Take steps to figure out if your condition is mild or severe.
Stomach pain is something pretty much everyone is acquainted with at some point in their lives. While some conditions are mild enough to be treated with at-home remedies, it’s possible you’re dealing with something more serious if your pain is severe or happening all the time. So you definitely want to get to the bottom of that tricky Q: Why does my stomach hurt?
“There are various causes of stomach pain, which can be acute or chronic and can be caused by issues relating to the stomach, appendix, gallbladder, spleen, bowel, liver, gynecological issues, or other issues,” says Michael D. Dann, MD, a gasteroenterologist at Manhattan Gastroenterology in New York City. “A thorough examination and further investigation can help you to understand and properly treat the cause of your pain.”
Because the list of possible causes is pretty long, Dr. Dann recommends that all persistent or intense abdominal pain always be evaluated with a thorough consultation and examination by a gastroenterologist for an accurate diagnosis and treatment plan. While there are tons of totally harmless reasons that you’re stomach hurts (hi, indigestion!), you def want to rule out a serious illness or condition.
Read on for 32 potential causes of stomach pain, as well as how to identify and treat them.
1. Irritable bowel syndrome
IBS is one of the most common causes of abdominal pain, says Dr. Dann. Symptoms typically include pain in the belly and abdomen area that is nagging and chronic, altered bowel habits, nausea, and vomiting.
How to treat it: Treatment will vary depending on symptoms can include dietary modifications, medication, and lifestyle behavior changes (think: adapting new stress management techniques, as stress can exacerbate IBS symptoms).
2. Lactose intolerance
Symptoms of lactose intolerance include a crampy abdominal pain (often in the lower abdomen), bloating, flatulence, nausea, diarrhea and vomiting, all after eating dairy products that contain the sugar molecule lactose.
How to treat it: The most obvious way to treat lactose intolerance is to eliminate or limit dairy products from your diet, says Dr. Dann. You can also take an enzyme replacement to relieve symptoms, or treat secondary causes of lactase deficiency, such as with calcium and vitamin D supplementation.
3. Gastroesophageal reflux disease
Patients with gastroesophageal reflux disease (GERD) typically complain of heartburn, regurgitation, and difficulty swallowing, says Dr. Dann. However, some patients may also deal with abdominal or chest pain, nausea, chronic cough, hoarseness, or wheezing.
How to treat it: Mild and intermittent symptoms can be managed with lifestyle and dietary modification, says Dr. Dann. Medication may be needed for persistent or frequent symptoms and can include antacids, histamine H2 receptor blockers (such as Pepcid, a.k.a. famotidine), or proton pump inhibitors such as Prilosec (omeprazole). Severe symptoms may require surgery.
4. Gas and bloating
Gas in your digestive tract comes from either swallowed air and the normal breakdown of certain undigested foods by harmless bacteria that are naturally present in the large intestine, per Dr. Dann. Although it can often cause embarrassing moments, it’s a normal aspect of digestion. Gas pain and other symptoms like burping, flatulence, bloating, and cramping can be exacerbated by certain foods such as dairy products and artificial sweeteners, according to the Mayo Clinic.
How to treat it: If it’s not related to another condition, gas can often be treated and managed with various over-the-counter medications (such as Beano or Gas-X) and dietary changes. If you experience chronic gas and severe pain, it could be a sign of another underlying GI condition, which a doc can help to diagnose.
5. Food poisoning
Food poisoning results from eating contaminated food, causing symptoms such as nausea, vomiting and diarrhea, in addition to abdominal pain, according to the Mayo Clinic.
How to treat it: Food poisoning can often be treated at home by replacing fluids and electrolytes and letting it run its course. But if you experience severe symptoms like dehydration, bloody stool, and a fever over 100 degrees, you should seek medical attention.
Indigestion is pretty much just the formal name for having an upset stomach, marked by upper abdominal pain, often after a meal. Other symptoms can include gas and nausea, according to the Mayo Clinic.
Gastritis is the term for inflammation involving the lining of the stomach. Symptoms are similar to GERD and include abdominal discomfort/pain, heartburn, nausea, and vomiting. Gastritis can be caused by irritation due to excessive alcohol use, stress, medication such as anti-inflammatory drugs, bile reflux, and infections caused by bacteria like Helicobacter pylori, the latter of which can also lead to ulcers and stomach cancer.
How to treat it: Treatment depends on the specific cause, of course. For example, acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. Medications that block or reduce acid production and promote healing can also help, as can antacids and antibiotics to treat H. pylori infection.
8. Peptic ulcer disease
This condition typically includes upper abdominal pain with the pain occasionally localizing to one side, says Dr. Dann. Additional symptoms include abdominal bloating, fullness, nausea, and the inability to eat a full meal, or feeling full after only a small amount of food.
How to treat it: To treat this condition, with the guidance of a doctor, discontinue use of nonsteroidal anti-inflammatory drugs and work to eliminate H. pylori with appropriate medications to promote ulcer healing, says Dr. Dann.
9. Functional dyspepsia
This is the term used to describe gastrointestinal symptoms where the cause seems to be unknown. Symptoms of functional dyspepsia can overlap with GERD and gastritis, says Dr. Dann.
How to treat it: Patients under 60 years of age should be tested and treated for H. pylori, says Dr. Dann. This sometimes will include an upper endoscopy, particularly if they’re over age 60. Patients who are H. pylori negative or who continue to have symptoms after gettiing rid of the bacteria should be treated with antisecretory therapy with a proton pump inhibitor.
10. Gastroenteritis and infectious colitis
These are the terms for inflammation in the lining of the intestines and colon, respectively. Symptoms will vary based on the location and cause. In both cases, the underlying cause could be due to a condition such as Crohn’s disease or even something more benign such as a lack of blood flow to the abdominal area, says Dr. Dann. Patients with infectious colitis generally have diarrhea associated abdominal pain, which may be severe.
How to treat it: Depending on the severity of symptoms, antibiotics may be needed.
Acute appendicitis typically presents initially with pain around the belly button which radiates into the right lower quadrant of the abdomen area, says Dr. Dann. It is associated with nausea, vomiting, and loss of appetite.
How to treat it: For patients with non-perforated appendicitis (meaning the appendix hasn’t bursted), you’ll likely need an appendectomy in a fairly timely fashion. If the appendix hasn’t been ruptured, you may be able to treat it solely with antibiotics. If the appendix has ruptured? You’ll need emergency surgery.
Gallstones can cause intense discomfort or sharp pain located in the right upper quadrant or other area below the chest. That’s because gallstones occur when digestive fluid deposits have hardened in the gallbladder, and these “stones” have temporarily blocked the duct, causing discomfort and pain. The pain may radiate to the back and right shoulder blade and symptoms can also include nausea, vomiting, and sweating. Pain can last 30 to 90 minutes at a time, and an abdominal examination unfortunately won’t tend to show much, says Dr. Dann.
How to treat it: During a gallstone attack, pain can be controlled with nonsteroidal anti-inflammatory drugs. “Elective gallbladder removal should be considered for patients with gallstones on imaging to prevent future attacks and complications of gallstone disease,” says Dr. Dann.
13. Acute cholecystitis
This is the term for when inflammation occurs in the gallbladder, typically from a clogged duct (like from a gallstone). Acute cholecystitis symptoms can include severe, prolonged, steady pain (like for more than four to six hours) involving the right upper quadrant. You may also have a fever and an elevated white blood cell count, and you may be hypersensitive when you put pressure on the area below the ribs while breathing deeply.
How to treat it: This is a more serious condition that requires hospitalization, says Dr. Dann. Treatment will include intravenous hydration (meaning through an IV), pain meds, IV antibiotics, and surgery to remove the gallbladder.
14. Acute cholangitis
Acute cholangitis can present similarly to acute cholecystitis but is typically more severe, says Dr. Dann. It occurs when a stone becomes impacted in ducts draining bile from the liver into in the small intestine, leading to an infection. Symptoms include fever, jaundice (yellowing of the skin or the whites of the eye), and abdominal pain. The abdominal pain is typically vague and located in the right upper quadrant.
How to treat it: Similarly to the previous condition, treatment will include hospitalization with intravenous hydration, pain medications, antibiotics, and surgery.
15. Celiac disease
The OG reason for going gluten-free, celiac disease sufferers tend to experience abdominal pain and excessive flatulence in addition to diarrhea, which is often foul-smelling due to malabsorption, says Dr. Dann. Symptoms can present as early as infancy but most commonly present between the ages of 10 and 40. Patients may also experience weight loss, anemia (low red blood cell count), neurologic disorders from deficiencies of B vitamins, and osteopenia (thinning of the bones) due to vitamin D and calcium deficiencies.
How to treat it: Most patients can manage celiac disease with a gluten-free diet, as well as by monitoring and reporting any complications to their doctor.
Pancreatitis can be acute and chronic. The pain is typically severe and can even radiate to the back. Symptoms can also include nausea and vomiting, and you might feel a little bit of relief when you sit upright or lean forward, says Dr. Dann.
How to treat it: Most cases of pancreatitis require hospitalization, along with fluid replacement and pain meds.
17. Acute hepatitis
Hepatitis is when there is inflammation in the liver due to one fo the five hepatitis infections. Patients with acute hepatitis may have pain in the right upper quadrant, fatigue, nausea, and vomiting. Other symptoms include jaundice, dark urine, and light colored stools.
How to treat it: Treatment will vary depending on the underlying cause and may require hospitalization for supportive care, says Dr. Dann.
Gastroparesis is a condition when the stomach can’t properly empty itself of food contents. In addition to abdominal pain, a person with gastroparesis will have nausea, vomiting, early satiety, bloating, and in severe cases, weight loss. The cause is often unknown, but gastroparesis can be seen in diabetics and post-surgery patients.
How to treat it: Treatment typically includes making changes to your diet, getting your blood sugar levels and changes under control if you’re diabetic, and hydrating. Medication such as metoclopramide (Reglan) may be necessary, and some patients may require a feeding tube, says Dr. Dann.
19. Kidney stones
Kidney stones occur when a stone passes from the kidney into the ducts carrying urine to the bladder. Mild to severe pain is the most common symptom and can occur in the back or abdomen. Additional symptoms include nausea, vomiting, painful or urgent urination, and blood in the urine.
How to treat it: Kidney stones are most often treated with pain medication and hydration until the stone passes naturally through your urinary system. Large stones may require additional treatment, like lithotripsy (a procedure used to help break up the stones) or surgical removal.
20. A bladder or kidney infection
Bladder infections can definitely cause abdominal pain, as well as painful and urgent urination, and/or blood in the urine. If it’s a kidney infection you’re dealing with, you may also have a fever, chills, thigh pain, and joint tenderness.
How to treat it: Most cases can be treated with a course of oral antibiotics, though severe cases may require hospitalization and IV antibiotics. In rare cases, surgery may be required, says Dr. Dann.
21. Heart attack
You may be surprised by this, but symptoms for acute myocardial infarction (the medical term for heart attack) can include abdominal pain, belching, nausea, and indigestion, as well as shortness of breath or chest pain.
How to treat it: Management will depend on the underlying cause but will always requires prompt recognition and hospitalization, says Dr. Dann. Heart attacks are no joke.
Endometriosis is a disorder in which tissue that normally lines the uterus grows outside of it, often leading to lower abdominal/pelvic pain. Symptoms include painful periods with abdominal cramps, painful during sex, and/or infertility. Endometriosis can also lead to bowel and bladder issues, says Dr. Dann.
How to treat it: Initial treatment typically includes oral contraceptives and nonsteroidal anti-inflammatory drugs, says Dr. Dann. However, recurrence rates are high if you stop taking medication. If treatment isn’t successful, surgery to remove the tissue growth is an option.
23. Uterine fibroids
Also known as leiomyomas, uterine fibroids typically lead to chronic lower abdominal/pelvic pressure or pain. Symptoms will vary depending on the size and number of fibroids and can include abdominal tenderness and low-grade fever, and your gyno may be able to feel large fibroids during an external abdominal exam.
How to treat it: Treatment can include oral contraceptives or GnRH agonists (medications that affect hormone levels). Some women also find relief with an IUD as a birth control method. In other cases, myomectomy (a surgical procedure to remove uterine fibroids) might be necessary.
24. Ovarian cysts
Ovarian cysts are solid or fluid-filled sacs or pockets in or on top of an ovary. Pain is often a sign that the cyst has ruptured or burst, says Dr. Dann. The most common symptom is lower quadrant pain, and especially pain after sex.
How to treat it: Ovarian cysts can often be managed with monitoring by your doctor and with over-the-counter pain-relief meds. In severe cases, surgery may be required.
25. Ovulatory pain
This pain can occur in the middle of your menstrual cycle, coinciding with timing of ovulation. It may be right- or left-sided, depending on which side you’re ovulating from during that cycle.
How to treat it: This pain usually goes away within 24 hours, says Dr. Dann. You can treat it with over-the-counter nonsteroidal anti-inflammatory drugs such as ibuprofen. If ovulation is particularly painful for you, taking birth control pills to prevent ovulation may be a solution worth talking to your gyno about.
26. Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, typically on the fallopian tube. It typically occurs during the first trimester, with symptoms such as abdominal pain and or vaginal bleeding that can be life-threatening.
How to treat it: With an early diagnosis, most patients may be treated with a drug called methotrexate (MTX). But in some cases, a woman may need surgery, says Dr. Dann.
27. Pelvic inflammatory disease
Pelvic inflammatory disease (PID) typically includes acute lower abdominal and or pelvic pain. Patients may also have pelvic organ tenderness and evidence of inflammation of the genital tract. Any sexually active woman is at risk of developing PID, and it most often happens when an STD is left untreated, causing this infection of the reproductive organs.
How to treat it: Treatment can include antibiotics used to treat gonorrhea, chlamydia, and other bacterial infections. Severe or complicated PID may require hospitalization.
28. Ovarian torsion
Ovarian torsion occurs when an ovary becomes twisted around the ligaments that hold it in place. Symptoms can include moderate to severe pelvic pain, typically associated with nausea, a noticeable mass or bloating in the pelvic area, and sometimes vomiting, says Dr. Dann.
How to treat it: Ovarian torsion can sometimes resolves itself, but it often involves surgery. Surgical removal of the ovary may sometimes be required as well, says Dr. Dann.
29. Ovarian cancer
Ovarian cancer has a reputation as a “silent killer,” as it’s often asymptomatic until it’s in an advanced stage. But early symptoms may include bloating or abdominal/pelvic pain, urinary urgency or frequency, and postmenopausal bleeding.
How to treat it: Treatment will require surgery followed by chemotherapy, says Dr. Dann.
30. Ovarian hyperstimulation
Ovarian hyperstimulation syndrome (OHSS) can cause abdominal discomfort from enlarged ovaries in women undergoing fertility treatment. Early symptoms are usually mild to moderate and begin four to seven days after the ovulatory dose of the human chorionic gonadotropin (hCG) hormone. Late symptoms are typically more severe and begins at least nine days after the ovulatory dose of hCG during a conception cycle.
How to treat it: Mild or moderate OHSS and can be managed with analgesics such as Tylenol (acetaminophen), and by avoiding intense physical activity, says Dr. Dann.
Endometritis is the inflammation of the inner lining of the uterus, a.k.a. the endometrium. It typically involves lower abdominal and pelvic pain, as well as painful periods with cramping, pain during sex, and/or infertility. It can also lead to bowel and bladder issues, notes Dr. Dann.
How to treat it: Most infections are mild and cured with antibiotic therapy, though some may require IV antibiotics or curettage, a surgical scraping procedure to remove the affected tissue.
32. Crohn’s disease
Crohn’s disease is another type of inflammatory bowel disease that causes inflammation in the digestive tract. It’s marked by symptoms such as abdominal pain, severe diarrhea, cramping, and bloody stool, according to the Mayo Clinic. If you have have symptoms that could be consistent with Crohn’s disease or have already been diagnosed, you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan, and to exclude a more serious or urgent condition, says Dr. Dann.
How to treat it: While there’s unfortunately no cure for Crohn’s, it’s often treated and managed with medications such as corticosteroids, immune system suppressors, and antibiotics. In severe cases, surgery may be required.