Common causes of stomach pain

‘Stomach pain’ is a term often used to describe pain or discomfort anywhere in your abdomen, the space between your ribs and your hips. The abdomen holds many of our internal organs, and stomach pain may be related to your stomach, intestines (bowels), pancreas, liver, bladder, or reproductive organs.

Stomach pain is common and most stomach pain is not serious and resolves without treatment. But sometimes stomach pain may be a sign of a serious health problem, and, in rare cases, may even be life threatening.

Let’s look at some common causes of stomach pain, some things you can do at home to help with stomach pain, and when you should see a doctor.

What does stomach pain feel like?

Stomach pain can feel different depending on the cause. How stomach pain feels varies in the severity and type of pain, where the pain is located, and whether it is accompanied by other symptoms.

Severity

Stomach pain can be mild, moderate, or severe. Pain is subjective, which means everyone experiences pain differently and what is mild to some people may be unbearable to others. Your healthcare provider may use a pain scale to help you describe how bad your pain is. Some pain scales use the numbers 0 to 10, with 0 being no pain and 10 being the worst pain you’ve ever experienced. Other pain scales may use pictures of facial expressions or nonverbal signals to assess pain.

Type of pain

Your stomach pain may feel like a dull ache, cramping, or a sharp stabbing pain. You may have pain all the time, or it may come and go.

Stomach pain can be:

• Acute (starts suddenly and lasts for a short time)
• Chronic (lasts for several months or years)
• Progressive (gets worse over time)

Location

You may feel pain high up under your ribs, in your sides, or low down in your belly. Pain may be localised, meaning it affects a specific area of your abdomen, or generalised across a large area.

Sometimes abdominal pain can radiate (spread) to other areas of your body, like your back or chest. 

Other symptoms

You may have stomach pain on its own, or it may be accompanied by other symptoms such as:

• Nausea
• Vomiting
• Gas
• Bloating
• Constipation
• Diarrhoea
• Fever
• Pain when peeing
• Vaginal bleeding

Common causes of stomach pain

Below are some of the more common causes of stomach pain. Many of them can be treated at home and resolve after a few days, but in some cases you may need medical treatment.

Food poisoning (gastroenteritis)

Food poisoning is very common and occurs as a result of eating or drinking something contaminated by germs such as campylobacter enteritis or E coli.

Symptoms of food poisoning may include:

• Abdominal pain
• Vomiting
• Diarrhoea
• Fever
• Weakness
• Headache

Food poisoning isn’t usually serious, and symptoms normally resolve in a couple of days. Rest and drink plenty of fluids, such as water or oral rehydration drinks, to replace the fluids your body is losing. One of the biggest risks of food poisoning is dehydration, which can be serious.

When should I see a doctor?

See a doctor if:

• You have diarrhoea for more than 5 days (2 days for babies and small children), or diarrhoea that is getting worse
• Your child has been vomiting for more than 12 hours (for babies under 3 months of age, seek medical attention as soon as vomiting or diarrhoea start)
• You can’t keep fluids down
• You have a temperature above 38.3C
• You have diarrhoea containing blood or pus
• You have severe weakness or dizziness
• You have recently travelled to a foreign country

Babies, the elderly, pregnant women, and people with weakened immune systems, or medical conditions like diabetes, cancer, or AIDS, have a higher risk of complications, and should seek medical attention early.

Constipation

Constipation is difficulty emptying your bowels (pooping). It is a common cause of stomach pain and can usually be treated at home.

Symptoms of constipation may include:

• Emptying your bowels less than 3 times a week
• Pain or straining when emptying your bowels
• Your poo may be hard, dry, or lumpy

Most constipation can be treated with dietary changes like drinking more water or eating a high fibre diet. Sometimes, you may need to take a mild laxative to help with constipation. Your pharmacist can recommend one.

When should I see a doctor?

See a doctor if:

• Your constipation isn’t getting better with changes to your diet and laxatives
• You are regularly bloated and constipated
• You feel constantly tired or fatigued
• You notice blood in your poo
• You have lost weight without trying
• You are taking medications that can cause constipation like some strong painkillers or certain blood pressure medications

Period pain (dysmenorrhoea)

Period pain is abdominal pain during menstruation (having your period). It occurs when your uterus (womb) contracts (tightens and relaxes) during your period. Period pain is common and isn’t usually anything to worry about, but in some cases, can be a sign of an underlying medical condition such as fibroids, endometriosis, or pelvic inflammatory disease (PID).

Symptoms of period pain may include:

• Abdominal pain, before, or during your period. Pain may be sharp, or a dull ache, and can range from mild to severe
• Cramping in your abdomen that spreads to your back or thighs
• Pain usually starts 1 to 3 days before your period and peaks during the first 24 hours before easing off over the next 2 to 3 days
• Nausea
• Dizziness
• Headaches
• Diarrhoea

Most period pain can be treated at home with over-the-counter painkillers like paracetamol or ibuprofen. You can also try placing a hot water bottle on your belly and taking gentle exercise to help relieve pain.

When should I see a doctor?

Make an appointment to see a consultant if:

• Your period pain is disrupting your life
• Your period pain is getting worse, or your periods are heavier, or less regular than usual
• You start having severe period pain after the age of 25
• You have pain during sex
• You have pain when using the bathroom (peeing or pooing)
• You have bleeding between periods (spotting)

Irritable bowel syndrome (IBS)

Irritable bowel syndrome is the medical term for a group of symptoms that occur despite there being no signs of damage or disease in your bowels. IBS can cause diarrhoea (IBSD), constipation (IBSC), or both. The cause of IBS is unknown. IBS is a chronic condition that needs to be managed long term.

Symptoms of IBS may include:

• Abdominal pain
• Diarrhoea
• Constipation
• Changes in bowel habit (how often you poo)
• Bloating
• Gas
• Needing to poo urgently
• Passing mucus from your bottom
• Fatigue

IBS is normally treated with medications like probiotics and dietary changes, such as the FODMAP diet.

When should I see a doctor?

Make an appointment with your consultant if you have symptoms of IBS. Your consultant can prescribe medication to help manage your condition as well as refer you to a dietician for advice on making changes to your diet.

Seek urgent medical attention if:

• You have a change in bowel habit that has lasted for more than 6 weeks
• You have severe abdominal pain, or pain that isn’t relieved by passing gas, or moving your bowels
• You have swelling or a lump in your rectum (back passage)
• You are bleeding from your rectum, or notice blood in your poo
• You have lost weight without trying

Kidney stones (renal calculi)

Kidney stones occur when chemicals in the urine build up and form stones. Some kidney stones are small and cause no, or mild symptoms, but if they are large, they can cause severe pain as they pass through the urinary tract.

Symptoms of kidney stones may include:

• Severe pain in your sides or lower back. This often comes and goes
• Constant dull pain in the abdomen
• Cloudy or strong-smelling urine
• Blood in your urine
• Pain or burning when passing urine
• Fever
• Nausea or vomiting

Kidney stones can be very painful, but usually pass by themselves without treatment. You can help manage the pain by taking over-the-counter painkillers and applying a heat pack or hot water bottle to the area. Make sure you drink plenty of water to help flush the kidney stone out.

Large kidney stones may need to be removed with surgery, or a procedure to break the stone down into smaller fragments that can be passed in your urine.

When should I see a doctor?

See a consultant if you have any symptoms of a kidney stone.

Stomach ulcer (gastric ulcer)

Stomach ulcers are sores caused by damage to the lining of the stomach. They are normally caused by infection with a type of bacteria called Helicobacter pylori (H. pylori), or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen.

Symptoms of a stomach ulcer may include:

• Abdominal pain — this is often described as a burning, gnawing pain, and usually starts within a few hours of eating
• Indigestion
• Acid reflux (heartburn)
• Nausea and vomiting
• Loss of appetite
• Weight loss

When should I see a doctor?

Make an appointment to see a consultant if you have symptoms of a stomach ulcer.

Seek immediate medical attention if:

• You have sudden, severe pain in your abdomen
• Your poo is dark, sticky, and tar-like
• You are vomiting blood or dark brown liquid that looks like coffee grounds

Gallstones

Gallstones are stones that form in your gallbladder. They usually don’t cause any symptoms and don’t need to be treated, but sometimes a stone can block a duct inside the gallbladder, causing intense pain. Pain normally gets worse very quickly and can last from a few minutes to several hours.

Treatment for gallstones is normally with surgery to remove your gallbladder.

Symptoms of gallstones may include:

• Sudden, severe, rapidly worsening pain in the upper right, or central part of your abdomen
• Pain in your right shoulder
• Pain in your back beneath your shoulder blades
• Nausea
• Vomiting

When should I see a doctor?

Make an appointment with a consultant if you have symptoms of gallstones.

Urinary tract infection (UTI)

Urinary tract infections occur when bacteria, usually from the skin or rectum, enter the urinary tract. They can affect the kidneys, bladder, or urethra (the tube that carries urine out of your body). UTIs are common, especially in women, as they have a shorter urethra and there is less distance from the urethra to the rectum.

Symptoms of a UTI may include:

• Pain low in your abdomen
• Back pain
• Needing to pee urgently
• Peeing more often than usual
• Pain or a burning sensation when peeing
• Strong-smelling urine
• Blood in your urine
• Cloudy urine
• Fever

UTIs are normally treated with antibiotics, though sometimes this isn’t necessary. You can help relieve symptoms of a UTI by taking over-the-counter painkillers and drinking plenty of water. Applying a heat pad or hot water bottle to your tummy can help with pain. Avoid having sex until you feel better.

When should I see a doctor?

Men, children, and the elderly should see a doctor if they develop symptoms of a UTI.

Women should see a doctor if:

• You have symptoms of a UTI for the first time
• Your symptoms are getting worse, or last longer than 2 days
• You still have symptoms after treatment with antibiotics
• You keep getting UTIs
• You have a fever
• You have blood in your urine
• You have abdominal or back pain

Diverticulitis and diverticulosis (diverticular disease)

Diverticulitis and diverticulosis are common conditions that affect the colon (large intestine). Diverticulosis is when small pockets or pouches called diverticula develop in the colon wall. Diverticulitis occurs when these abnormal pouches become infected or inflamed. Together, these conditions are known as diverticular disease.

Symptoms of diverticulosis may include:

• Abdominal pain
• Bloating
• Constipation
• Diarrhoea
• Gas
• Blood in your poo
• Anaemia from ongoing bleeding

Symptoms of diverticulitis tend to be more severe than diverticulosis and may include:

• Severe abdominal pain, usually on the left side
• Diarrhoea
• Fever

When should I see a doctor?

See a doctor as soon as possible if you have symptoms of diverticular disease.

Endometriosis

Endometriosis is a condition where tissue similar to the endometrium (the tissue that lines the womb) grows outside the womb. It can cause problems with your period, such as pain and heavy bleeding and difficulty getting pregnant (infertility).

Symptoms of endometriosis may include:

• Period pain
• Pain during or after sex
• Heavy or irregular periods
• Fatigue
• Diarrhoea or constipation during your period
• Pain when peeing or pooing during your period
• Bleeding between periods (spotting)
• Infertility

When should I see a doctor?

Make an appointment with a consultant if you have symptoms of endometriosis.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an infection that affects the female reproductive organs, such as the uterus (womb), fallopian tubes and ovaries. It’s commonly caused by a sexually transmitted infection (STI) and often has mild or no symptoms. Left untreated, PID can cause infertility (difficulty getting pregnant).

Symptoms of pelvic inflammatory disease may include:

• Pain in your lower abdomen or deep within your pelvis
• Heavy or painful periods
• Pain when peeing
• Pain or bleeding after sex
• Bleeding between periods (spotting)
• Yellow, green, or strong-smelling vaginal discharge

Occasionally, PID can cause more severe symptoms, such as:

• Severe abdominal pain
• Nausea
• Vomiting
• Fever

When should I see a doctor?

See a consultant if you have symptoms or think you may be at risk of PID. Early diagnosis and treatment can reduce the risk of complications.

Less common causes of stomach pain

Sometimes stomach pain can be a sign of something more serious and may even be life-threatening. If you have any of the following symptoms, seek immediate medical attention.

Appendicitis

Appendicitis is inflammation of the appendix, a thin tube that is connected to your large intestine. It is a medical emergency and needs urgent treatment. Untreated appendicitis can cause the appendix to rupture (burst) leading to a serious infection in the abdominal cavity called peritonitis. Peritonitis can lead to sepsis, a widespread infection throughout the body which can be life-threatening.

Symptoms of appendicitis may include:

• Pain in the centre of your abdomen, which gets worse quickly and moves to the lower right side of your belly. Pain may also start on the lower right side of your abdomen
• Pain may be worse when you press on the area, cough, sneeze, take a deep breath, or move
• Nausea
• Vomiting
• Constipation or diarrhoea
• Fever
• Bloating
• Loss of appetite

Pancreatitis

Pancreatitis is inflammation of the pancreas, an organ in your digestive system that produces enzymes to help you digest food and hormones like insulin. Pancreatitis can be acute (starts suddenly and lasts a short time), or chronic (long-lasting).

Symptoms of pancreatitis include:

• Severe abdominal pain that may spread to your back or chest
• Pain that gets worse after eating
• Swelling and tenderness in your upper abdomen
• Nausea and vomiting
• Fever
• Fast heart rate
• Yellowing of the skin and the whites of the eyes (jaundice)

Abdominal aortic aneurysm (AAA)

The aorta is the main artery that takes blood from the heart to the abdomen. An abdominal aortic aneurysm occurs when there is a weakness in the wall of the aorta, causing it to bulge out and potentially burst. Most people with an abdominal aortic aneurysm don’t have symptoms and are unaware that they have one. If your aneurysm becomes large, you may feel a pulsating sensation in your abdomen, or have stomach or back pain.

A burst abdominal aortic aneurysm is a medical emergency that needs urgent treatment.

Symptoms of a burst AAA may include:

• Sudden severe pain in your abdomen or back
• Feeling cold, clammy, dizzy, sweaty, or short of breath
• Loss of consciousness

Stomach cancer

Stomach cancer is a type of cancer that affects the stomach. Cancer occurs when body cells behave abnormally and grow in an uncontrolled way.

Stomach cancer is uncommon in the UK. Symptoms of stomach cancer are similar to those of other diseases and may be overlooked.

Symptoms of stomach cancer may include:

• Pain high in your abdomen
• A lump high in your abdomen
• Acid reflux (heartburn)
• Indigestion
• Nausea
• Vomiting
• Difficulty swallowing (dysphagia)
• Feeling full quickly after eating
• Loss of appetite
• Losing weight without trying
• Fatigue

Ovarian cancer

Ovarian cancer is a type of cancer that affects the ovaries, the part of the female reproductive system where eggs are produced. It is most common in women over 50.

Ovarian cancer symptoms can be mild and vague, and ovarian cancer is often diagnosed in the late stages of the disease. Treatment for ovarian cancer is more effective if started early, so see a doctor as soon as possible if you have symptoms.

Symptoms of ovarian cancer may include:

• Abdominal pain
• Bloating
• Feeling full quickly after eating
• Loss of appetite
• Needing to pee frequently, or urgently
• Back pain
• Fatigue
• Constipation or diarrhoea
• Losing weight without trying
• Vaginal bleeding after the menopause

Ectopic pregnancy

An ectopic pregnancy occurs when an embryo starts to grow outside the uterus (womb), usually in one of the fallopian tubes. As the embryo grows, it can cause the tube to rupture (burst) causing internal bleeding. This is a medical emergency and needs immediate treatment.

Symptoms of an ectopic pregnancy normally develop between the 4th and 12th week of pregnancy.

Early symptoms of an ectopic pregnancy may include:

• Normal signs of pregnancy such as a missed period, nausea, and breast tenderness
• Abnormal vaginal bleeding
• Mild abdominal pain or cramping on one side of the abdomen
• Pain in the tip of your shoulder

Late symptoms of an ectopic pregnancy may include:

• Sudden, severe abdominal pain
• Weakness
• Dizziness
• Nausea
• Pallor (looking very pale)
• Shoulder pain

Bowel obstruction

A bowel obstruction is a blockage in the bowel, the tube that takes waste matter out of your body. The bowel may be completely or partially blocked, meaning waste can’t move past the blockage. Left untreated, a bowel obstruction may cause the bowel to rupture (burst) leading to a life-threatening infection (peritonitis).

Bowel obstructions are commonly caused by hernias, abdominal adhesions, inflammatory bowel disease and some cancers.

A bowel obstruction is a medical emergency and needs immediate treatment.

Symptoms of a bowel obstruction may include:

• Abdominal pain that may come and go
• Bloating
• Nausea
• Vomiting — you may vomit large amounts of undigested food or bowel fluid
• Constipation
• Not being able to pass gas
• Loss of appetite

Summary

Stomach pain is a common problem with a wide variety of causes. Fortunately, most stomach pain isn’t serious and usually resolves by itself within a few days. If you are worried about your stomach pain, your pain is getting worse, or not getting better, speak to a healthcare professional for advice.