Signs and symptoms that warrant a trip to your healthcare provider or the ER

By Barbara Bolen, PhD 

 Medically reviewed by Barbie Cervoni, RD

You can't know for sure if your stomach pain is due to something serious or not without an evaluation, but some signs indicate you need urgent medical attention. For example, if your abdomen is sensitive to touch or your pain is accompanied by high fever, persistent vomiting, or chest pain, you need to go to the hospital.

If you're pregnant or have had recent abdominal surgery, you should consider any stomach pain potentially serious.

This article walks you through how to know if your stomach pain is likely serious or not and how quickly you should seek medical care. It also provides some suggestions for how to ease stomach pain when the cause is not serious.

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Signs Stomach Pain Is an Emergency

Your stomach pain may be serious and indicate a medical emergency if it is accompanied by any of the following symptoms:

  • Extremely hard abdomen

  • Abdominal tenderness when touched

  • Coughing up or vomiting blood

  • Vomiting that won't stop

  • Bloody diarrhea

  • Chest pain or pressure

  • Trouble breathing

  • Dizziness

  • Fainting

  • Inability to have a bowel movement, along with vomiting

  • Pain in the neck, shoulder, or between shoulder blades

  • Vision changes

  • Pain that starts in the belly button and moves to the right side (a warning sign of appendicitis)

  • Fever

Sometimes stomach pain is mild at first but gets worse after a few hours. These symptoms may not develop until that time.

If you have these symptoms, call for an ambulance or have someone drive you to the ER. You should not "wait and see" or take medicine for the pain. Get help right away.

Causes of Serious Stomach Pain

When stomach pain is associated with other serious symptoms, it may be caused by a life-threatening condition. Some examples of these conditions include:

  • Appendicitis (inflammation of the appendix)

  • Bowel obstruction (when food or waste blocks the intestine)

  • Bowel perforation (a hole in the intestine that leaks food material)1

These emergencies usually cause pain that feels extreme.

Other circumstances in which you should discuss stomach pain with a healthcare provider include when:

  • You're pregnant

  • Your pain started within a week of abdominal surgery

  • Your pain started after a procedure in your stomach area, like an endoscopy

  • You have ever had surgery on your digestive tract, like a gastric bypass, colostomy, or bowel resection

  • Your pain started shortly after an abdominal trauma

  • Your abdomen is bruised or rapidly expanding

  • Excessive vaginal bleeding, or blood clots and bleeding longer than usual

  • You have rectal bleeding or tarry-looking or bloody stool2

Lower Abdominal Pain

The area of your stomach below your belly button is called your lower abdomen. Pain in this area can have many different causes. While it may be a sign of an emergency such as appendicitis, it may also be related to minor ailments or situations that don't need immediate medical attention, including colitis, cystitis, kidney stones, trapped gas, menstrual cramps, constipation, and irritable bowel syndrome (IBS) are some possibilities.

When to See a Healthcare Provider

Some kinds of stomach pain need immediate attention. With others, you can call or visit your healthcare provider. It can be hard to know what you should do. Listen to your body and trust your instincts if you're not sure. Speak to your healthcare provider if you have:

  • Burning with urination

  • An urgent need to urinate

  • Blood in the urine

  • Pain, discomfort, or nausea when you eat

  • Diarrhea that lasts more than five days

  • Fever above 100 degrees

  • Fever for three days or longer

  • Loss of appetite

  • Pain that gets worse or doesn't get better within one or two days

You should also call your healthcare provider if you have stomach pain while being treated for cancer.

Stomach Pain in Children

Stomach pains are common in children. Causes include indigestion, stress, constipation, food allergies, or more serious cases like appendicitis. Stomach pain of three hours or less is usually not severe.3 Call your healthcare provider immediately if a child has a fever of 100.4F or other symptoms such as diarrhea that could lead to dehydration.

How to Manage Stomach Pain

If your stomach pain is not severe or long-lasting, and if you're not having symptoms like those mentioned above, the pain may go away on its own.

This pain is often caused by minor problems such as constipation, gas, or something you ate. Waiting a few hours, having a bowel movement, or passing gas may help.

You can also try taking these steps:

  • Limit yourself to clear liquids for a few hours.

  • If you have vomiting or diarrhea, make sure to stay hydrated. Small sips of fluids and electrolyte replacement beverages are important. If you can tolerate food, eat low-fiber foods such as bread and crackers until you feel better. Some people find success following the BRAT diet for the short term until symptoms have improved.

  • Avoid foods that are hard to digest. Fatty, fried, or spicy foods can cause stomach pain. So can drinks containing alcohol or caffeine.

  • Try an over-the-counter antacid or a product to relieve gas.

  • If you are constipated, eating foods with fiber can help to initiate a bowel movement. Fruits, vegetables, high-fiber grains, breads, and cereals can help. Make sure you drink plenty of fluids with your fiber.

  • Use a hot water bottle or heating pad. Place the pad on your abdomen for a half hour at a time, with a towel under the pad to protect your skin.

Your symptoms may improve within a day or two. If they do not, call your healthcare provider.

Acute vs Chronic Pain

Acute abdominal pain comes on suddenly. It may be severe and is usually due to a short-term condition. Chronic pain is long term. It often comes and goes and is due to a chronic condition like IBS.

Pain Reliever

Some people choose to take OTC pain relievers for stomach pain, and you can, but choose wisely. Avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, Motrin or Advil (ibuprofen), or Aleve (naproxen). These can irritate your stomach lining and cause ulcers. Tylenol (acetaminophen) tends to be easier on the stomach.4

Summary

Stomach pain may mean you have an urgent medical problem like appendicitis or a blockage or leak in your intestines. A hard stomach, vomiting, bleeding, dizziness, or fainting are signs of a medical emergency when they happen with stomach pain.

If you're pregnant, being treated for cancer, or have had an abdominal procedure or trauma, don't wait. Go to the emergency room right away.

Call your doctor if you have other symptoms such as fever or diarrhea with stomach pain. You may have a health condition that needs treatment. Otherwise, you may be able to try some home remedies to ease the pain.

Sources

Cervellin G, Mora R, Ticinesi A, et al. Epidemiology and outcomes of acute abdominal pain in a large urban emergency department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016;4(19):362. doi:10.21037/atm.2016.09.10

Lohsiriwat V. Anorectal emergencies. World J Gastroenterol. 2016;22(26):5867-5878. doi:10.3748/wjg.v22.i26.5867

Michigan Medicine. Abdominal pain, age 11 and younger.

Harvard Health Publishing. Where to turn for pain relief - acetaminophen or NSAIDs?.

Additional Reading

Poonai N, Cowie A, Davidson C, et al. Reported provision of analgesia to patients with acute abdominal pain in Canadian pediatric emergency departments. CJEM. 2016;18(5):323-30. doi:10.1017/cem.2015.112

Wöhrl S. NSAID hypersensitivity - recommendations for diagnostic workup and patient management. Allergo J Int. 2018;27(4):114-121. doi:10.1007/s40629-018-0064-0

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By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.