when to seek care for stomaches

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 often is due to stress and worry, even in children. 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.

Common Causes of Stomach Pain

Harmless abdominal pain usually subsides or goes away within two hours. Some of the common causes for stomach pain are from:

  • Gas: Formed in the stomach and intestines as your body breaks down food, gas can cause general stomach pain and cramps. This often can be indicated by belching or flatulence.
  • Bloating: Related to gas, bloating occurs when excess gas builds up in your digestive tract. Your stomach usually will 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 uncomfortable, you may experience cramping and pain in your rectum.
  • Indigestion: This is typically experienced 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, stomach pain may get worse or become constant. This may be an indication of a more severe condition.

Conditions that cause severe abdominal pain

Appendicitis: This illness 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, called an appendectomy, is the usual treatment.

Stomach (peptic) ulcers: Crater-like sores in the lining of the stomach and small intestine. They 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, can 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 can build up in your kidneys and cause severe pain. 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.

Causes of stomach pain based on location

  • 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 (IBD), constipation.
  • Middle center: Umbilical hernia, appendicitis, stomach ulcer, IBD, pancreatitis.
  • Middle left: Kidney stones, kidney infection, IBD, constipation.
  • Lower right: Appendicitis, IBD, constipation, pelvic pain.
  • Lower center: Bladder infection, prostatitis, IBD, inguinal hernia, pelvic pain.
  • Lower left: Constipation, diverticulitis, irritable bowel syndrome, IBD, pelvic pain, inguinal hernia.

When to Seek Medical Help

According to Dr. Kingsley, 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.

Upper stomach

Right-side pain Center pain Left-side pain
Gallstones Heartburn Functional dyspepsia
Cholecystitis Hiatal hernia Gastritis
Stomach ulcer Stomach ulcer Stomach ulcer
Duodenal ulcer Duodenal ulcer Pancreatitis
Hepatitis Hepatitis

Middle stomach

Right-side pain Center pain Left-side pain
Kidney stones Umbilical hernia Kidney stones
Kidney infection Early appendicitis Kidney infection
IBD Stomach ulcer IBD
Constipation IBD Constipation
Pancreatitis

Lower stomach

Right-side pain Center pain Left-side pain
Appendicitis Bladder infection Constipation
IBD Prostatitis IBD
Constipation Diverticulitis IBD
Pelvic pain (gyne) IBD Pelvic pain (gyne)
Inguinal Hernia (groin) Inguinal Hernia (groin)

About digestive disorders

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

when to seek care for stomaches

“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 health care provider if you’re concerned about lingering or unusual stomach pain.

Editor's Note: This infographic was originally published on , and was last reviewed on .

Sources
National Health Service UK. Stomach ache. “Most stomach aches are not anything serious and will go away after a few days.”. National Health Service Inform. Stomach ache and abdominal pain. Abdominal pain. U.S. National Library of Medicine.

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About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal (GI) conditions and diseases, from diagnosis to treatment. Whether your digestive condition is common or complicated, our experts can help. 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. Find a GI doctor near you.