UNEXPLAINED ABDOMINAL PAIN
CAUSES, SYMPTOMS & DIAGNOSIS OF:
UNEXPLAINED ABDOMINAL PAIN
Private Abdominal Pain Specialist
Mr Peter Asaad provides expert assessment for patients experiencing unexplained abdominal pain, taking a detailed medical history, performing a thorough examination and arranging appropriate investigations where needed, including blood tests, imaging scans and endoscopy.
With extensive experience in diagnosing and treating abdominal pain, he helps patients across the North West identify the cause of their symptoms and develop an effective treatment plan.
Symptom
What is unexplained abdominal pain?
Abdominal pain can occur anywhere between the chest and the pelvis and may be constant or intermittent. It can be sharp, dull, cramping or burning, and may last for a few hours, several days or become a long-term problem.
The location of the pain, how long it has been present and any associated symptoms all provide important clues to the underlying cause. Symptoms such as nausea, vomiting, changes in bowel habit, bloating, rectal bleeding, fever or unexplained weight loss can help guide further investigation.
Many causes of abdominal pain can be identified through a detailed medical history, examination and appropriate investigations such as blood tests, scans and endoscopy. However, in some patients no specific cause is found despite thorough assessment. This is sometimes referred to as unexplained or idiopathic abdominal pain. Although this can be frustrating, the absence of a diagnosis often means that many of the more serious conditions have been excluded, allowing treatment to focus on managing symptoms and improving quality of life.
Causes
Common causes of abdominal pain
Abdominal pain can have many different causes, ranging from relatively minor conditions to those requiring urgent medical or surgical treatment. The location of your pain, associated symptoms and the results of your examination and investigations all help determine the underlying cause.
Gallstones commonly cause pain in the upper right side of the abdomen, often after eating, particularly fatty meals. This is known as biliary colic and typically lasts from 30 minutes to several hours before settling completely.
A hernia may cause discomfort or pain, particularly during lifting, coughing or exercise, and is often associated with a lump. Although most hernias are not dangerous, they do not usually improve without surgery.
Although abdominal pain alone is rarely caused by bowel cancer, persistent pain associated with rectal bleeding, unexplained weight loss, anaemia or a change in bowel habit should always be investigated.Â
Appendicitis typically begins with pain around the tummy button before moving to the lower right side of the abdomen. It is often associated with loss of appetite, nausea and fever and usually requires urgent surgery to prevent complications.
Conditions such as Crohn’s disease can cause abdominal pain together with diarrhoea, weight loss, fatigue and rectal bleeding. Although primarily managed by a gastroenterologist, some patients may require surgery to treat complications
Diverticular disease commonly causes pain in the lower left side of the abdomen. If the bowel becomes inflamed (diverticulitis), the pain is often constant and may be associated with fever, changes in bowel habit and, complications requiring hospital treatment.
When is abdominal pain an emergency?
Most causes of abdominal pain are not life-threatening. However, some symptoms may indicate a more serious condition and require urgent medical assessment.
If you are concerned that your symptoms may represent a medical emergency, you should attend your nearest Emergency Department or call 999 without delay.
You should seek immediate medical attention if you experience:
- Sudden, severe abdominal pain
- Severe pain that is getting worse
- Pain associated with a high fever or shivering
- Persistent vomiting or inability to keep fluids down
- A swollen or rigid abdomen
- Jaundice (yellowing of the skin or eyes)
- Heavy rectal bleeding
- Collapse, fainting or confusion
When should you see an abdominal pain specialist?
Many episodes of abdominal pain settle without treatment. However, if your symptoms persist, keep returning or you are unsure of the cause, a specialist assessment can help identify the underlying problem and determine whether further investigations or treatment are required.
You should consider seeing a specialist if your abdominal pain:
- Persists for more than a few weeksÂ
- Keeps recurringÂ
- Is becoming more frequent or more severeÂ
- Occurs after eatingÂ
- Is affecting your work, daily activities or quality of lifeÂ
- Is associated with:Â
- Unexplained weight lossÂ
- Loss of appetiteÂ
- Persistent nausea or vomitingÂ
- Changes in your bowel habitÂ
- Rectal bleedingÂ
- Persistent bloatingÂ
- Occurs in the context of a family history of bowel disease or bowel cancerÂ
- Persists following previous abdominal surgeryÂ
Diagnostics
How is unexplained abdominal pain investigated?
The investigations required will depend on your symptoms, medical history and examination findings. Not every patient requires every test, and investigations are tailored to identify the most likely cause of your abdominal pain.
Your consultation begins with a detailed discussion about your symptoms, including the location, severity and duration of your pain, together with any associated symptoms, previous medical conditions, medications and previous abdominal surgery.
A thorough abdominal examination helps identify areas of tenderness, abdominal wall hernias, scars from previous surgery, abdominal masses and signs of more serious underlying conditions.
Blood tests may be arranged to look for signs of infection, inflammation, anaemia, liver or kidney problems, or abnormalities of the pancreas and other organs.
Depending on your symptoms, imaging may include an ultrasound scan, CT scan or, less commonly, an MRI scan. These investigations help identify conditions affecting the gallbladder, liver, pancreas, bowel and other abdominal organs.
If appropriate, a flexible sigmoidoscopy or colonoscopy may be recommended to examine the bowel, particularly if you have rectal bleeding, a change in bowel habit, unexplained weight loss or other symptoms suggesting bowel disease.
Following your assessment and any necessary investigations, the findings will be discussed with you and a personalised management plan agreed. This may involve treatment, surgery, reassurance or referral to another specialist where appropriate.
Treatment
Conditions that may require surgical treatment
Although many causes of abdominal pain can be managed without surgery, some conditions are best treated with an operation. Identifying the correct diagnosis is the first step in deciding whether surgery is appropriate.
As a consultant general and colorectal surgeon, I assess patients with a wide range of abdominal conditions, from relatively straightforward problems such as gallstones and hernias through to more complex colorectal diseases. Following your consultation and any necessary investigations, Mr Peter Asaad will advise whether surgery is appropriate and discuss the available treatment options with you.
Some conditions are well suited to treatment within the private sector, while others are more appropriately managed within the NHS, particularly if they require emergency treatment, highly specialised surgery or ongoing multidisciplinary care. Where this is the case, he will explain the reasons and help ensure you are referred to the most appropriate service.
Whether your symptoms require surgery, medical treatment or further investigation, the aim is to establish an accurate diagnosis and develop a personalised treatment plan. If a non-surgical cause is identified, or another specialist is better placed to manage your condition, an appropriate referral will be arranged.
Common conditions treated:
- ANAL FISTULAS
- ANAL FISSURES
- BOWEL CANCER
About
Mr Peter Asaad
Mr Peter Asaad is a Consultant General and Colorectal Surgeon with over 17 years’ experience in the NHS.
He specialises in colorectal surgery and the treatment of bowel conditions, alongside common general surgical problems such as hernias and gallstones. His practice includes advanced keyhole techniques for colorectal cancer and the management of conditions such as haemorrhoids, fissures and fistulas.
He sees patients within Wrightington, Wigan and Leigh NHS Trust and privately across Manchester and Cheshire.
Mr Asaad provides clear, pragmatic advice and a straightforward approach to treatment, ensuring patients understand their options and can proceed with confidence.
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What Patients Say
Frequently Asked Questions
These are some of the most common questions patients ask about unexplained abdominal pain. As new questions arise, this section will be updated to provide clear and relevant information.
What causes unexplained abdominal pain?
Abdominal pain can have many different causes, including gallstones, appendicitis, diverticular disease, hernias, inflammatory bowel disease and bowel cancer. In some patients, no specific cause is identified despite appropriate investigations, allowing serious conditions to be excluded and symptoms to be managed appropriately.
Can stress cause abdominal pain?
Yes. Stress and anxiety can contribute to abdominal pain and may worsen existing digestive conditions such as irritable bowel syndrome (IBS). However, persistent or severe abdominal pain should not automatically be attributed to stress without appropriate medical assessment.
When should I worry about abdominal pain?
You should seek urgent medical attention if you develop sudden severe abdominal pain, pain associated with fever, persistent vomiting, jaundice, heavy rectal bleeding, a swollen or rigid abdomen, or if you feel faint or collapse. Persistent or recurrent abdominal pain should also be assessed by a specialist.
Can abdominal pain be a sign of cancer?
Most abdominal pain is not caused by cancer. However, persistent abdominal pain associated with unexplained weight loss, rectal bleeding, anaemia or a change in bowel habit should always be investigated to exclude more serious conditions.
Why do I have abdominal pain and nausea?
Nausea commonly occurs alongside abdominal pain and may be caused by a wide range of conditions, including gallstones, appendicitis, bowel obstruction, stomach conditions or viral illnesses. The underlying cause can often be identified through a detailed assessment and appropriate investigations.
Is unexplained weight loss with abdominal pain serious?
Unexplained weight loss should always be assessed, particularly when associated with persistent abdominal pain. Although there are many possible causes, it can occasionally indicate a more serious underlying condition and should not be ignored.
What tests may be needed?
The investigations required depend on your symptoms and examination findings. These may include blood tests, ultrasound or CT scans, MRI scans, flexible sigmoidoscopy or colonoscopy. Investigations are tailored to your individual presentation rather than every patient undergoing the same tests.
Should I see a specialist?
If your abdominal pain persists, keeps returning, is becoming more severe or is associated with symptoms such as rectal bleeding, weight loss, changes in bowel habit or persistent nausea and vomiting, a specialist assessment is recommended. Early assessment can often provide reassurance, establish a diagnosis and allow appropriate treatment to begin.
Will I need surgery?
Not necessarily. Many causes of abdominal pain can be treated without an operation. If surgery is appropriate, this will be discussed with you in detail. If your condition is better managed without surgery, or by another specialist, you will be advised of the most appropriate treatment pathway.
What if no cause is found for my abdominal pain?
Despite thorough assessment and appropriate investigations, some patients do not have a specific cause identified for their abdominal pain. Although this can be frustrating, it often means that serious conditions have been excluded. Treatment can then focus on managing symptoms, improving quality of life and monitoring for any changes over time.