Abdominal Tightness (Tight Stomach Feeling)

Abdominal discomfort and pain can be described in many ways. Sometimes these descriptions may not have any medical significance yet it conveys the type of sensation a person is experiencing more accurately than terms like discomfort or pain. Abdominal tightness is one such term and may also be referred to as a tight feeling in the stomach. This type of sensation is usually associated with muscles but sometimes could arise from deeper lying organs.

Possible Symptoms

A tight feeling in the abdomen is a symptom on its own. Depending on the cause it may be accompanied by a host of other symptoms. When the cause is the digestive system, there may be symptoms like:

  • Nausea
  • Vomiting
  • Belching
  • Diarrhea
  • Flatulence
  • Constipation

Since the abdominal cavity is filled predominantly with digestive organs, it is not uncommon for the cause of abdominal symptoms to usually be due to the organs of the digestive system. Symptoms from organs of other symptoms include:

  • Small or large volume urine, frequent urination and urine discoloration – kidneys and urinary tract.
  • Menstrual pain, irregular menses and abnormal menstrual flow – female reproductive system.
  • Difficulty passing urine, dribbling and sometimes blood in the urine – prostate (males).

Abdominal Tightness Location

The location of the tight abdominal feeling can give an indication of the affected organ. Broadly the abdomen can be divided into four quadrants left and right upper quadrants, and the left and right lower quadrants.

  • Tightness in the RUQ (right upper quadrant) is related to the right kidney, liver, gallbladder and pancreas.
  • Tightness if the LUQ (left upper quadrant) is related to the left kidney, spleen, stomach and pancreas.
  • Tightness in the RLQ (right lower quadrant) is related to the right ureter, appendix, right ovary and fallopian tube (women).
  • Tightness in the LLQ (left lower quadrant) is related to the left ureter, left ovary and fallopian tube (women).

Diseases of the small and large intestine can cause tightness in any of these quadrants since these organs are large and coiled to occupy most of the abdominal cavity. Similarly conditions involving the peritoneum can cause diffuse discomfort that may be described as abdominal tightness.

Causes of Tight Abdominal Sensation

The exact cause of abdominal tightness can be difficult to diagnose without the presence of specific symptoms. It may further be confusing if the pain is diffuse and not localized to one regions. It is therefore important to undergo further diagnostic investigations at times to isolate possible causes when it cannot be diagnosed based on the history, symptoms and findings of a physical examination.

Abdominal Wall and Cavity

Injury to the abdominal wall (skin, subcutaneous tissue, muscles) may occur with blunt or sharp force trauma. Sometimes the former can cause vague symptoms like abdominal tightness while the latter almost always presents with pain. The abdominal muscles can become strained or cramp mainly due to overexertion in a person who is not physically conditioned to certain levels of activity. Accumulation of fluid in the abdominal cavity (ascites) or any large mass can also cause abdominal tightness. Peritonitis is inflammation of the abdominal lining (peritoneum) which can cause abdominal discomfort and eventually pain.


  • Gastritis where there is inflammation of the stomach wall mainly due to H.pylori infection and the excessive use of NSAIDs.
  • Peptic ulcer disease where open sores develop in the wall of the stomach (stomach ulcers) or duodenum (duodenal ulcers).
  • Hiatal hernia where a portion of stomach becomes trapped in the small hole of the diaphragm through which the esophagus passes.
  • Gastric outlet obstruction where the last portion of the stomach becomes narrowed or blocked like with pyloric stenosis.

Liver, Gallbladder and Bile Duct

  • Hepatitis where the liver becomes inflamed usually due to a viral infection but also with alcoholism.
  • Cholecystitis or cholangitis where the gallbladder or bile duct becomes inflamed and this mainly occurs with an infection.
  • Gallstones where stones form in the gallbladder and it is usually symptomatic when it blocks the neck of the gallbladder.
  • Bile duct stones where stones form or become obstructed within the bile duct.
  • Cancer of the liver, gallbladder or bile duct.


  • Pancreatitis where the pancreas becomes inflamed often related to gallstones and excessive alcohol consumption.
  • Pancreatic pseudocyst is where a sac forms in the abdominal cavity and is filled with pancreatic enzymes and tissue.
  • Pancreatic carcinoma (cancer) where a malignant tumor forms in the pancreas.

Small and Large Intestines

  • Peptic ulcer disease where an open sore forms in the duodenum or stomach.
  • Intestinal obstruction where a mass obstructs the lumen of the intestine or it narrows from external compression.
  • Inflammatory bowel disease where the bowels become inflamed and open sores (ulcers) form in it.
  • Irritable bowel syndrome where there is slow or rapid movement within the bowels as well as cramping.
  • Diverticulitis where abnormal outpouchings of the colon becomes infected.
  • Appendicitis where a small protrusion from the large intestine (appendix) becomes infected.
  • Fecal impaction where stool becomes ‘stuck’ in the lower colon.

Kidney and Urinary Tract

  • Pyelonephritis where the kidney is inflamed usually from an infections.
  • Ureteritis which is an infection of the ureters that carry urine from the kidney to the bladder.
  • Hydronephrosis where the kidney becomes swollen due to urine accumulation.
  • Cystitis is where the bladder becomes inflamed usually due to an infection.
  • Cancer of the kidney or bladder.

Reproductive System

  • Pregnancy where the expanding pregnant uterus presses against the abdominal wall and surrounding organs.
  • Endometriosis where inner uterine tissue grows outside of the uterus.
  • Polycystic ovarian syndrome (PCOS) where cysts form in the ovaries.
  • Uterine fibroids where abnormal masses forms in the uterus from uterine tissue.
  • Prostatitis or benign prostatic hyperplasia where the prostate becomes infected or enlarged.
  • Cancer of the uterus, fallopian tube, ovaries or prostate.

Other causes

  • Abdominal obesity.
  • Tight clothing around the abdomen.
  • Sleeping on the abdomen when not accustomed to this position.
  • Strenuous physical activity like running when not properly condition can strain the abdominal muscles.
  • Diarrhea and constipation are symptoms caused by a variety of diseases and there is often abdominal discomfort, cramping or pain.

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