Merck Manual

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History in People With Acute Abdominal Pain

History in People With Acute Abdominal Pain

Questions That Doctors Ask

Possible Responses

Possible Causes or Source

Where is the pain?

What is the pain like?

Waves of sharp pain that “take the breath away”

Renal or biliary colic (episodes of intense pain in the kidneys or gallbladder)

Waves of dull pain with vomiting

Colicky pain that becomes steady

Strangulating intestinal obstruction (blockage that cuts off the blood supply to the intestines)

Sharp, constant pain, worsened by movement

Tearing pain

Dull ache

Kidney infection

Have you had it before?


Did the pain begin suddenly?

Sudden ("like a light switching on”)

Some ruptured aneurysms

Less sudden

Most other causes

How severe is the pain?

Severe pain

A tear (perforation) in an organ

Severe pain but a comparatively normal physical examination

Does the pain travel to any other part of your body?

Right shoulder blade

Gallbladder pain

Left shoulder region

Pubic bone or vagina

Kidney pain


Sometimes perforated ulcer

What relieves the pain?



Lying as quietly as possible

What other symptoms occur with the pain?

Vomiting that precedes the pain and is followed by diarrhea

Delayed vomiting, no bowel movements, and no passing of gas (flatulence)

Severe vomiting that precedes intense pain in the upper middle of the abdomen, left chest, or shoulder