Midabdominal pain is pain that occurs in the middle of the torso. Many conditions can cause it, including Crohn’s disease, celiac disease, gastroenteritis, and small bowel obstruction.

Abdominal pains are quite common and account for 4–5% of all emergency department visits. The onset of pain can be rapid, sudden, or gradual. The type of pain onset can help doctors diagnose what might be causing it.

In this article, we will discuss midabdominal pain, including its locations, causes, and treatment.

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Doctors categorize abdominal pain into upper, middle, and lower abdominal pain. This can help describe where the pain is and may help with identifying the cause.

Midabdominal pain may stem from problems in the middle of the digestive system, which includes the:

  • last part of the duodenum, which connects the stomach to the small intestine
  • jejunum, or the middle part of the small intestine
  • ileum, or the third part of the small intestine
  • cecum, which is a pouch where the small and large intestines meet
  • appendix, which is a slim pouch connected to the large intestine
  • ascending colon, which is the first part of the large intestine and runs up the abdomen
  • first part of the transverse colon, which runs across the abdomen

However, pain in the mid abdomen does not necessarily indicate a problem with one of these body parts. There are three types of abdominal pain:

  • Somatic pain: This type of pain is constant and localized. It occurs due to the irritation of the parietal peritoneum, or the lining of the walls of the abdomen and pelvis.
  • Visceral pain: This pain can be sharp or dull. It results due to stretching of the walls of the viscera, which is the tissue that covers the abdominal organs.
  • Referred pain: This is pain that occurs in a different part of the body from the origin of the pain. For example, appendicitis can cause referred pain in the middle upper abdomen, even though the cause is an infection further down the abdomen.

Therefore, conditions affecting the lining of the abdominal walls or organs, or originating elsewhere in the body, could also be the cause of midabdominal pain.

Possible causes of midabdominal pain include:

Gastroenteritis

Gastroenteritis, or stomach flu, is an infection in the intestines. In most cases, it is not a serious condition and will usually go away on its own.

Gastroenteritis can have different causes, such as:

  • viruses, including rotavirus and norovirus
  • bacteria
  • parasites
  • chemicals

The symptoms of gastroenteritis include:

  • pain in the abdomen
  • nausea
  • vomiting
  • diarrhea

Gastroenteritis does not usually require medical treatment. However, people must drink enough fluids and electrolytes to avoid dehydration.

Some people are more at-risk for severe symptoms and complications, such as pregnant people, those with weakened immune systems, older adults, and infants. People in these groups may need treatment.

Celiac disease

Celiac disease is an autoimmune disease in which a person’s immune system reacts to gluten. Gluten is a protein that is present in wheat, barley, and rye, as well as in foods such as bread, cakes, and pasta.

The gene variants DQ2 and DQ8 are the most common cause of celiac disease. People with these variants are more likely to develop the disease. However, it can also occur in some people who do not possess these variants.

A few common symptoms of celiac disease include:

Celiac disease affects about 1 in 100 people globally. However, only 30% of these people have a formal diagnosis.

The treatment for celiac disease is a strict gluten-free diet. People must read the labels of products such as herbal and nutritional supplements, toothpaste, and skin and hair products to check for hidden sources of gluten.

Crohn’s disease

Crohn’s disease is a type of inflammatory bowel disease (IBD) that results in chronic inflammation of the gastrointestinal tract. About half a million people in the United States have Crohn’s disease.

A few common symptoms include:

There is no cure for Crohn’s disease. Doctors prescribe medications to reduce symptoms. These can include:

  • aminosalicylates
  • immunomodulators
  • corticosteroids
  • biologic therapies

Doctors recommend surgery in severe cases. The types of surgery that may help improve symptoms include:

Small bowel obstruction

Small bowel obstruction is a blockage in the small intestine. The symptoms of small bowel obstruction include:

  • abdominal pain
  • vomiting
  • bloating
  • discomfort

Common causes of small bowel obstruction include:

  • adhesions
  • IBD
  • hernias
  • the presence of foreign objects
  • abnormal twisting of the intestine

Antibiotics, pain control medication, and replenishment of fluids can be useful for treating small bowel obstructions. In some cases, a person may need surgery to remove the blockage.

Chronic mesenteric ischemia

Chronic mesenteric ischemia is a condition that occurs due to inadequate blood flow to the small intestine. This occurs due to blockage or narrowing of the blood vessels.

This condition does not always cause symptoms initially. When symptoms do develop, they include:

  • pain after eating
  • fear of eating
  • weight loss
  • nausea and vomiting
  • constipation or diarrhea

Treatment for chronic mesenteric ischemia can involve surgery to remove any blood clots and widen the blood vessels to restore normal blood flow.

Abdominal pain is common during pregnancy and does not necessarily indicate a serious condition. Abdominal pain in pregnancy can occur due to:

However, abdominal pain can also be due to:

These conditions and complications of pregnancy require treatment, and some are medical emergencies.

Anyone with persistent midabdominal pain should speak with a doctor. This is especially important if they also experience:

  • night sweats
  • unexplained weight loss
  • pain that occurs after eating
  • fear of eating food or trouble eating enough

People who have weakened immune systems, a history of cancer, or cardiovascular disease should also consult a doctor if they develop midabdominal pain.

Pregnant people should seek urgent medical attention if they have abdominal pain along with:

  • bleeding or spotting
  • unusual discharge
  • frequent cramping
  • lower back pain
  • severe pain that does not go away after resting
  • burning or pain when urinating

If any person has the following symptoms, get immediate help:

  • sudden and severe midabdominal pain
  • cramps that keep getting worse
  • severe or bloody vomiting or diarrhea
  • signs of dehydration, such as extreme thirst, dry mouth, lack of tears, or in babies, a soft spot on top of the head

The mid abdomen is a region that comprises parts of the small and large intestines. Pain in this region can occur for many reasons. Some examples include stomach flu, Crohn’s disease, celiac disease, small bowel obstruction, and chronic mesenteric ischemia.

Abdominal pain is common in pregnancy and does not necessarily mean a person has a serious condition. However, people with severe or persistent midabdominal pain should consult a doctor for diagnosis and treatment.