Abdominal Cramping

What is it?

Abdominal cramping — colicky pain that comes in waves — is among the most common GI complaints. The character of colic (building-peaking-subsiding in cycles) reflects smooth muscle contractions in hollow organs. Menstrual cramping (dysmenorrhea) affects 50–90% of menstruating women. IBS is characterized by abdominal cramping relieved by defecation. Biliary colic from gallstones causes intense right upper quadrant cramping. Kidney stone colic is classically severe, unilateral, and radiating from flank to groin. New, severe, or progressive cramping always merits evaluation.

Common causes

When to see a doctor

• 1Severe cramping unresponsive to OTC medications, especially with fever or vomiting
• 2Cramping that begins periumbilically and migrates to the right lower quadrant (appendicitis)
• 3Cramping with inability to pass gas or stool — possible bowel obstruction
• 4Severe flank-to-groin cramping — kidney stone, warrants evaluation for size and passage
• 5Cramping with bloody diarrhea — may indicate IBD or infectious colitis
• 6In women: severe sudden pelvic cramping with a missed period — rule out ectopic pregnancy

What you can do

• ✓Apply a heating pad to the abdomen for menstrual and IBS cramping
• ✓Identify and avoid dietary triggers — common offenders include dairy, fatty foods, and high-FODMAP foods
• ✓Peppermint oil capsules (enteric-coated) reduce IBS abdominal pain and spasm
• ✓Regular physical activity reduces IBS cramping frequency and severity

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions