This could be due to an inflammation, by stretching or distention of an organ, or
by loss of the supply of blood to an organ. Conditions such as appendicitis
, diverticulitis, colitis, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis and even ulcer
. To determine the exact cause, complete medical history and direct clinical evaluation are important. Diagnostic tests such as blood and imaging tests may also be indicated.