Abdominal rigidity is a state of stiffness of your stomach muscles that worsens when you touch (or someone else touches) your abdomen. This is an involuntary response to prevent pain caused by pressure on your abdomen. Another term for this protective mechanism is guarding.
This symptom isn’t the same as intentionally flexing your abdominal muscles or the rigidity associated with severe gas. Guarding is a completely involuntary response of the muscles. In other words, you have no control over it. It’s a sign that your body is trying to protect itself from pain. It can be a symptom of a very serious and even life-threatening medical condition.
If you have abdominal rigidity, you should see your doctor right away.
Abdominal Rigidity and Abdominal Pain
Abdominal rigidity and pain often occur together. Every condition that causes abdominal pain can cause guarding. Disorders of your abdominal organs can cause abdominal pain. Organs inside your abdomen include your liver, pancreas, gallbladder, stomach, small and large intestines, aorta (main artery), vena cava (main vein), and kidneys and ureters. One of the most common abdominal causes of rigidity is appendicitis.
Problems with your pelvic organs can also cause abdominal pain. Your pelvic organs include your bladder and lower ureters, uterus, fallopian tubes, and ovaries (in women), prostate gland (in men), and rectum.
It’s less common to find diseases of the lower lung as a cause of abdominal pain and rigidity, but it does sometimes happen.
The location of pain varies with the location of the organ that’s causing the problem. For medical purposes, your stomach is divided into four sections called quadrants. For instance, stomach ulcers can cause pain in the left, upper quadrant of your abdomen. Gallstones can cause right, upper quadrant pain because they are in the upper right part of your abdomen.
Abdominal pain can also travel to other areas of the abdomen. Appendicitis can start off as right, lower quadrant pain, but the pain can start to move toward your belly button.
The causes of abdominal pain (and rigidity) can be different based on age. Adults (most common in elderly adults) may experience an abscess inside the abdomen, cholecystitis (gallbladder inflammation), cancer, bowel obstruction or blockage, or a perforation or hole in the intestines, stomach, or gall bladder. Pancreatitis, trauma to the abdomen, and peritonitis can also lead to abdominal pain and rigidity.
Adolescents sometimes have painful menstruation (dysmenorrhea), pelvic inflammatory disease (from sexually transmitted infections), ovarian cysts, or peritonitis. Adolescent women may also have abdominal pain and rigidity if they’re pregnant (including an ectopic pregnancy).
Older children may experience urinary tract infections (UTIs), appendicitis, or may have ingested toxins (poisons). Infants can have colic, gastroenteritis (digestive irritation caused by a virus), a viral infection, or pyloric stenosis (narrowing of the stomach outlet).
Abdominal rigidity is nearly always a medical emergency. Severe symptoms that could indicate a life-or-death situation include vomiting blood (also called hematemesis), rectal bleeding, black, tarry stools (or melena), fainting, or an inability to eat or drink anything. Severe vomiting, increased abdominal girth (distended abdomen), and shock (very low blood pressure) are also signs of an emergency.
Other symptoms to look for include tenderness, nausea, yellowing of the skin or jaundice, loss of appetite, and a feeling of fullness after eating small amounts of food (early satiety). Abdominal rigidity that occurs with an inability to pass gas from the rectum, pale skin, diarrhea, or constipation are also reasons to seek medical attention.
If you have involuntary abdominal rigidity, you should see a doctor right away to rule out serious problems. Although something as minor as a stomach virus could cause guarding, you won’t know until your doctor gives you a proper diagnosis.
Don’t attempt to take medication to dull the pain before seeing your doctor. It will alter the pain pattern and make it more difficult for your doctor to diagnose your condition.
When you talk to your doctor, it’s helpful for you to be aware of when the symptoms started, the qualities of the pain (if it’s dull, sharp, occurring off and on, or travels to another area), how long the pain lasts, and what you were doing when the rigidity/pain began. Ask yourself what makes it better and what makes it worse. Your doctor will also want to know any other symptoms you may have and when they started, and the time of your last meal (in case you need surgery).
Being aware of these factors will help your doctor establish your diagnosis.
The first steps in finding the cause of abdominal rigidity are to discuss your medical history. A physical exam will usually reveal the cause. Your doctor may also order blood tests, including:
- CBC (complete blood count)
- serum electrolytes (potassium, sodium, chloride, bicarbonate)
- BUN (blood urea nitrogen)
- creatinine (indication of kidney functioning)
- ultrasound scan of your abdominal or pelvic regions
- liver function tests
- test for blood in your stool
Additional tests you may need include abdominal X-rays to evaluate for obstruction or perforation, an abdominal ultrasound, or an abdominal CT scan.
The treatment your doctor chooses will depend on the cause of the abdominal rigidity. Obviously, treatment for colic in an infant will be different than treatment for cancer, for instance. While minor conditions may only require monitoring, self-care, and prescription antibiotics, more serious causes of abdominal rigidity could warrant more aggressive treatments.
Depending on your diagnosis, aggressive treatment can include intravenous fluids to prevent dehydration, nasogastric (feeding) tube to provide nourishment, intravenous antibiotic, or surgery.
Untreated causes of abdominal rigidity can be fatal. Abdominal infection can cause bacteria to enter the blood. This can cause your blood pressure to fall dangerously low (shock). Severe blood loss can also cause death. Dehydration and electrolyte imbalance from prolonged vomiting can cause dangerous heart rhythm problems, shock, and kidney failure.
Medically Reviewed by: Steve Kim, MD
Published By: Healthline Networks, Inc.