Sudden or severe abdominal pain that needs careful assessment. Some causes are manageable at home. Others — appendicitis, ectopic pregnancy, obstruction — are surgical emergencies.
Locate the pain precisely. Ask the person to point with one finger to where it hurts most. The location is the most important diagnostic clue.
RIGHT LOWER ABDOMEN — appendicitis territory. Pain that starts around the navel and moves to the right lower abdomen, worsens over hours, with fever and nausea. This is a surgical emergency.
UPPER ABDOMEN — gastritis, peptic ulcer, or pancreatitis. Burning or gnawing pain, worse after eating or with alcohol.
LOWER ABDOMEN IN WOMEN — ovarian cyst, ectopic pregnancy, pelvic inflammatory disease. One-sided pain in a woman of reproductive age needs urgent assessment.
GENERALISED ABDOMEN — peritonitis, bowel obstruction. Board-like rigid abdomen with severe diffuse pain is a surgical emergency.
Assess the severity: Can the person stand up straight? Does movement or pressing make it much worse? Is there fever? Is there vomiting without diarrhoea?
Position of comfort: most people with abdominal pain prefer to lie still. Encourage the least painful position — usually knees drawn up.
Do not give food or water if surgery may be needed.
Monitor closely — note whether pain is improving, staying the same, or worsening over 30 to 60 minutes.
Pain in the right lower abdomen that is worsening over hours — possible appendicitis.
Rigid board-like abdomen — peritonitis or perforation.
One-sided pelvic pain with positive pregnancy test — possible ectopic pregnancy.
Severe pain with vomiting and no bowel movement for more than 24 hours — possible obstruction.
Pain following abdominal trauma.
Vomiting blood or passing black tarry stool with abdominal pain.
Fever above 38.5°C with abdominal pain.
Do not give strong painkillers that mask symptoms — this can delay diagnosis of a surgical emergency.
Do not apply heat to an acutely painful abdomen — can worsen inflammation.
Do not give laxatives for abdominal pain — dangerous if bowel obstruction is present.
A rigid board-like abdomen is always a surgical emergency.
✓ What Helps
· Paracetamol for mild to moderate pain — does not mask surgical symptoms the way stronger drugs do
· Antacids for confirmed gastric pain — aluminium hydroxide or omeprazole
✗ What To Avoid
· Ibuprofen and aspirin worsen gastric ulcers and cause stomach bleeding
· Laxatives with any abdominal pain until cause is known
· Strong opioid painkillers before diagnosis
→ Ask The Pharmacist For
· Urgent medical assessment for any abdominal pain with fever
· Pregnancy test for any woman of reproductive age with lower abdominal pain
· Omeprazole for gastric pain with known ulcer history
🏥 Get Professional Help
Go to hospital immediately for pain in the right lower abdomen that is worsening, a rigid abdomen, one-sided pelvic pain in a woman who could be pregnant, pain with vomiting and no bowel movements, or any severe pain with fever. These are potential surgical emergencies.