It's amazing all the aches and pains that can crop up inside a woman's belly! I've written before about urinary tract infections, a common cause of lower abdominal pain. Let's run through a few other possible sources of pain, going clockwise around the abdomen.

At 12 o'clock is the stomach:

• Nausea is a common symptom that can have many causes. Is your period late? Could you be pregnant? Consider a urine pregnancy test.
• Heartburn can be a sign of gastritis (inflammation of the stomach lining), and is common among singers and pregnant women. Try Tums^®, Pepto-Bismol^®, or Maalox^®. If you take a lot of ibuprofen (Motrin^®) or naprosyn (Aleve^®), you may have developed an ulcer. If symptoms persist, your doctor may recommend starting antacid medicines like Prevacid^® or Prilosec^®.

From 2 to 5 o'clock is the area of the descending colon:

• Constipation, especially in young women, can cause pain in this area. Based on the many abdominal X-rays I've seen, more people are constipated than will admit it. If you don't have a daily soft stool that is easy to pass, consider increasing your fluid intake and drink a glass of water with fiber (like Metamucil or Citrucel) every day.

From 4 to 8 o'clock is the lower abdomen, a high-traffic area for pain:

• Ectopic pregnancy, a pregnancy growing outside of its proper position in the uterus, is of great medical concern. This is a medical emergency, since medical intervention is needed to keep it from rupturing and bleeding.
• Urinary tract infections (UTIs) can cause lower abdominal pain. A urine test is needed to confirm the infection so that treatment can begin immediately. If left untreated, UTIs can progress to pyelonephritis, a serious kidney infection. If a urine test is negative for UTI infection, then a pelvic exam is needed to assess for pelvic inflammatory disease.
• Pelvic inflammatory disease (PID), often caused by untreated sexually transmitted infections like gonorrhea or chlamydia, can also lead to intense pain in the lower abdomen. Antibiotics are necessary to prevent scarring of the reproductive organs, which can lead to subsequent infertility.
• The left ovary. During ovulation, some women can feel a pain referred to as "Mittlesmirtz." Less common is the intermittent, severe pain caused by ovarian torsion, when the ovary twists on the supplying blood vessels. During early and mid-pregnancy, women often get round ligament pain in this area. Unlike ovarian torsion, this type of pain in either ovary is not a cause for concern.

At 7 o'clock is not only another ovary but also the appendix:

• Appendicitis can cause persistent pain here. This disorder is also associated with a lack of appetite - yet another reason to seek medical attention.

At 10 o'clock is the liver and gallbladder:

• Gallstones, which occur more commonly in women than in men, can cause bouts of pain here, especially after eating a fatty meal. Gallstones are first treated with a reduced-fat diet, but oftentimes they must be surgically removed.

In the center of the clock are the small bowels:

• Excess swallowed air may cause bloating and pain in this area.
• Lactose intolerance, an inability to digest the sugar in dairy products (lactose), can cause cramping and lead to diarrhea.

There are many other causes of pain at each of these locations throughout the abdomen. To help you determine the cause of unexplained pain, keep a journal and bring it to your appointment with your doctor. Record the locations and times of your symptoms, the foods consumed, the quality and severity of the pain (burning, gassy, sharp, cramps), and any medications you've tried either successfully or unsuccessfully. This information will help your doctor to more quickly identify and treat your pain.