Severe abdominal pain is one of the most common reasons people rush to the emergency room. While mild stomach discomfort can be due to gas or indigestion, sudden and intense abdominal pain should never be ignored. In many cases, it may indicate a serious underlying condition that needs immediate medical attention.
From a surgical perspective, some causes of acute abdominal pain are more common—and more dangerous—than others. In this blog, we will focus on three major causes of severe abdominal pain in adults:
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Gallbladder z(Gallstones)
Understanding these conditions can help you recognize warning signs early and seek timely treatment.
What Is Severe (Acute) Abdominal Pain?
Acute abdominal pain is pain that:
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Starts suddenly
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Is intense or progressively worsening
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May be localized or spread across the abdomen
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Often interferes with normal activities
Such pain can signal inflammation, infection, obstruction, or reduced blood supply to abdominal organs. Delay in treatment can lead to complications.
1. Appendicitis – A Surgical Emergency
Appendicitis is one of the most common causes of severe abdominal pain requiring surgery.
What happens in appendicitis?
The appendix, a small finger-like pouch attached to the large intestine, becomes inflamed—usually due to blockage by stool, infection, or swelling.
Typical symptoms
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Pain starting near the navel and shifting to the right lower abdomen
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Pain that worsens with movement, coughing, or walking
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Fever
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Nausea or vomiting
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Loss of appetite
Why it is dangerous
If untreated, the appendix can burst, spreading infection inside the abdomen (peritonitis), which can be life-threatening.
Treatment
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Early diagnosis through clinical examination and imaging
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Appendectomy (surgical removal of the appendix) is the standard treatment
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Delaying surgery increases the risk of complications
2. Gallbladder Stones – Pain After Food
Gallbladder stones (gallstones) are another frequent cause of acute abdominal pain, especially in adults.
What are gallstones?
Gallstones are hardened deposits of bile that form inside the gallbladder. They can block bile flow, causing inflammation and pain.
Common symptoms
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Severe pain in the upper right abdomen
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Pain that may radiate to the back or right shoulder
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Pain often triggered after fatty or heavy meals
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Nausea, vomiting
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Fever if infection develops
When it becomes serious
Gallstones can lead to:
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Acute cholecystitis (gallbladder infection)
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Pancreatitis
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Jaundice due to bile duct blockage
Treatment
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Pain control and infection management initially
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Laparoscopic gallbladder removal (cholecystectomy) is the definitive solution for recurrent or complicated gallstones
3. Hernia – Pain That Worsens on Straining
A hernia occurs when an internal organ or tissue pushes through a weak spot in the abdominal wall.
Common types
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Inguinal hernia (groin)
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Umbilical hernia (near the navel)
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Incisional hernia (previous surgery site)
Symptoms to watch for
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A visible or palpable bulge in the abdomen or groin
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Pain that worsens while lifting, coughing, or standing
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Sudden severe pain if the hernia gets trapped (incarcerated)
Why hernia pain can become severe
If a hernia becomes strangulated, the blood supply to the trapped tissue is cut off. This is a surgical emergency.
Treatment
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Elective hernia repair for uncomplicated cases
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Emergency surgery if pain is sudden, severe, and associated with vomiting or redness
When Should You See a Doctor Immediately?
Seek urgent medical attention if abdominal pain is associated with:
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Sudden onset and rapid worsening
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Persistent vomiting
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Fever
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Abdominal swelling
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Inability to pass gas or stools
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Severe tenderness on touch
Early evaluation can prevent serious complications and reduce the need for extensive surgery.
Why Early Diagnosis Matters
Many patients delay consultation thinking the pain will settle on its own. However, conditions like appendicitis, gallbladder infection, and strangulated hernia do not improve without treatment.
Timely diagnosis allows:
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Minimally invasive surgery
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Faster recovery
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Lower complication risk
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Shorter hospital stay
Final Words from a Surgeon’s Perspective
Severe abdominal pain is the body’s warning signal. While some causes may be minor, appendicitis, gallbladder stones, and hernia are conditions that should never be ignored.
If you or a family member experience sudden or intense abdominal pain, consult a qualified surgeon immediately. Early action can be lifesaving.