Reasons for Chronic Abdominal Pain

Chronic abdominal pain describes persistent or recurrent pain anywhere in the abdomen, which includes the area from the lower edge of the rib cage to the pelvic bone. The digestive organs, including the stomach, liver, gallbladder, pancreas, small intestine and colon, occupy the abdominal cavity. Infections, inflammation, tumors or other abnormalities of the abdominal organs can cause chronic abdominal pain.

Chronic abdominal pain commonly disrupts activities of daily living. (Image: Highwaystarz-Photography/iStock/Getty Images)

Inflammatory Bowel Diseases

Inflammatory bowel diseases are chronic, relapsing disorders affecting the small intestine and colon. The Cleveland Clinic explains that the two variants of inflammatory bowel disease--ulcerative colitis and Crohn’s disease--typically cause episodic, chronic abdominal pain. The pattern of pain mirrors the level of activity of the disease and the areas of intestinal involvement. Ulcerative colitis characteristically affects the colon and rectum. Crohn’s disease may affect any area of the digestive tract, with the small intestine most frequently involved. The Crohn’s and Colitis Foundation of America says that up to 1 million Americans are living with inflammatory bowel disease.

Celiac Disease

Celiac disease, also known as gluten-sensitive enteropathy, is a disorder of the small intestine in which ingestion of gluten-containing foods provokes an aggressive immune response. The absorptive structures of the small intestine sustain damage, leading to a markedly reduced capacity to absorb nutrients. Abdominal pain and gas, weight loss and bloating result. Foods containing wheat, rye or barley contain gluten, as do certain medicines and over-the-counter supplements and vitamins. Complete elimination of dietary gluten permits healing of previous intestinal damage and restoration of normal nutrient absorption. The National Institute of Diabetes and Digestive and Kidney Diseases reports that an estimated one out of 133 people in the United States has gluten-sensitive enteropathy.

Chronic Pancreatitis

Persistent inflammation of the pancreas with concomitant destruction of the organ tissues defines chronic pancreatitis. Chronic, severe abdominal pain proves a hallmark symptom of this condition. In a 2007 review article published in American Family Physician, Dr. Rajasree Nair and colleagues report that alcohol abuse accounts for approximately 70 percent of cases of chronic pancreatitis. Other possible causes include autoimmune disease, cystic fibrosis, chronic renal failure, hyperparathyroidism, primary biliary cirrhosis and tumors in or near the pancreas. Treatment varies according to the underlying cause of the condition.

Chronic Cholecystitis

Repeated gallbladder attacks among people with gallstones may lead to unrelenting gallbladder inflammation, a condition termed chronic cholecystitis. Inflammation causes scarring of the gallbladder wall and shrinkage of the organ. According to “The Merck Manual for Healthcare Professionals,” episodic attacks of gallbladder pain, usually in the right upper region of the abdomen, typify chronic cholecystitis. Nausea and abdominal tenderness may occur, but fever is notably absent. Surgical removal of the gallbladder remains the definitive treatment for chronic cholecystitis.

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