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What causes abdominal tenderness? 16 possible conditions

Point Tenderness in Abdomen

Point tenderness in your abdomen is pain that occurs when your abdomen is pressed in a specific area. It is also known as abdominal tenderness. Point tenderness is often a sign that something is wrong with one or more organs in the area being pressed. All disorders that cause abdominal point tenderness are medical emergencies. Always seek emergency medical help if you have abdominal tenderness.


Doctors divide the area of the abdomen into four quadrants:

  • right upper quadrant (liver and gallbladder)
  • left upper quadrant (stomach and duodenum)
  • right lower quadrant (appendix)
  • left lower quadrant (sigmoid colon)

Problems with pelvic organs can also cause right or left lower quadrant tenderness. These organs include the ovaries and fallopian tubes. The most well known type of point tenderness is McBurney’s point. McBurney’s point is located in the right lower quadrant, in the area of your appendix. Point tenderness over McBurney’s point tells the doctor that your appendix is very inflamed. At this point, you are at risk for rupturing.

Common Causes of Abdominal Point Tenderness

Point tenderness is generally a sign of inflammation or other acute processes in one or more organs, located in the same area as the tenderness. Twisted or blocked organs, such as your fallopian tubes or colon, can also cause point tenderness.

Some common causes of abdominal point tenderness are:

  • appendicitis
  • abdominal abscess
  • Meckels diverticulum (a small pouch on the lower large intestine that is present at birth; occurs in two percent of the population)
  • hernias
  • twisted fallopian tubes
  • ruptured ovarian cyst
  • ruptured ectopic pregnancy
  • diverticulitis (inflammation of the inner lining of the intestines)
  • pelvic inflammatory disease

Associated Symptoms

Symptoms that go along with abdominal point tenderness are:

  • loss of appetite
  • nausea
  • vomiting
  • abdominal pain
  • constipation
  • diarrhea
  • pale stools
  • distended abdomen
  • jaundice
  • fainting
  • missed periods
  • fever

What to Expect From the Doctor

Your doctor will take a complete medical history and perform a physical examination. Your doctor will want to know about all of the symptoms you have and when they started. Your doctor will also want to know what makes your symptoms feel better and what makes them worse.


Some of the tests that will help pinpoint the cause of abdominal point tenderness are:

  • complete blood count (a blood test that helps assess your general health. An elevated white blood cell count tells the doctor that inflammation is present.)
  • C-reactive protein (a blood test that is positive when inflammation is present)
  • serum pregnancy test (a blood test for pregnancy that is more sensitive than a urine pregnancy test)
  • abdominal or pelvic ultrasound (a noninvasive test that uses sound waves to make images of abdominal and pelvic organs)
  • abdominal X-ray (a noninvasive test that uses X-rays to examine your abdominal organs)
  • abdominal computed tomography (CT) scan (a noninvasive test that uses X-rays to make high resolution images of your abdominal organs)


The treatment of abdominal point tenderness depends upon the underlying cause. Options for treatment of appendicitis include intravenous antibiotics and surgical removal of the appendix. Colon obstruction may require that a part of the colon be removed. Hernias, twisted fallopian tube, and ectopic pregnancy may require surgery.

If you are very ill and tests don’t show exactly which organ is causing abdominal point tenderness, doctors may perform a laparoscopic examination. A laparoscopic examination is a surgical procedure that requires general anesthesia. It involves inserting a laparoscope (a thin tube with a light attached to it) into the abdomen. The laparoscope is inserted through a small incision in the skin. Once inside, it allows doctors to see which organ inside your abdomen or pelvis is causing the problem.

Other treatment options include intravenous fluids and electrolytes. Nausea, vomiting, and diarrhea can cause your body to become dangerously low in water and electrolytes. Water and electrolytes (such as sodium, potassium, chloride, and bicarbonate) help to maintain your blood pressure and acid-base balance. Severe dehydration can cause dangerously low blood pressure (shock). Shock reduces blood flow to all vital organs. It can also damage your kidneys, heart, and brain. Your doctor may give you intravenous fluids and electrolytes. Both help treat dehydration and maintain your blood pressure.

Long-Term Consequences of Non-Treatment

Long-term consequences for untreated abdominal point tenderness are life-threatening. Left untreated, appendicitis can result in a ruptured appendix and peritonitis (inflammation of the inner lining of the abdomen). An untreated ectopic pregnancy can cause death. This would occur as a result of severe blood loss. An untreated twisted fallopian tube or pelvic inflammatory disease can cause you to have pelvic scarring and infertility. Untreated diverticulitis can be fatal.

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See a list of possible causes in order from the most common to the least.



This condition is considered a medical emergency. Urgent care may be required.

Appendicitis is inflammation of the appendix, which can be fatal if left untreated. The telltale sign is pain that usually starts as mild cramping, especially on the right side, and becomes more severe over time.

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This condition is considered a medical emergency. Urgent care may be required.

Peritonitis is the inflammation of a thin layer of tissue inside the abdomen. Caused by bacteria or fungus, it causes tenderness, bloating, fatigue, greying of the skin, and other problems.

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Acute Appendicitis

Acute appendicitis is a painful inflammation of your appendix, a small sac connected to your large intestine. It is an urgent condition that must be addressed immediately. If you have appendicitis, your appendi...

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Salmonella Food Poisoning (Salmonella Enterocolitis)

Salmonella food poisoning is an infection in the small intestine by Salmonella, which is found in animal feces. It's marked by abdominal pain, chills, diarrhea, fever, muscle pain, and vomiting.

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Hepatitis refers to an inflammatory condition of the liver. It's commonly caused by a viral infection, but there are other possible causes of hepatitis.

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Alcoholic Liver Disease

Damage to the liver from excessive drinking can lead to ALD. Years of alcohol abuse cause the liver to become inflamed and swollen. This damage can also cause scarring known as cirrhosis. Cirrhosis is the final stage o...

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Toxic Megacolon

This condition is considered a medical emergency. Urgent care may be required.

Toxic megacolon is a rare, life-threatening widening of the large intestine and is usually a complication of inflammatory bowel disease (IBD).

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Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the reproductive organs in women. It's marked by pain in the abdomen, especially during urination or sex.

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Urethritis is an infection of the urethra, the tube that carries urine from the bladder and semen out of the body. Symptoms include burning while urinating, abdominal pain, and discharge.

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A hernia occurs when an organ pushes through the muscle or tissue that holds it in place. Hernias are most common in the abdomen but can appear elsewhere.

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Diverticula are bulging sacs that can appear in the lining of your large intestine. Diverticulitis occurs when these sacs get acutely infected or inflamed.

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Amebiasis is a parasitic infection, common in the tropics and caused by contaminated water. Symptoms can be severe and usually start 1-4 weeks after exposure.

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Polycystic Kidney Disease

Polycystic kidney disease (PKD) is an inherited kidney disorder that causes fluid-filled cysts to form in the kidneys. Abdominal and back pain, easy bruising, and fatigue are possible signs.

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Endometrial Cancer (Cancer of the Uterine Endometrium)

Endometrial cancer is a type of cancer that starts in the inner lining of the uterus. You are at greater risk if you are 60-70 years old and have used hormone replacement therapy that contains estrogen.

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Ischemic Colitis

Ischemic colitis (IC) is inflammation of the large intestine (colon). IC occurs when not enough blood flows to the colon. Abdominal pain is a common symptom.

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Actinomycosis is a long-term infection that causes abscesses to form in the soft tissues of the body. Lumps in the neck or face can be a sign of actinomycosis.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.