Types of Onset of Abdominal Pain How did the pain begin? It is an important question doctors ask when a patient presents with abdominal pain. The type of beginning of pain indicates a lot about the underlying cause. Abdominal pain is usually of 3 types; Sudden onset – perforation of the gastrointestinal tract, gastric or duodenal ulcer, foreign body, colonic diverticulum, ruptured ectopic pregnancy, ruptured aortic aneurysm, abdominal vessel embolism, and mesenteric infarction Rapid onset - cholecystitis, intestinal obstruction, pancreatitis, diverticulitis, ureteral stone, appendicitis,and penetrating gastric or duodenal ulcer. Gradual onset - neoplasms, chronic inflammatory processes, and large bowel obstruction