Body News, Health & Fitness, Wellbeing

When It’s More Than Just A Stomachache – Tan Lili

How do we know if that nagging discomfort is simply a symptom of irritable bowel syndrome (IBS), or something worse? Tan Lili speaks to a gastroenterologist and an urologist to find out more.

This abdominal pain is not a first-world problem, thank you very much.

This abdominal pain is not a first-world problem, thank you very much.

All of us experience abdominal pain many times in our lives, but because stomachache is so common, diagnosing the cause of it can be difficult. At best, it is mild and can be effectively treated by self-medication – which is usually the case; at worst, it could be a sign of something sinister and lead to life-threatening consequences if not managed early.

The most common cause of abdominal pain, according to Dr Lim Lee Guan, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine Centre, is irritable bowel syndrome (IBS). Studies showed that the prevalence of IBS in Singapore was 8.6 percent in 2004 – up from 2.3 percent in 1998. But how do we know if the pain is caused by something more serious?

“Abdominal pain may be sometimes be caused by serious conditions, such as acute appendicitis (severe pain in right lower abdomen) and acute cholecystitis (inflammation of gallbladder, usually with pain in right upper abdomen),” says Dr Lim. “In females, abdominal pain may also be caused by gynaecological conditions, such as ectopic pregnancy. These conditions may be life-threatening if they are not managed early. These conditions require specialised treatment in a hospital, and could involve surgery.”

Below, Dr Lim explores the different causes of abdominal pain and their symptoms.


A condition in which you suffer from abdominal discomfort that’s often accompanied by diarrhea, constipation, or alternating diarrhea and constipation, IBS is the most common cause of abdominal pain in Singapore. Management includes lifestyle and dietary adjustments as well as medical treatment. Some of the former include avoiding stimulants such as caffeine, dairy products and artificial sweeteners; drinking lots of water and avoiding carbonated beverages; and maintaining good physical fitness.


A burning sensation felt around the lower chest area, heartburn is caused by gastric acid refluxing into the oesophagus/food pipe. It can be treated via over-the-counter antacids, which work to quickly neutralise acid and soothe the burn. Lifestyle changes can also be adopted to improve your heartburn symptoms, like eating slowly and avoiding trigger foods such as caffeine.


Stomach and duodenal ulcers are caused by variable factors such as Helicobacter pylori and medications (e.g. NSAIDs), which result in the thinning of the layer of mucus that is supposed to protect your stomach from digestive juices. This, in turn, causes painful sores in the stomach lining or small intestine. Medications are usually prescribed to alleviate the symptom; if the ulcers perforate and bleed, an endoscopic treatment would be required.

Gastroenteritis (stomach flu/food poisoning)

Common symptoms of patients with gastroenteritis include abdominal pain, vomiting and diarrhea. In severe cases, you can get dehydrated, in which case you may need intravenous hydration. Most acute gastroenteritis cases improve with symptomatic treatment, although in some cases antibiotics may be needed.


The pain is felt over the lower right part of your abdomen, and it can either come on slowly or manifest as sharp, stabbing pains that worsen with movement. Caused by an inflammation of the appendix, it requires immediate medical attention and surgery to remove said appendix (don’t worry, we can all live without it). If not treated quickly, the inflamed appendix may perforate or burst, which could lead to peritonitis – a potentially fatal inflammation of the abdomen’s lining.

Since the abdomen constitutes the part of the body between the chest and pelvis, you should never rule out urological conditions when experiencing abdominal pain. Here, Dr Fong Yan Kit, Specialist in Urology & Consultant, Raffles Urology Centre, explains two possible causes:

Bladder Infection

It is very common among women – most would have at least one infection in their lifetime. The typical symptoms are lower abdominal pain, associated with painful and frequent urination. Bladder infections are generally not serious and can be treated with antibiotics.

Kidney Stones

Pain caused by obstructing kidney stones is one of the worst pains one could ever experience. It typically starts from the loin then radiates to the groin. The treatment depends on the size and location of the stones. While small stones can usually pass through the urinary tract, larger stones would need to be fragmented through either shock wave or laser therapy.

This list, of course, only serves as a general guide to the more common causes of abdominal pain. Always consult your doctor if your, um, gut tells you your condition requires medical attention.

About The Author: A founder of Material World, Tan Lili has previously worked in magazines The Singapore Women’s Weekly and Cosmopolitan Singapore, as well as (now, the online counterpart of Her World). She is now a freelance writer who works on this website full-time. Lili hopes to travel the world, work with wild animals, and discover more awesome Twilight fan-fiction. Follow her on Twitter @TanLiliTweets.