Manhattan Gastroenterology
  • MIDTOWN 51 EAST 25TH, 4 FL New York, NY, 10010
  • UPPER EAST SIDE 983 PARK AVE, STE 1D New York, NY, 10028
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Abdominal pain
is very common, and in many instances, it gets better after some time. However, extreme abdominal pain can be serious as it becomes difficult to pinpoint the exact location where it is occurring and what may be causing it. To prevent stomach problems and ensure you continue to enjoy the foods you love, you must consult experienced and board-certified gastroenterologists in NYC. The top-rated gastro doctors at Manhattan Gastroenterology are renowned for their expertise in preventing, diagnosing, and treating digestive disorders and help to relieve your pain by detecting its exact causes. Combining their unmatched knowledge and skills with state-of-the-art technology, the GI specialists deliver highly personalized care to ensure your long-term stomach health and overall wellbeing.

Pain Locator
Pain Locator

Most of us experience abdominal discomfort or pain several times during our lives. Also known as stomach ache or bellyache, adnominal pain is usually felt in the part of the trunk below the ribs, above the pelvic, and the groin. It can range in intensity from a mild ache to severe, restricting pain.

There can be several causes behind abdominal pain. Some of them may be obvious like upset stomach, food poisoning, gas, constipation or medical conditions like gallstones or pancreatitis, or even some injury. In many cases, getting to the root of stomach pain is not easy, and seeking professional care becomes necessary to determine where it is originating from. Understanding the regions and quadrants of the abdomen can help pinpoint the possible sources and conditions associated with them.

It is essential to become acquainted with the nine regions and four quadrants of the abdomen to know how digestive organs function and are susceptible to a variety of medical issues. Learning about the type of pain you are experiencing, where it is coming from, and the severity of your ailment can help you seek correct treatment before your condition worsens.

9 Regions of the Abdomen

Your abdomen can be divided into several sections or regions to simplify diagnosis and locate the precise area where you are experiencing pain. Each region or section of the abdomen can be numbered. Regions 1 to 3 are the top row from right to middle and left, regions 4 to 6 are the middle portions, while regions 7 to 9 comprise the bottom row.

Region 1 – Right Hypochondriac Region

The liver, gallbladder, right kidney, and small intestine are present in the upper right side of this region.

Region 2 – Epigastric Region

It is the upper middle part of the stomach where liver, pancreas, duodenum, and the first part of the small intestine, spleen, and adrenal glands are present.

Region 3: Left Hypochondriac Region

It is the upper left region where the spleen, colon, left kidney, and pancreases are present.

Region 4: Right Lumbar Region

The gallbladder, liver, and colon are located in the middle right part of the stomach.

Region 5 – Umbilical Region

Umbilicus (navel), Jejunum (the part of the small intestine between the duodenum and ileum), Ileum (the third portion of the small intestine, between the jejunum and the cecum), and duodenum are present in the center part of the stomach.

Region 6 – Left Lumbar Region

It is the middle and left part of the stomach that consists of the descending colon, the part of the large intestine that passes downward on the left side of the abdomen toward the rectum and the left kidney.

Region 7 – Right Iliac Fossa

Appendix and cecum, a pouch connected to the junction of the small and large intestines, are present in this part of the abdomen.

Region 8 – Hypogastric Region

It is the lower and middle part that contains the urinary bladder, the sigmoid colon, which is the S-shaped last part of the large intestine, leading into the rectum and the female reproductive organs.

Region 9 – Left Iliac Fossa

Descending colon and sigmoid colon are present in this section.

Quadrants

It is often a challenge to pinpoint the exact origins of abdominal pain. Identifying the location of the pain can help healthcare providers work out the source and causes of stomach pain. The quadrants represent locations, as they are formed by a vertical and horizontal imaginary line that divides the abdominal-pelvic cavity into four parts.

The four quadrants are:

  • Right upper
  • Right lower
  • Left upper
  • Left lower

Right Upper Quadrant

Organs located in this quadrant include:

  • Liver
  • Gallbladder
  • Duodenum
  • The upper portion of the pancreas
  • The hepatic flexure of the colon

Pain in the upper right quadrant may be resulting from hepatitis, cholecystitis, or the formation of a peptic ulcer.

Cholecystitis

This condition occurs if the gallstones make their way into the bile duct, which prevents the bile from flowing out. It can lead to inflammation in the gallbladder. Symptoms of Cholecystitis include:

  • Nausea
  • Vomiting
  • Belly pain that worsens when you take deep breaths
  • Possible aches in the back or right shoulder blade

In some cases, the presence of bacteria can also cause Cholecystitis.

Hepatitis

Inflammation of the liver, due to any reason, can cause hepatitis. Most cases of hepatitis result from viral infections, but it could also result from excessive use of drugs or alcohol abuse.

The most common types of hepatitis are:

  • Hepatitis A – This virus causes acute inflammation and usually heals by itself. It is easily spread in food and water and often infects many people at once.
  • Hepatitis B – This virus can result in acute or short-term illness and chronic, ongoing illness. It spreads through blood or other body fluids in various ways.
  • Hepatitis C – The Hepatitis C Virus (HCV) is almost always chronic and spreads usually by blood. Certain strains of Hepatitis C may be cured by a regimen of direct-acting antiviral medications.

Hepatitis A and B can be prevented by vaccination, but vaccines cannot prevent hepatitis C.

Peptic Ulcer

A hole in the lining of the digestive tract is a peptic ulcer. The ulcers occur when the lining of the stomach, duodenum, or esophagus is eroded by the acidic digestive juices secreted by the stomach.

Causes of peptic ulcer formation are linked to the following:

  • Helicobacter pylori (H. pylori) – a type of stomach infection and inflammation-causing bacteria
  • Excessive use of non-steroidal anti-inflammatory drugs non-steroidal anti-inflammatory drugs, NSAIDs such as aspirin, ibuprofen, and other anti-inflammatory drugs
  • Smoking and drinking
  • Radiation therapy
  • Stomach cancer
  • Certain genetic factors

Right Lower Quadrant

Organs located in this quadrant include:

  • Appendix
  • The upper portion of the colon
  • The right ovary
  • Fallopian tube in women

Healthcare providers assess the right lower quadrant when they are striving to diagnose appendicitis. In such a case, this quadrant will be painful and tender.

Appendicitis

It is a condition in which the appendix becomes inflamed and filled with pus, causing pain. If it is left untreated, appendicitis can cause the rupture of the appendix and cause infection, which can be serious and even fatal.

Left Upper Quadrant

Organs located in the left upper quadrant include:

  • Stomach
  • Spleen
  • The left portion of the liver
  • The main body of the pancreases
  • The left portion of the kidney
  • Adrenal glands
  • Splenix flexure of the colon
  • The bottom part of the colon

In case of appendicitis or any abnormalities of the intestines, such as malrotation, this quadrant may feel tender and hurt.

Left Lower Quadrant

Organs found in the quadrant include:

  • Sigmoid colon
  • Left ovary
  • Fallopian tube in women

Pain in this quadrant indicates symptoms of colitis, diverticulitis, or kidney stones. In women, pain in this part of the stomach may be resulting from an ovarian cyst or pelvic inflammation.

Diverticulitis

Diverticulitis is the infection or inflammation of small pouches that form in the lining of the digestive system. These pouches, known as the diverticula, are found in the lower part of the large intestine. They are not harmful, but when one or more diverticula becomes infected or inflamed, it can result in pain and other symptoms.

Ureteral Colic

Also known as renal colic, this condition results from the obstruction of the urinary tract by kidney stones.

Colitis

Colitis is inflammation of the colon, also known as the large intestine. The three most common forms of colitis are:

  • Ulcerative colitis – It is the most commonly known type of colitis that occurs when the immune system overreacts to bacteria and other substances in the digestive tract. It causes sores or ulcers and inflammation in the lining of the color.
  • Crohn’s disease – It is a chronic inflammatory bowel disease (IBD) that occurs in the small intestine and the colon, causing inflammation and pain. It can affect any part of the gastrointestinal tract (GI) and produce mild to debilitating symptoms.
  • Infection – It occurs from the overgrowth of the bacterium Clostridium difficile (C. diff). This kind of bacteria is present in the intestine but does not pose a threat as it is balanced by the presence of good bacteria. The use of certain medications like antibiotics can kill healthy bacteria, and C. diff releases toxins that cause inflammation.

What Abdominal Pain Feels Like?

You may experience the following in case of abdominal pain:

  • Cramps
  • Pressure
  • Bloating
  • Sharp, intense pain
  • Stabbing or tearing pain
  • Twisting or perching

Other types of pain have been described as:

  • Constant
  • Recurring
  • Fluctuating
  • Modified by movement, eating, bowel movements, or walking
  • Pain that is affected by situations like stress or medications

You may experience one type of pain, or the type of pain may change depending on its causes and source. If you experience any symptoms associated with stomach pain, call your primary care doctor to have your condition accurately diagnosed and treated.

How Long Does Abdominal Pain Last?

Stomach pain can last anywhere from a few minutes to several hours and even more. Some people experience sudden, sharp pain in particular areas of the stomach that subsides after a short time, while others experience lasting mild or severe stomach pain, which becomes unbearable.

Seek immediate medical attention if your abdominal ache is accompanied by any of these:

  • Fever
  • Bloody stool
  • Nausea and vomiting that do not seem to go away
  • Weight loss
  • Yellowish skin
  • Abdomen very tender to touch
  • Swollen abdomen

These symptoms indicate a disruption of the normal functioning of an organ or area of tissue inside the abdomen.

What Triggers Sudden Stomach Pain?

Stomach pain gets triggered by gas, acidity, food or constipation, or even gallstones and injury to the surrounding areas. Pain resulting from food-related problems is not harmful and improves with time and medication.

However, if you have suffered an injury or have gallstones and you feel sharp pain in the right side, left side, upper side, lower side, and middle, you should seek immediate medical help. Discomfort in the stomach without apparent cause may indicate an underlying health condition. By understanding the region of pain, you can make out the type of pain you are experiencing. It also helps your doctor identify what is causing the pain and begin with the treatment.

How Abdominal Pain Is Diagnosed?

The doctor will work out the causes of your abdominal pain by noting down your symptoms and medical history, performing a physical exam, and conducting tests if needed. You will be asked questions about the type of pain you are experiencing and if you have any physical or mental health issues that may be contributing to your condition.

The doctor may ask the following questions about the pain you are going through:

  • Where it is located?
  • How intense is it?
  • Is it dull or sharp or intense and stabbing?
  • Does it come and go, or it is persistent?
  • When do you feel or notice it most?
  • Does it radiate outward to other areas of the body?
  • How long have you been experiencing this pain?
  • Does it intensify or subside with any activities or movements?

The doctor takes in factors like recent injuries and your lifestyle habits to analyze your condition and find the exact location of your abdominal discomfort.

The following tests are used for interpreting the cause of your abdominal pain if your doctor suspects something serious:

  • Blood, urine, or stool tests
  • Abdominal x-ray
  • Ultrasound
  • CT scan of the abdomen
  • Colon x-ray, also known as barium enema
  • Endoscopy

Identifying the location of the pain is the first step towards treatment. Many forms of abdominal pain get better on their own or need home care, such as those resulting from food allergies, constipation, or stomach viruses. But abdominal disturbances caused by acute or chronic conditions require extensive treatment before they get better.

Abdominal pain is not normal, but it is not necessarily critical and often resolves itself. Persistent, recurring, or intense abdominal pain should not be ignored as it may be a sign of some underlying medical problem. Schedule an appointment with top board-certified and experienced GI specialists to get the best gastroenterology care. They work closely with you to fully understand your pain and its effects to diagnose your condition and provide lasting relief. With their expertise and knowledge, gastrointestinal doctors NYC determine which region or quadrant of your abdomen is hurting and come up with targeted solutions that alleviate the pain and enhance your quality of life.

Updated on Aug 27, 2022 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology