Health condition
Chronic abdominal pain
Abdominal pain lasting three months or more has a wide range of causes, and when structural disease has been excluded, gut-brain (functional) pain is common and genuinely treatable.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
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Structural causes are sought first: gallstones, ulcers, IBD, pancreatic and gynaecological disease
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Red flags: weight loss, bleeding, vomiting, fever, nocturnal pain or abnormal blood tests
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Specialist: a consultant gastroenterologist coordinates targeted investigation
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Treatment of functional pain includes neuromodulators (such as low-dose amitriptyline) and gut-brain therapies
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
Long-standing abdominal pain wears people down, and its assessment benefits from structure: the site, pattern, meal relationship and accompanying features narrow a long list that spans acid-related disease, gallstones, inflammatory bowel disease, pancreatic problems, gynaecological conditions, nerve entrapment in the abdominal wall, and centrally mediated abdominal pain syndrome.
Diagnosis and treatment routes
Investigation is targeted rather than exhaustive, bloods, stool markers, imaging and endoscopy as the picture dictates, and a confidently negative work-up is itself diagnostic, pointing to gut-brain pain. That diagnosis opens effective options: neuromodulating medication, CBT and gut-directed hypnotherapy, and avoiding the cycle of repeated scans and opioids that makes chronic pain worse. In many parts of the UK, routine NHS referrals for this kind of problem currently take 20-45+ weeks, whereas an initial appointment with a private consultant is typically available within around two weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant gastroenterologist. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Chronic abdominal pain.
Quick, plain-English answers to what people ask us most.
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What is chronic abdominal pain?
Chronic abdominal pain is pain in the abdomen lasting for three months or more, or recurring frequently over that period, which can have a wide range of possible causes, from functional conditions like irritable bowel syndrome to structural or inflammatory conditions such as inflammatory bowel disease or gallstones. Because the range of causes is so broad, a systematic assessment is usually needed to identify the underlying reason. It can significantly affect quality of life if not adequately investigated and managed.
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What causes chronic abdominal pain?
Common causes include irritable bowel syndrome, inflammatory bowel disease, gallstones, chronic pancreatitis, endometriosis, and functional dyspepsia, among many other possibilities. Sometimes pain persists even after a specific structural cause has resolved, related to changes in pain processing (sometimes called visceral hypersensitivity). Identifying the specific pattern, location, and associated symptoms helps narrow down the likely cause.
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When is chronic abdominal pain more concerning?
Certain features increase the likelihood of a more significant underlying cause needing prompt investigation, including unexplained weight loss, blood in stool, fever, pain that wakes you from sleep, or onset after age 50. These 'red flag' features generally prompt more urgent or thorough investigation. Pain without these features is more likely, though not certain, to reflect a functional cause.
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How is chronic abdominal pain investigated?
Investigation typically starts with a detailed history and examination, blood tests, and sometimes stool tests, followed by imaging (such as ultrasound or CT) or endoscopic procedures depending on the suspected cause and any red flag features present. The specific pathway depends on your age, symptom pattern and any additional risk factors. A structured, stepwise approach usually identifies the cause or provides reassurance that no serious cause is present.
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Can chronic abdominal pain be treated even without a clear structural cause?
Yes, functional pain conditions like irritable bowel syndrome, while not caused by a visible structural abnormality, are genuinely painful and can often be significantly improved with dietary changes, specific medications, and, for some people, psychological approaches such as gut-directed hypnotherapy or CBT that address the pain-processing aspect. Getting an accurate diagnosis, including ruling out other causes, is an important first step before starting targeted treatment. Many people achieve meaningful symptom improvement with the right combination of treatments.
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When should I see a specialist?
See a doctor if abdominal pain persists for more than a few weeks, worsens, or occurs with weight loss, bleeding, fever, or other concerning symptoms. NHS gastroenterology referral can take several weeks; a private gastroenterology consultation is typically available within about 2 weeks for earlier, more thorough investigation.