Abdominal rigidity

When there is a sore area inside the belly or abdomen, the pain will often get worse when a hand presses against your belly area.

Your fear or nervousness about being touched (palpated) may cause your abdominal muscles to stiffen, but there should be no pain.

If you have pain when you are touched and you tighten the muscles to guard against more pain, it is more likely caused by a physical condition inside your body. The condition may affect one or both sides of your body.

Abdominal rigidity may occur with:

• Abdominal tenderness
• Nausea
• Pain
• Swelling
• Vomiting

Causes can include:

• Abscess inside the abdomen
• Appendicitis
• Cholecystitis caused by gallstones
• Hole that develops through the entire wall of the stomach, small intestine, large bowel, or gallbladder (gastrointestinal perforation)
• Injury to the abdomen
• Peritonitis

Get medical care right away if you have pain when the belly is gently pressed and then released.

You will probably be seen in an emergency room.

The health care provider will examine you. This may include a pelvic exam, and possibly a rectal exam.

The provider will ask questions about your symptoms, such as:

• When did they first start?
• What other symptoms do you have at the same time? For example, do you have abdominal pain?

You may have the following tests:

• Abdominal and pelvic CT scan
• Abdominal and pelvic ultrasound
• Blood tests
• Colonoscopy
• Esophagogastroduodenoscopy (EGD)
• Paracentesis
• Sigmoidoscopy
• Stool analysis
• Urine tests
• X-rays of the chest or abdomen

You will probably not be given any pain relievers until a diagnosis is made. Pain relievers can hide your symptoms.

Rigidity of the abdomen

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 18.

Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 123.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.