Abdominal Pain and Rash in Adults: Causes & Treatment

Key takeaways:

• Typically abdominal pain and a rash are seen in a viral infection.
• Children are more commonly affected than adults.
• Sometimes more urgent care is needed, so please talk with your doctor.

There are many causes of abdominal pain and a rash. Thankfully most of the time this is just a viral illness that will resolve on its own. However, there are times when further care is needed and we will review some of these here.

The connection between abdominal pain and rashes

Usually, when abdominal pain and a rash are present, a virus or bacteria is causing both symptoms.

Most of the time this is due to a viral infection. Viruses cause our immune system to react in different ways depending on the organ they are infecting. Viruses can infect more than one organ at once, so you may feel abdominal pain and develop a rash due to the same illness.

Common causes of abdominal pain accompanied by a rash

Let’s discuss some of the most common causes of abdominal pain and a rash.

Viral gastroenteritis

This is the most common cause of abdominal pain and a rash. This is especially true for children. Typically, a child will develop fever and abdominal pain, plus other GI symptoms like vomiting or diarrhea. Most of the time the rash then appears after the fever has gone away. The rash is typically described as “salmon pink” and is usually on the face and upper chest.

This condition is known as viral exanthem and can be present in both children and adults. It may or may not be itchy. It usually starts on the face or torso and then spreads.

Hand, foot, and mouth disease

Hand, foot, and mouth disease is a viral illness that most commonly affects children under age 10, although anybody can get it. It usually begins with a mild fever, loss of appetite, and sometimes a stomach ache.

After a few days, these symptoms disappear and an itchy rash on the hands, feet, legs, and buttocks appears. There are also painful sores in the mouth that look like small pink bumps. Usually, within 7-10 days these symptoms clear.

Shingles

Shingles is a viral infection that causes a painful rash to develop. Usually, this rash is on one side of the body, the torso or the abdomen.

Shingles is caused by the chickenpox virus. It can occur anywhere on the body and is quite painful. While it doesn’t cause abdominal pain it can cause pain on the skin of the abdomen. Telling the two apart can be difficult.

E. coli infection

E. coli is a bacteria that lives in our intestines and normally doesn’t cause any problems. However, there are strains of this bacteria that are harmful to us.

Usually, infection with E. coli causes diarrhea, abdominal pain, and sometimes nausea and vomiting. Most patients recover within a week or so. In rare cases (usually children), a patient develops hemolytic uremic syndrome (HUS).

HUS can cause a rash that looks like small red spots all over the body. This rash is usually accompanied by bloody diarrhea and fever. If your child is experiencing these symptoms, please seek emergency medical care.

Henoch-Schonlein Purpura (also known as IgA Vasculitis)

Henoch-Schonlein Purpura (HSP or IgA vasculitis) is inflammation of the small blood vessels, usually in the skin, joints, bowels, and kidneys.

It causes abdominal pain and a purple rash on the lower legs and buttocks. Patients with HSP may also experience joint pain and swelling. This is most common in children under the age of 10. Usually, HSP improves on its own.

Necrotizing fasciitis

Necrotizing fasciitis, otherwise known as the flesh-eating disease, is a bacterial infection that can affect any part of the body. It destroys the tissue under your skin known as fascia. It is painful and causes the overlying skin to turn purple, red, or even black in severe cases.

This disease is often accompanied by fever and chills, with severe pain at the site of the skin changes. This disease can spread quickly, sometimes in a matter of hours. If you are experiencing the above symptoms, please go to the emergency room immediately. This is a life-threatening condition that is survivable if treated early.

Other symptoms associated with a rash and abdominal pain

Sometimes the location of the rash can be a clue to the cause.

Abdominal pain and a rash on the face

Abdominal pain accompanied by a facial rash is likely due to a non-specific viral infection and will resolve with time. This is the viral exanthem discussed above. The rash may spread or move around but frequently starts on the face or torso.

Abdominal pain and a rash on the stomach

While viral exanthem could cause this, another possibility is shingles infection. This is especially true for older patients or those with a weakened immune system.

Abdominal pain and a rash on the legs

Both Henoch-Schonlein Purpura (HSP) and hand, foot, and mouth disease (HFMD) can cause abdominal pain in combination with a rash on the legs or feet.

HSP typically causes a rash on the buttocks and lower legs, while HFMD causes a rash not only on the feet but also on the knees and hands, as well as sores inside the mouth.

Abdominal pain and a rash on the arms or hands

As stated earlier, Hand, Foot, and Mouth Disease causes abdominal pain followed by a rash on the hands, feet, and lower legs as well as mouth sores.

Read our full guides on rash symptoms and types of rashes for more.

Diagnosing abdominal pain and a rash

If your doctor suspects your symptoms are due to a viral infection, no bloodwork or testing may be necessary.

However, there are times when bloodwork or taking a sample from the rash may help your physician make the right diagnosis. Be sure to ask questions if there is something you don’t understand.

Treatment options for abdominal pain and a rash

Most treatments will be directed at your symptoms, though there are times when specific medications are needed.

Over-the-counter and home remedies

Many causes of abdominal pain and a rash are due to viruses. This means that there is no specific medication for the virus, but treatment will be focused on your symptoms.

Over-the-counter pain medication or anti-nausea medication may be given to you, based on your symptoms. For hand, foot, and mouth disease, patients often find an oatmeal bath soothing.

Antibiotics

Antibiotics are only given when your doctor suspects a bacterial infection, such as E. coli. It is important to take the full course prescribed to you, even if you start to feel better.

Antivirals

Antiviral medications are given in certain cases. Shingles is an example of a disease that responds well to antiviral treatment. While it won’t cure you, it will improve your symptoms and may make them stop sooner.

When to see a doctor for abdominal pain and a rash

Please call your doctor if you develop abdominal pain and a rash. There are also times when you should either go to your doctor’s office or the emergency room.

You should see a doctor if:

• You have had symptoms for more than 3 days.
• You have a fever (temperature above 100.4 degrees Fahrenheit).
• Your pain is severe and limits your ability to complete normal activities.

You should go to the emergency room if:

• You have bloody diarrhea.
• You have a rash that is quickly spreading (over hours).
• You have bloody urine or haven’t urinated in 4-6 hours.
• You notice you are bruising easily.
• You are bleeding from the nose or mouth.

Read our full guide on when to worry about a rash for more.

Questions to ask your doctor about abdominal pain and a rash

• What is causing my symptoms?
• Am I contagious?
• Is there anything I can do about the symptoms?
• How long will it take before I feel better?

Frequently asked question: abdominal pain with a rash

It is normal to have questions about your symptoms. Please ask questions until you feel satisfied that you understand what is happening.

What does it mean when a child experiences abdominal pain and a rash?

When a child has abdominal pain and a rash, it is most commonly due to a viral infection. This frequently disappears after 2-3 days. It is not harmful to your child’s long-term health.

What if the abdominal pain and rash are accompanied by joint pain?

If you are experiencing joint pain you may be experiencing a reaction to a virus or there is a more significant infection. Please call your doctor in this case.

Closing thoughts

Abdominal pain and a rash are common, especially in children. If you have questions or concerns, please contact your doctor to discuss them.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

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Bhandari, Jenish, and Yub Raj Sedhai. “Hemolytic Uremic Syndrome.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK556038/.

Roache-Robinson, Porsha, and David T. Hotwagner. “Henoch Schonlein Purpura (Anaphylactoid Purpura, HSP).” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK537252/.

Wallace, Heather A, et al. “Necrotizing Fasciitis.” Nih.gov, StatPearls Publishing, 2019, www.ncbi.nlm.nih.gov/books/NBK430756/.

Nair, Pragya A., and Bhupendra C. Patel. “Herpes Zoster (Shingles).” PubMed, StatPearls Publishing, 4 Sept. 2023, www.ncbi.nlm.nih.gov/books/NBK441824/.