Surgical Emergency SignsSudden severe pain, rigid abdomen (peritonitis), pain with shoulder tip, collapse, or known AAA — call 999/911. Do not eat or drink.
Pain Location Guide
| Region | Top Causes |
|---|---|
| Right upper quadrant (RUQ) | Gallstones, cholecystitis, hepatitis, liver abscess |
| Left upper quadrant (LUQ) | Splenomegaly, gastric ulcer, pancreatitis (left-sided) |
| Epigastric (centre-upper) | GERD, peptic ulcer, pancreatitis, MI (atypical) |
| Right lower quadrant (RLQ) | Appendicitis, ovarian cyst, ectopic pregnancy, Crohn's |
| Left lower quadrant (LLQ) | Diverticulitis, IBS, ovarian cyst, ectopic pregnancy |
| Periumbilical | Early appendicitis, bowel obstruction, mesenteric ischaemia |
| Suprapubic | UTI, cystitis, fibroid, ectopic, PID |
| Diffuse / generalised | Peritonitis, obstruction, severe gastroenteritis, IBS |
Murphy's Sign
RUQ pain that worsens sharply when the patient takes a deep breath while the examiner presses under the right rib cage — highly suggestive of acute cholecystitis (gallbladder inflammation).
When to Go to A&ESevere sudden-onset pain, fever above 38.5 °C with abdominal pain, vomiting blood, no bowel movement for >3 days with distension, or pain in a known pregnancy.
How do I know if I have appendicitis?
Pain that starts around the navel and moves to the right lower quadrant, accompanied by fever, nausea, and loss of appetite is classic appendicitis. It typically worsens over 12–24 hours — seek urgent care.
Can stress cause abdominal pain?
Yes. Irritable bowel syndrome (IBS) is closely linked to stress and anxiety. The pain is typically crampy, comes with altered bowel habit, and is relieved by passing wind or stool.
What causes sudden severe upper abdominal pain?
Consider pancreatitis (radiates to back, worse lying flat), peptic ulcer perforation (sudden, board-like abdomen), or biliary colic (gallstones, RUQ, after fatty meal).
Is period pain normal?
Mild-to-moderate cramping is normal. Severe pain that disrupts daily life, pain outside of periods, or progressively worsening period pain may indicate endometriosis — see a GP.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.