This document discusses the mechanisms of abdominal pain. It begins by explaining the embryological development of pain pathways in the embryo that determine how we perceive pain as adults. Different patterns of abdominal pain can indicate different underlying pathologies. Large bowel problems cause pain in the periphery while small bowel issues are usually more central. Basic causes of abdominal pain include inflammation, infection, trauma, vascular issues, tumors, obstruction, distension, and perforation. The nerve supply of the bowel is also described, explaining how visceral pain is vague while somatic pain from irritated peritoneum is sharp and localized. Location, timing, character, and worsening/relieving factors of pain can provide clues to its source.