is an “acute abdomen”?
A medical term for sudden, severe abdominal pain that may need urgent surgery (e.g. appendicitis, obstruction, perforation). Don’t wait — seek immediate care.
Will I always need a CT scan?
Not always. Ultrasound may be enough for gallbladder or hernia problems. CT is used when the diagnosis isn’t precise or to identify complications early.
Meet Your Surgeon
All general, upper GI, laparoscopic, and bariatric surgical procedures at RCG Health are performed by our founder, Mr Ricardo Camprodon, Consultant Surgeon. He leads a multidisciplinary team to ensure you receive safe, evidence-based, and compassionate care — from first assessment to full recovery.
