Usually a combination of factors is involved. Sometimes the factors that cause an attack can't be identified. Symptoms Symptoms occur in attacks lasting several days or longer. Attacks appear after puberty and are more common in women than in men. In some women, attacks develop during the second half of the menstrual cycle.
Abdominal pain is the most common symptom.
The pain can be so severe that the doctor may mistakenly think that abdominal surgery is needed. Gastrointestinal symptoms include nausea, vomiting, constipation or diarrhea, and abdominal bloating. The bladder may be affected, making urination difficult. A rapid heart rate, high blood pressure, sweating, and restlessness are also common during an attack. All of these symptoms, including the gastrointestinal ones, result from effects on the nervous system.