Medical Director
Senior Consultant, General & Colorectal Surgeon
MBBS (Singapore), MRCS (Edinburgh), MMed (Surgery), FRCS (Edinburgh)
That nagging ache in your stomach, the cramps that come and go, or the sharp pain that catches you off guard can be difficult to ignore. Many people brush off abdominal discomfort as something they ate, stress or a temporary digestive upset. While that is sometimes true, persistent or recurring pain is your body’s way of signalling that something may need attention.
Abdominal pain can arise from different parts of the digestive system, including the colon and rectum. When symptoms linger, worsen or are accompanied by changes in bowel habits, it is important to understand what might be causing them. Identifying the source early allows for clearer answers and more effective treatment.
Common Causes of Abdominal Pain
Identifying the cause of abdominal pain is important, especially when symptoms persist or are accompanied by changes in bowel habits. Early evaluation allows for a more accurate diagnosis and timely management. Common causes include:
Colorectal Cancer
Colorectal cancer develops when abnormal cells grow uncontrollably in the colon or rectum and form tumours. In its early stages, symptoms may be minimal or absent. As the disease progresses, it can cause persistent abdominal pain or cramping, sometimes due to partial bowel obstruction or inflammation around the tumour.
Colorectal Polyps
Colorectal polyps are small growths that form on the lining of the colon or rectum. While many polyps are benign, some may develop into cancer over time. Larger polyps can cause abdominal discomfort, bloating or changes in bowel habits, particularly if they interfere with the normal passage of stool.
Diverticular Disease
Diverticular disease occurs when small pouches, known as diverticula, develop in the lining of the colon. While these pouches may not cause symptoms on their own, they can become inflamed or infected, leading to diverticulitis. This condition often causes abdominal pain, commonly in the lower abdomen, along with fever, nausea and changes in bowel habits.
Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis, both of which involve chronic inflammation of the digestive tract. Abdominal pain may range from mild cramping to severe discomfort, depending on the extent and location of inflammation.
Crohn’s disease can affect any part of the gastrointestinal tract and may cause pain in the lower abdomen or around the navel. Ulcerative colitis primarily affects the colon and rectum, often resulting in lower abdominal pain accompanied by diarrhoea, sometimes with blood.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a functional gastrointestinal disorder characterised by abdominal pain, bloating and altered bowel habits, including diarrhoea, constipation or both.
Unlike inflammatory bowel disease, IBS does not cause structural damage or visible inflammation in the bowel. Instead, it involves altered gut sensitivity and bowel motility. Abdominal pain in IBS is often linked to stress, dietary triggers or hormonal changes and may improve after passing stool.
Gastrointestinal Infections
Gastrointestinal infections caused by bacteria, viruses or parasites can lead to sudden abdominal pain. Common examples include food poisoning, norovirus and bacterial infections such as Salmonella or E. coli. These infections often cause cramping, diarrhoea, nausea and sometimes fever.
When to Seek Prompt Medical Attention
Not all abdominal pain requires urgent care, but certain symptoms should prompt medical evaluation. Seek medical attention if you experience:
- Severe or persistent abdominal pain that lasts more than a few days or worsens over time
- Pain accompanied by fever, vomiting, blood in the stool or unexplained weight loss
- Sudden, intense abdominal pain, which may indicate a medical emergency such as bowel obstruction or perforation
- Significant or ongoing changes in bowel habits
- New abdominal pain if you have a history of colorectal cancer, polyps or inflammatory bowel disease
How Is Abdominal Pain Diagnosed?
To determine the cause of abdominal pain, doctors rely on a combination of medical history, physical examination and diagnostic tests.
- Stool Tests: These are used to detect infections, inflammation or the presence of hidden blood in the stool. They are particularly useful in identifying bacterial or parasitic infections and monitoring conditions like IBD.
- Imaging Tests: Imaging techniques, such as CT scans or abdominal ultrasounds, can help identify structural abnormalities in the gastrointestinal tract. These tests are often used to diagnose conditions like diverticulitis, intestinal blockages or tumours.
- Colonoscopy: A colonoscopy is considered the gold standard for evaluating the colon and rectum. This procedure involves the use of a flexible camera to examine the lining of the colon and rectum, allowing for the identification of polyps, inflammation or cancer. If necessary, small tissue samples (biopsies) can be taken during the procedure for further analysis.
Manage Persistent Abdominal Pain with Dr Chew Min Hoe
Living with ongoing abdominal discomfort can be frustrating and unsettling, particularly when the cause is unclear. A proper assessment not only identifies the source of the pain but also helps rule out more serious colorectal conditions, giving you confidence about the next steps.
Senior Consultant General and Colorectal Surgeon Dr Chew Min Hoe provides careful evaluation of abdominal and bowel-related symptoms at our endoscopy clinic. If your pain has not resolved or you are concerned about accompanying changes in your bowel habits, arrange a consultation to receive a clear diagnosis and appropriate guidance.