Abdominal Pain & Vomiting, But No Fever: Causes & Treatment

Key takeaways:

• Many causes of abdominal pain and vomiting are benign, but it’s important to recognize signs of more serious underlying issues.
• Paying attention to the location of your abdominal pain can lead to a diagnosis.
• Children and pregnant women with these symptoms should have a lower threshold for consulting their healthcare provider.

Abdominal pain and vomiting are two distressing symptoms, often prompting patients to seek medical attention. You might be wondering if you should still be concerned when you experience abdominal pain and vomiting without fever.

In this article, we will explore the potential causes of these symptoms and discuss when you should seek care, regardless of if a fever is present.

Causes of abdominal pain and vomiting without a fever

The abdomen houses many of our organs. That’s why you should always note where you are feeling pain. Abdominal pain and vomiting without a fever can have various causes depending on the originating site of the symptoms.

Gastroenteritis

Viral gastroenteritis, commonly referred to as the stomach flu or stomach bug, is one of the most common causes of abdominal pain and vomiting without a fever.

This infection is usually the result of a virus or due to food poisoning from contaminated food. It leads to inflammation of the stomach and intestines, causing symptoms like nausea, vomiting, diarrhea, and abdominal pain. Gastroenteritis will often occur without a fever. Symptoms usually resolve on their own within a few days.

This is rarely considered a medical emergency and seldom leads to serious complications.

Appendicitis

Appendicitis is caused by inflammation of the appendix. It typically starts with centralized abdominal pain surrounding the belly button and eventually localizes to the right, lower aspect of the abdomen.

In addition to the hallmark symptoms of right lower abdominal pain, nausea and vomiting are common symptoms of appendicitis. Although some patients with advanced stages of appendicitis do experience a fever, it is not common to have a fever with the initial onset of symptoms.

Kidney stones

Pain associated with kidney stones is commonly referred to as renal colic. This pain usually starts in the mid-to-lower back and radiates to the side and lower abdomen or groin.

Renal colic is usually intermittent in nature and comes and goes as a stone moves through the urinary tract. Nausea and vomiting are common symptoms that accompany the pain felt with kidney stones. It is uncommon to experience a fever with kidney stones unless an infection is present.

Pancreatitis

Pancreatitis is caused by inflammation of the pancreas and can be acute or chronic.

Acute pancreatitis is often caused by gallstones and resolves after a few days of treatment. Chronic pancreatitis is most commonly caused by heavy alcohol use and does not improve but rather worsens over time, leading to permanent damage to the pancreas.

Symptoms of pancreatitis include upper abdominal pain, nausea, and vomiting. Weight loss is another symptom that may be noted with chronic pancreatitis.

Causes of abdominal pain and vomiting without a fever with an additional symptom

Depending on the location of the abdominal pain, some cases of abdominal pain and vomiting without fever should be treated more urgently than others. This is especially true if other symptoms are present.

It’s important to share information about pain location and the presence of other symptoms with your healthcare provider.

Upper abdominal pain and vomiting without a fever

Upper abdominal pain and vomiting can have a number of different causes.

If the pain is mainly located on the right side, inflammation of the gallbladder and gallstones might be the cause. Mid-upper abdominal pain and vomiting may be due to pancreatitis or acid reflux. Left upper abdominal pain may be due to peptic ulcer disease or infections causing inflammation in the stomach, such as viral gastroenteritis.

Lower abdominal pain and vomiting without a fever

In female patients experiencing lower abdominal pain and vomiting without a fever, ruptured ovarian cysts and symptoms related to the menstrual cycle should be considered.

More urgently, ectopic pregnancy should be ruled out in female patients of childbearing age. In both male and female patients, left lower abdominal pain may be due to a condition known as diverticulitis which is due to inflammation in the intestines. Right lower abdominal pain may be due to appendicitis, and central lower abdominal pain may be due to a urinary tract infection.

Abdominal pain, vomiting, and diarrhea without a fever

When abdominal pain and vomiting are accompanied by diarrhea, viral gastroenteritis is often the culprit.

This condition typically resolves itself after a few days, but it is important to stay hydrated throughout the duration of your illness. If you experience more than 24 hours in which you are unable to tolerate fluids, you should see your healthcare provider for IV fluids.

Abdominal pain and vomiting without a fever during pregnancy

Abdominal pain and vomiting during pregnancy should always be urgently evaluated.

While symptoms may be due to something less severe such as acid reflux or viral gastroenteritis, they can also be due to something serious such as an ectopic pregnancy. It is important to visit your healthcare provider when experiencing vomiting during pregnancy.

When to see a doctor about abdominal pain and vomiting without a fever

Even when abdominal pain and vomiting occur without a fever, there are certain instances where you should still seek medical care. Some symptoms warrant outpatient evaluation, while other symptoms may require a trip to the emergency department.

You should see a doctor if:

• Symptoms persist for more than 24 hours.
• You experience significant abdominal pain that is worsening.
• You notice blood in your vomit or stool.
• You feel dehydrated (dry mouth, dizziness, decreased urine output).

You should go to the emergency room if:

• You describe your abdominal pain as severe.
• You experience vomiting and are unable to consume fluids for a period longer than 24 hours.
• You notice swelling, masses, or tenderness in your abdomen.
• You are pregnant and have severe abdominal pain with vomiting.

Questions to ask a doctor about abdominal pain and vomiting

• What could be causing my abdominal pain and vomiting?
• Am I considered contagious, and if so, for how long?
• What tests will be done to diagnose the cause of my symptoms?
• What treatment options are available for my symptoms?

Treatment options for abdominal pain and vomiting

Several treatment options exist for abdominal pain and vomiting. Treatment can vary based on the underlying cause of your symptoms.

Medications

Anti-nausea medications may be prescribed to reduce nausea and to stop vomiting. If your symptoms are caused by acid reflux or peptic ulcer disease, your healthcare provider may recommend acid-reducing medications.

Pain medication may be prescribed for causes like kidney stones, gallstones, or ovarian cysts. In some situations, such as appendicitis or urinary tract infections, antibiotics may also be prescribed.

IV fluids

Treatment should always focus on hydration when vomiting is one of the main symptoms. IV fluids can also help promote urination and the passage of kidney stones.

Surgery

Depending on the underlying cause, surgery may be necessary. In recent years, there has been a switch to attempt to manage appendicitis with antibiotics.

However, in many cases, surgery ends up being the definitive treatment. Gallstones are another indication for surgery if symptoms cannot be managed with dietary changes.

Frequently asked questions: abdominal pain and vomiting

If you are experiencing abdominal pain and vomiting, you likely have some questions. Here are answers to some of the most common questions about these symptoms.

What should you do immediately after vomiting while experiencing abdominal pain?

It is important to remain hydrated when you experience vomiting. Start with small sips of water or drinks containing electrolytes, and avoid solid food until the abdominal pain and vomiting subside.

If symptoms persist or worsen, you should consult with your healthcare provider for evaluation and further dietary recommendations.

What should happen if a child is experiencing abdominal pain and vomiting without a fever?

Children who experience abdominal pain and vomiting without fever should be closely monitored, especially young children who are more likely to become easily dehydrated.

If their abdominal pain becomes severe or their symptoms persist or worsen, they should be evaluated by a healthcare provider. Viral gastroenteritis, appendicitis, and urinary tract infections are some of the most common reasons for abdominal pain and vomiting without fever in children.

Managing abdominal pain and vomiting without a fever

Ranging from the fairly benign stomach bug to the more severe ruptured appendix, abdominal pain with vomiting has a wide array of causes and should always prompt a visit with your healthcare provider. Understanding some of the common causes and how they present themselves can help guide the discussion with your healthcare provider and achieve an accurate diagnosis.

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

“Abdominal Pain: MedlinePlus Medical Encyclopedia.” Medlineplus.gov, 2013, medlineplus.gov/ency/article/003120.htm. Accessed 14 Oct. 2024.

Lotfollahzadeh, Saran, et al. “Appendicitis.” StatPearls, StatPearls Publishing, 12 February 2024, https://www.ncbi.nlm.nih.gov/books/NBK493193/.

“Pancreatitis.” Medlineplus.gov, National Library of Medicine, 2019, medlineplus.gov/pancreatitis.html. Accessed 14 Oct. 2024.

Patti, Laryssa. and Stephen W. Leslie. “Acute Renal Colic.” StatPearls, StatPearls Publishing, 6 June 2024, https://pubmed.ncbi.nlm.nih.gov/28613743/.

“Viral Gastroenteritis (Stomach Flu): MedlinePlus Medical Encyclopedia.” Medlineplus.gov, 4 May 2022, medlineplus.gov/ency/article/000252.htm. Accessed 14 Oct. 2024.