But retrospectively, the severity of Abe's illness, an intestinal disease known as ulcerative colitis, may well have been evident in the build-up to him stepping down.
Abe's admission to hospital on Aug. 17 came a day after former economy minister Akira Amari told a TV program that the prime minister needs to rest, intimating he may be suffering from exhaustion, one of the causes of ulcerative colitis, along with stress.
Amari, who is close to the prime minister, said that Abe felt guilty about the idea of taking a break and that those around him needed to force him to get rest, if only for a few days.
Abe was back in the Keio University Hospital just one week later, this time for a more than four hours check up and further tests.
Even Deputy Prime Minister Taro Aso said that it was not a surprise that Abe was in "rough shape" as he had worked for 147 consecutive days through June 20 without taking a break, but suggested this was par for the course for Abe, known for his solid work ethic.
Going back to July 6, a weekly magazine even reported that the prime minister had vomited blood at his office, which first sent the rumors about his ill health swirling.
Nevertheless, political analysts said they were still shocked at the sudden news.
"This is a surprise ... We can expect a period of uncertainty now until the successor is determined," said Liu Jie, professor of graduate school of Asia-Pacific Studies at Waseda University.
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