Causes of abdominal pain and diarrhea
Pro Research Analysisby 
Searched over 200M research papers
Common Infectious Causes of Abdominal Pain and Diarrhea
Infections are among the most frequent causes of abdominal pain and diarrhea. Viral gastroenteritis, often called the "stomach flu," is a leading cause, typically resulting in watery diarrhea, abdominal pain or cramping, nausea, and sometimes fever. Bacterial infections, especially from Escherichia coli, Salmonella spp., and Staphylococcus aureus, are also significant contributors, particularly in foodborne outbreaks. These pathogens are commonly identified in adults presenting with these symptoms, highlighting the importance of food safety and public health interventions to prevent such illnessesBabu2024Sriramulu2024Myerson2019.
Chronic and Functional Bowel Disorders
Chronic conditions like irritable bowel syndrome (IBS) and Crohn’s disease are well-known causes of recurrent abdominal pain and diarrhea. IBS, especially the diarrhea-predominant type (IBS-D), can present with long-standing symptoms and is sometimes difficult to distinguish from inflammatory bowel diseases like Crohn’s disease. Notably, IBS can coexist with Crohn’s disease, even when the latter is in remission, complicating diagnosis and managementBabu2024Haedrich2025Veronesi2003.
Less Common and Rare Causes
Intestinal Spirochetosis
Intestinal spirochetosis is a rare bacterial infection that can cause chronic abdominal pain and watery diarrhea. It is more frequently found in immunocompromised individuals but can also occur in healthy people. Diagnosis is often incidental during colonoscopy, as the colon may appear normal or show non-specific lesions. Confirmation requires biopsy and special staining techniques. Treatment with metronidazole is effective, and clinicians should consider this diagnosis in patients with unexplained chronic symptoms, especially if they have not responded to standard IBS treatmentsAgulto2022Valenzuela2020Kamionkowski2020.
Drug-Induced Enteritis
Chronic cocaine use can lead to enteritis due to repeated episodes of bowel ischemia from vasospasm. This can result in chronic abdominal pain and persistent watery diarrhea, sometimes with significant weight loss. Diagnosis may require advanced imaging and endoscopic evaluation, and cocaine-induced enteritis should be considered in patients with a history of substance abuse presenting with these symptoms.
Cytomegalovirus (CMV) Colitis
CMV colitis is typically seen in immunocompromised patients but can rarely affect immunocompetent individuals, especially the elderly. It presents with abdominal pain and bloody diarrhea and may be mistaken for other forms of colitis. Diagnosis is confirmed by biopsy showing CMV-infected cells, and it should be considered in cases of refractory symptoms.
Other Considerations
Stress, food allergies, and lactose intolerance are additional non-infectious causes of abdominal pain and diarrhea. Chronic pancreatitis can also present with long-standing abdominal pain and episodes of diarrhea, particularly if the pain worsens with eating or alcohol consumption.
Conclusion
Abdominal pain and diarrhea have a broad range of causes, from common infections and functional disorders like IBS and Crohn’s disease to rare conditions such as intestinal spirochetosis, drug-induced enteritis, and CMV colitis. Accurate diagnosis often requires careful clinical evaluation, laboratory testing, and sometimes endoscopic or histological assessment. Awareness of both common and uncommon causes is essential for effective management and improved patient outcomesBabu2024Shane2017Sriramulu2024+7 MORE.
Sources and full results
Most relevant research papers on this topic
An uncommon cause of chronic abdominal pain and diarrhea.
Intestinal spirochaetosis is a rare infection with common symptoms of watery diarrhoea and non-specific abdominal pain, and should be considered in patients with common gastrointestinal symptoms.
DOI