About Stomachaches

Most stomachaches are nothing more than indigestion or gas. But stomach pain also could be appendicitis, gallstones, a tubal pregnancy, or other serious conditions. The features of the pain and its severity, location, and duration are clues to its cause.

What to ask

These are questions to consider when describing the pain to your health care provider:

  • Where is the pain? Is it in the upper, middle, or lower abdomen? Is it on one side only or on both sides?

  • Does the pain stay in one spot or does it seem to travel?

  • Is it related to eating or going to the bathroom?

  • Does it come and go or stay the same?

  • Does anything make it worse or better?

Other important things to tell your health care provider:

  • Whether you have vomited or have diarrhea

  • If you had blood in the vomit, diarrhea, or urine

  • Whether you have shortness of breath, dizziness, or a fever 

The usual suspects

  • Gastroesophageal reflux disease (GERD), a cause of indigestion and heartburn, and inflammation in the stomach are the most common causes of stomach problems. 

  • A stomach viral infection, also known as gastroenteritis, can cause symptoms that include nausea, vomiting, cramps, diarrhea, and fever. It usually goes away without medical treatment. 

  • Food poisoning causes nausea, vomiting, stomach cramps, and diarrhea. Symptoms can occur within 30 minutes or up to 2 days after eating contaminated food.

  • Gallstones can cause steady pain in the upper belly that increases rapidly and lasts from 30 minutes to several hours. Other signs include bloating, gas, and indigestion.

  • Irritable bowel syndrome is one of the most common disorders diagnosed by health care providers. Belly pain, bloating, and discomfort are the main symptoms.

  • Appendicitis requires immediate medical attention. The symptoms typically start with a loss of appetite, mild fever, pain around the bellybutton, vomiting, diarrhea, or constipation. The pain usually moves to the belly's lower right side. 

  • Diverticulitis can feel like appendicitis, except the pain is in the lower left side of the belly. The pain is usually severe and comes on suddenly. 

  • Ectopic or tubal pregnancy symptoms include belly or pelvic pain. It can be sudden, constant, and severe but also may be mild. If a fallopian tube has burst, which is a medical emergency, there also may be signs of shock like a weak, racing pulse; pale, clammy skin; and dizziness or fainting.

  • Ovarian cancer symptoms can include periodic pelvic and abdominal pain. Other symptoms include more frequent urination and a more frequent urge to urinate; increased belly pain or bloating; and a feeling of fullness.

Treatment decisions

The following guidelines can help you determine how to respond to stomach pain:

  • Self-treat if the pain is mild.

  • See your health care provider if the pain is mild to moderate and happens again over time.

  • Go to the emergency room if your pain is severe, if you have a fever, if you have blood in your vomit, or if you have bowel movements that look like runny, black tar.

A health care provider should evaluate any pain that’s severe or interferes with your ability to go about your usual routine.

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