Lower abdominal pain: causes, pregnancy, and when to get urgent help

The NHS says stomach (abdominal) pains or cramps are common in pregnancy and are usually nothing to worry about, but can sometimes be a sign of something more serious that needs checking. It is probably nothing to worry about if the pain is mild and goes away when you change position, rest, do a poo or pass wind.

Harmless stomach pains, which can be dull or sharp, may be caused by ligament pain (often called growing pains, which can feel like a sharp cramp on one side of the lower tummy), constipation or trapped wind.

If you have stomach pains and are worried, the NHS says to call your maternity unit, or 111 if the unit is not available. If you are less than 20 weeks pregnant you may need to contact your GP or an early pregnancy unit, depending on what is available in your area.

The NHS says to call your maternity unit immediately if you have stomach pain with any of these: vaginal bleeding or spotting; regular cramping or tightenings; lower back pain; unusual vaginal discharge or fluid leaking; pain when you pee, or needing to pee suddenly or more often; cloudy, pink, red or brown pee; or severe stomach pain that does not go away after you have rested for 30 to 60 minutes. If the unit is not available, call 111. If the pain or bleeding is severe, the NHS says to call 999 and ask for an ambulance.

Pelvic girdle pain is a different, non-dangerous cause. The NHS says pregnancy-related pelvic girdle pain is not harmful to your baby but can be painful and make it hard to get around, and it may affect up to 1 in 5 pregnant women to some degree. Call your midwife or GP if it is hard to move around, or hurts to get out of a car, turn over in bed or go up and down stairs.

The NHS lists common and less common causes of stomach ache, and tells people not to self-diagnose and to see a GP if worried. The NHS also says that pelvic pain is more common in women, and can sometimes be caused in men by an inguinal hernia or by conditions affecting the testicles or prostate, such as prostatitis.

The NHS says to call 999 or go to A&E if a stomach ache came on very suddenly or is severe, hurts when you touch your stomach, or comes with vomiting blood (or vomit like ground coffee), bloody or black sticky and extremely smelly poo, being unable to pee, or unable to poo or fart, difficulty breathing, chest pain, vomiting if you have diabetes, or if someone has collapsed.

For pelvic pain specifically, the NHS says to call 999 or go to A&E if it is severe, getting worse or hurts when you move or touch the area, or you feel faint, dizzy or pass out, have pain in the tip of the shoulder, have difficulty breathing, heavy vaginal bleeding or sudden confusion.

Ask for an urgent GP appointment or get NHS 111 help if the pain gets much worse, does not go away or keeps coming back, you have bloating that persists, problems swallowing, you are losing weight without trying, you suddenly pee more or less often, peeing is painful, you bleed from the bottom or vagina, or you have diarrhoea that lasts more than a few days. The NHS says to get help from 111 for pelvic pain with difficulty peeing or pooing, blood in pee or poo, unusual discharge, a very high temperature, vomiting and diarrhoea, or if you are or may be pregnant.

The NHS says appendicitis usually starts with pain in the middle of the tummy, around the belly button. After a few hours the pain usually moves to the lower right side and gets worse. It may feel worse when you move, cough or press on the area. Other symptoms can include feeling or being sick, loss of appetite, a high temperature, constipation or diarrhoea.

The NHS notes that some people do not have the usual pain pattern; it can be less severe, develop more slowly or be in a different place, which is more likely in pregnancy, young children and older people. If appendicitis is not treated quickly the appendix can burst. Get medical help urgently if you suspect it.

Treatment depends on the cause. For common aches the NHS suggests speaking to a pharmacist about what might be causing the stomach ache and what treatments might help, including medicines for constipation and indigestion.

For pelvic pain the NHS says a GP might suggest antibiotics, painkillers, physiotherapy such as pelvic floor exercises, or hormone treatments, and may refer you for tests or to a specialist if the cause is unclear. Getting diagnosed may take some time, so it helps to give your doctor as much information as possible.

On the NHS, persistent or worrying lower abdominal pain is usually assessed by a GP, who may arrange urine tests, blood tests, scans or a referral to gynaecology, urology or general surgery. In pregnancy the first contact is your maternity unit or an early pregnancy unit.

Private gastroenterology, gynaecology and urology consultations, scans and blood tests are also available on a self-paid or insured basis. Severe or sudden pain should always go to emergency care rather than waiting for an appointment.