Abdominal pain is one of the most common reasons people attend A&E. In many cases, the cause is minor and settles on its own. In others, the pain is a warning sign of a surgical emergency where delay can significantly increase risk.

The difficulty for patients is knowing the difference. Emergency abdominal conditions often begin with vague or non‑specific symptoms before progressing rapidly. Understanding when pain is concerning, what happens during emergency assessment, and why prompt treatment matters can help people seek care at the right time without unnecessary panic.

This guide explains emergency abdominal pain, key red‑flag symptoms, common conditions such as appendicitis and bowel obstruction, what to expect in hospital assessment, and why delays increase the risk of complications.

What Is Emergency Abdominal Pain?

Emergency abdominal pain refers to sudden or worsening pain caused by conditions that may require urgent surgical treatment. Unlike mild digestive discomfort, this pain often progresses, fails to settle, or is accompanied by systemic symptoms such as fever or vomiting.

Emergency causes are not always obvious at first. Pain location can change, symptoms can evolve over hours, and early findings may be subtle. This is why repeated assessment and monitoring are sometimes necessary.

Red‑Flag Symptoms You Should Never Ignore

Certain features suggest that abdominal pain may be serious and require urgent medical review.

Seek urgent assessment or attend A&E if abdominal pain is associated with:

• Severe or worsening pain over several hours
• Pain that becomes constant rather than intermittent
• Fever or chills
• Persistent vomiting or inability to keep fluids down
• Abdominal swelling or distension
• Inability to pass stool or wind
• Blood in vomit or stool
• Pain with tenderness when the abdomen is pressed

These symptoms do not always mean surgery is required, but they do indicate that further assessment should not be delayed.

Common Surgical Causes of Emergency Abdominal Pain

Appendicitis Symptoms

Appendicitis often begins with vague discomfort around the belly button before moving to the lower right side of the abdomen. Symptoms may include:

• Increasing abdominal pain
• Loss of appetite
• Nausea or vomiting
• Fever
• Pain that worsens with movement or coughing

Early diagnosis reduces the risk of perforation and infection.

Bowel Obstruction Signs

A bowel obstruction occurs when intestinal contents cannot pass normally. Common features include:

• Cramping or severe abdominal pain
• Abdominal bloating or distension
• Vomiting
• Inability to pass stool or wind

Obstruction can worsen quickly and may compromise blood supply to the bowel if untreated.

Perforation and Infection

Conditions such as perforated ulcers, diverticulitis, or severe infections can allow bowel contents to leak into the abdomen. This often causes sudden, severe pain and rapid deterioration.

When to Go to A&E for Stomach Pain

A&E assessment is appropriate when abdominal pain is severe, worsening, or associated with red‑flag symptoms. It is also advised when pain is new and unexplained, particularly in older adults, pregnant patients, or those with previous abdominal surgery.

Trusting instinct matters. Pain that feels different from usual indigestion or that prevents normal movement should be assessed.

What Happens During Emergency Assessment?

Emergency abdominal assessment follows a structured approach designed to identify serious causes quickly.

Clinical Examination

Doctors assess pain location, severity, guarding, and signs of infection or dehydration. Repeated examinations may be necessary as symptoms evolve.

Blood Tests

Blood tests help identify infection, inflammation, dehydration, organ dysfunction, or internal bleeding.

Imaging

Ultrasound or CT scans are commonly used to clarify diagnosis. Imaging helps determine whether surgery is needed and how urgently.

Why Delays Increase Risk

Delaying assessment or treatment can allow inflammation, infection, or obstruction to worsen. This may lead to complications such as perforation, sepsis, or the need for more extensive surgery.

Early treatment often allows simpler procedures, shorter hospital stays, and better recovery.

Emergency Surgery: What Patients Should Expect

Not all patients assessed for emergency abdominal pain will need surgery. Many conditions can be treated with observation, antibiotics, or supportive care.

When surgery is required, decisions are made quickly but carefully, balancing urgency with safety. Patients are kept informed throughout the process whenever possible.

The Takeaway

Emergency abdominal pain should never be ignored, but it also does not always mean surgery. Recognising red‑flag symptoms, seeking timely assessment, and understanding the emergency process helps reduce risk and improves outcomes.

Prompt evaluation saves lives by ensuring that serious conditions are treated early and safely.

Frequently Asked Questions (FAQs)