Learn more about the symptoms of severe stomach pain

Updated Dec. 9, 2019

Everyone gets a stomach ache — or abdominal pain — from time to time. Usually, stomach pains are harmless conditions caused by overeating, gas, or indigestion. Frequent or recurring sharp stomach pain is often due to stress and worry, even in child care. But it can point to more serious medical problems like pancreatic diseases.

“When I hear about abdominal pain, I am interested to hear about the details of how a patient experiences the pain,” says Michael Kingsley, MD, a gastroenterologist at UPMC.

Dr. Kingsley says to pay attention to when the pain occurs and what makes it better or worse and provide that information to your doctor.

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Common Causes of Stomach Pain

Harmless abdominal pain usually subsides or goes away within two hours.

  • Gas: Formed in the stomach and intestines as your body breaks down food, this can cause general stomach pain and cramps. This often can be indicated by belching or flatulence.
  • Bloating: Related to gas, this occurs when excessive gas builds up in your digestive tract. Your stomach will usually feel full, and you may experience cramps.
  • Constipation: This occurs when you are having difficulty making bowel movements. If you are having two or fewer bowel movements a week, constipation is the likely cause. In addition to feeling bloated and nauseous, you may experience cramping and pain in your rectum.
  • Indigestion: You typically experience this as an upset stomach, burning, or belly pain after eating.
  • Stomach flu: Your stomach may hurt before each episode of vomiting or diarrhea.

Severe Stomach Pain

In serious cases, the stomach pain gets worse or becomes constant. This may be an indication of a more severe condition, such as:

  • Appendicitis: This happens when the appendix, which is part of the large intestine, becomes infected and inflamed. If the appendix ruptures, it can become life-threatening. Surgery to remove the appendix, an appendectomy, is the usual treatment.
  • Stomach (peptic) ulcers: Crater-like sores in the lining of the stomach and small intestine. These can bleed or burst and be life-threatening if not treated. Medication to reduce your stomach acid can help treat them.
  • Gallstones: Hard stones, made up of cholesterol and other materials, that form in the gallbladder, which is just below the liver. They can cause inflammation of the gallbladder, which can lead to inflammation – known as acute cholecystitis. Treatment for these problems includes removal of the gallbladder.
  • Kidney stones: Crystals of varying sizes that form in your urine and build up in your kidneys. The pain can be severe. You can pass some on your own through urination, or doctors may remove them surgically.
  • Inflammatory bowel disease (IBD): A chronic inflammation in the digestive tract that can cause severe abdominal pain, vomiting, diarrhea, weight loss, and rectal bleeding. Examples of IBD include Crohn’s disease and ulcerative colitis.
  • Pancreatitis: The pancreas produces insulin and glucagon – the two hormones that manage how your body processes sugar – and aids in digestion. Inflammation of the pancreas is called pancreatitis, which can affect its performance and cause severe stomach pain.
  • Hernia: Tissue from inside the abdomen that bulges out through a weak point in the abdominal wall. There are several different types depending on where the bulge appears.

The location of the pain in your stomach can determine the potential cause:

  • Upper right: Gallstones, cholecystitis, stomach ulcer, duodenal ulcer, hepatitis
  • Upper center: Heartburn/indigestion, hiatal hernia, epigastric hernia, stomach ulcer, duodenal ulcer, hepatitis
  • Upper left: Functional dyspepsia, stomach ulcer, gastritis, pancreatitis
  • Middle right: Kidney stones, kidney infection, inflammatory bowel disease, constipation
  • Middle center: Umbilical hernia, appendicitis, stomach ulcer, inflammatory bowel disease, pancreatitis
  • Middle left: Kidney stones, kidney infection, inflammatory bowel disease, constipation
  • Lower right: Appendicitis, inflammatory bowel disease, constipation, pelvic pain
  • Lower center: Bladder infection, prostatitis, inflammatory bowel disease, inguinal hernia, pelvic pain
  • Lower left: Constipation, diverticulitis, irritable bowel syndrome, inflammatory bowel disease, pelvic pain, inguinal hernia

This diagram illustrates the types of abdominal conditions you may have based on the location of the pain.

Learn about when you should seek medical care for stomach pain.

When to Seek Medical Help

According to Dr. Kingsley at UPMC, you should call your primary care physician if mild pain lasts more than a couple of days, or if the severe stomach pain is accompanied by other symptoms.

When to seek immediate medical attention

Get medical help immediately if:

  • You have abdominal pain that is very sharp, severe, and sudden.
  • You also have pain in the chest, neck, or shoulder.
  • You’re vomiting blood, have bloody diarrhea, or have black, tarry stools (melena)
  • You have a high fever.
  • You’re having difficulty breathing.
  • You develop consistent nausea and/or vomiting.
  • Your abdomen is stiff, hard, and tender to the touch.
  • You can’t move your bowels, especially if you’re also vomiting

When to make an appointment to see your doctor

Schedule an appointment to see your doctor if:

  • Your stomach pain doesn’t go away within a couple of days.
  • The pain comes back after going away.
  • Symptoms like diarrhea don’t go away within a couple of days.
  • You’re urinating more or less often, and/or it’s painful.
  • You have unintended weight loss.

“Know your body,” Dr. Kingsley says. “If you start having pain that you have not had before and does not go away, you should contact your doctor to be evaluated further.”

Bottom line: Trust your gut! Contact your doctor if you’re concerned about lingering or unusual stomach pain.

Sources

National Health Service, Stomach Ache (https://www.nhs.uk/conditions/stomach-ache/)

National Health Service Inform, Stomach Ache and Abdominal Pain (https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/stomach-ache-and-abdominal-pain)

U.S. National Library of Medicine, Abdominal Pain (https://medlineplus.gov/ency/article/003120.htm)

About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal conditions and diseases, from diagnosis to treatment. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Most of our office visits and outpatient procedures take place at UPMC Presbyterian or UPMC Magee-Womens Hospital in Oakland. We also provide inpatient care at UPMC Montefiore or UPMC Presbyterian in Oakland.