Understanding your stomach pain: When to worry


In this article: 

  • Stomach pain is a common complaint, but it can be a sign of something more serious.

  • Stomach pain can be an early sign of emergency conditions like appendicitis or a heart attack.

  • When in doubt about your abdominal pain, it’s important to see your doctor or go to the emergency room.

Understanding your stomach pain: When to worry

Everyone experiences stomach pain at some point in their life. Whether you ate something that didn’t agree with you or you suffer from a virus, stomach pain is often a normal, but aggravating, complaint. However, sometimes stomach pain can be cause for concern.

The Centers for Disease Control and Prevention (CDC) reports that 45.1 million people each year visit their doctor or emergency room because of stomach pain. There are many causes of abdominal pain. The severity of your pain and the location within your abdominal area may provide important clues about the cause of your pain and whether you should see a doctor.

What causes stomach pain?

There are many reasons you may experience stomach pain. The cause of your stomach pain may be from an illness or injury. Stomach pain is often referred to as discomfort in any part of your abdominal area between your ribs and pelvis. However, the pain can be associated with other organs located in the same region, including your:

  • Gallbladder
  • Large intestine
  • Liver
  • Pancreas
  • Small intestine

Stomach pain is subjective, which means only you can describe your symptoms. Many common complaints of stomach pain are:

  • Achy
  • Burning
  • Constant
  • Crampy
  • Dull
  • Intermittent
  • Nausea
  • Sharp

According to Hardeep Singh, M.D., a gastroenterologist from Providence St. Joseph Hospital in Orange, CA, it’s important to accurately describe your pain to your health care provider.

“Your doctor will be able to help confirm the severity of your condition and what tests you may need based on your description of the pain,” he says.

Normal stomach pain vs. something more serious

Most stomach pain is temporary and not the result of a serious condition. But in some cases, stomach pain can be a cause for serious concern. Dr. Singh says knowing the difference could save your life.

Symptoms of everyday stomach pain

Normal stomach pain is often mild to moderate and resolves within a few days. In many cases, it is the result of a digestive issue, menstrual pain, virus or infection. Pain and discomfort from this type of stomach pain can generally be treated with over-the-counter medications.

Some common digestive system-related stomach pain include:

  • Constipation
  • Diarrhea
  • Food allergies
  • Food poisoning
  • Gas pain
  • Indigestion
  • Lactose intolerance

Inflammation is another common cause of stomach pain. Stomach possible causes of abdominal inflammation may include:

  • Gallstones
  • Gastroesophageal acid reflux disease (GERD) also known as heartburn
  • Inflammatory bowel disease
  • Pancreatitis
  • Peptic ulcer disease
  • Stomach virus
  • Urinary tract infection

Serious stomach symptoms

In some cases, stomach pain may be a sign of a serious issue that requires medical attention. Dr. Singh says there are certain symptoms you should never ignore. “Anytime you have severe, sudden onset of abdomen pain, you should contact your doctor immediately,” he says.

Other signs of a serious stomach issue are:

  • Abdomen tenderness or swelling
  • Blood in your poop, urine or vomit
  • Persistent fever
  • Persistent vomiting
  • Shortness of breath
  • Severe abdominal pain
  • Vomiting blood

Specific stomach pain and what it may mean

With so many causes of stomach pain, it may be difficult to tell what’s serious. There are several warning signs Dr. Singh says you should never ignore.

Severe stomach pain after eating a fatty meal

If you find yourself doubled over after eating a high-fat meal, you may be experiencing a gallbladder attack. “Women are especially prone to gallbladder disease,” says Singh. “Overweight women in their 40s are at highest risk.” When you experience a gallbladder attack, the pain becomes worse after eating, lasts 30 to 60 minutes, and may come and go, becoming more constant and severe over time, says Singh.

You can help prevent gallbladder attacks with a diet that’s rich in nutrients and fiber and low in fatty foods.

Crampy pain with diarrhea or constipation

Lower “crampy” abdominal pain accompanied by bloating and diarrhea, or constipation can be signs of irritable bowel syndrome (IBS), says Singh. “It’s exceptionally common and affects 15% of the U.S. population, particularly younger women, although it can happen at any age.” Symptoms of IBS can usually be controlled by managing diet, lifestyle and stress. Medication and counseling may be needed in some cases.

Upper abdominal pain between the rib cage

Aching or stabbing pain or pressure in the upper abdominal area just under the ribs may indicate a heart-related problem. Heart issues may be accompanied by chest pain, shortness of breath and are concerning if the pain persists. You could mistake this type of pain for indigestion, and while that may be the case, if you have risk factors such as diabetes or hypertension, you should see a doctor as soon as possible.

If you do struggle with acid reflux, you may want to talk to a gastroenterologist. They can help you manage your symptoms through medications, lifestyle changes and diet. In some cases, antacids can help you minimize symptoms.

Severe, acute pain in the lower right side of the abdomen

Sudden pain in the lower part of the abdomen may be a sign of appendicitis. You may also experience a fever. Pain often begins around the belly button area and becomes worse with time. Vomiting, constipation or diarrhea along with the pain also indicate it’s time to go to the emergency room.

Appendicitis mostly affects kids and teens between the ages of 5 and 20. While many digestive health issues can cause stomach pain in kids, it’s important to talk to your child’s doctor immediately if you suspect appendicitis — especially if the pain comes on suddenly over several hours or is persistent. Appendicitis requires immediate medical attention and often leads to surgery. If left untreated, a ruptured appendix can be deadly.

Vague upper abdominal pain associated with nausea and belching

Sometimes stomach pain is hard to identify or comes with multiple symptoms. Vague pain in the upper and mid-abdominal area that is accompanied by nausea, burping or belching could be signs of a heart attack, particularly in older individuals. Tests like an ECG or cardiac markers can be lifesaving. Symptoms such as vomiting along with back or jaw pain and shortness of breath can also be a sign of a life-threatening emergency.

Women are more likely to experience abdominal pain or digestive issues during a heart attack. It’s important to learn how heart disease, including heart attacks, can affect women differently.

Sudden and severe onset stomach pain

When mid-abdominal pain occurs suddenly — especially in people with a history of peptic ulcer disease or in those who take excessive amounts of aspirin or NSAIDs — it may be a sign of a tear that could require emergency surgery. A tear could leak air and gastric content which can lead to a condition called peritonitis, and eventually, septic shock. Surgery would be required to seal the perforation.

If you’re experiencing chronic stomach pain, take steps now to head off any bigger problems down the road. Your primary care provider can help determine what’s causing your issues and create a plan to help improve your gut health. Your plan may include medication, lifestyle changes, a healthier diet and stress management techniques

Right or left lower abdominal pain in women

Sudden onset of right lower abdominal pain or left lower abdominal pain can indicate a ruptured ovarian cyst in a woman who is in the middle of her menstrual cycle. This kind of pain could also be a sign of ovarian torsion, which is the rotation of the ovary and part of the fallopian tube, or possibly a twisting of the ovary due to reduced blood supply. Seek treatment immediately at the nearest emergency department. Surgery to remove the ovary may be necessary.

Knife-like pain in the lower abdomen

Pain that wraps around the lower stomach area, commonly accompanied by nausea, vomiting, fever and chills, could be a sign of kidney stones or kidney infection. Kidney stones are diagnosed by ultrasound or CT scans and NSAIDs are often recommended for pain relief. In cases of persistent pain, rescue narcotics may be prescribed for immediate relief or alpha-blockers which can relax blood vessels allowing larger stones to pass. 

Belly pain in the lower left side that’s worse when you move

Abdominal pain in the left lower area of the abdomen may be a sign of diverticulitis, small pockets in the colon that can become obstructed and tear. Traditional treatment includes antibiotics and stool softeners to reduce the risk of abscess formation. According to research, antibiotics may no longer be needed in this scenario, and doctors recommend acetaminophen instead.

Contributing caregiver

Hardeep Singh, M.D., is a gastroenterologist from Providence St. Joseph Hospital in Orange, CA.

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Related resources

Maintain a healthy gut: Three reasons to see a gastroenterologist

When should you be concerned about your child’s stomach pain?

Coping with diverticulitis

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.