We all have stomachaches, upset stomach, and abdominal pain from time to time, and they’re usually not serious. But they can be a sign that something inside your body is not functioning the way it should – especially if you have severe stomach pain or sharp stomach pain. Causes can be anything from gas or a pulled muscle to something as serious as an internal infection or heart attack. If you get stomachaches or upset stomach often, or they hurt a lot or don’t go away, you may need to see a doctor.
Symptoms associated with abdominal pain
Call your doctor if you have severe stomach pain, sharp stomach pain, if your stomach pain does not improve in 24 to 48 hours or if you also have:
- Chest pain (get prompt medical attention)
- Bloating or swelling that lasts more than a few days
- An injury or recent accident
- Bloody or dark stools
- Vomiting blood or dark material
- Changes in bowel habits
- Unexpected weight loss
- Difficulty swallowing
- Diarrhea for more than five days
- Prolonged vagin*l bleeding
- Fever over 100 degrees
- Burning sensation when you urinate or frequent urination
Any of these additional conditions could indicate a more serious underlying cause that requires medical treatment.
Common causes of abdominal pain and upset stomach
The most common causes of abdominal pain or upset stomach can be classified into three general categories: digestive problems, inflammation and female reproduction.
- Digestive problems: If you experience abdominal pain after you eat, you may have indigestion, constipation, diarrhea, food allergies or food poisoning.
- Inflammation: Painful irritation or infection in your organs can be caused by inflammation from the stomach flu, a peptic ulcer, GERD (gastroesophageal reflux disease), gallstones, pancreatitis or a urinary tract infection.
- Female reproduction: Female abdonimal pain related to the reproductive cycle could be from menstrual cramps, ovulation or inflammation in the reproductive organs.
Abdominal pain diagnosis
Your doctor will perform a thorough physical exam and ask you to describe your symptoms and medical history. There are many different kinds of stomach pains, and your doctor may ask if it's mild or severe, burning or achy, dull or sharp, crampy or colicky, in one spot or all over, constant or in waves. All this information will help your doctor find the cause of your pain and determine what to do about it.
The location of your pain, such as upper or lower abdominal pain as described below, also gives your doctor clues for diagnosing the possible cause.
- General: Appendicitis, urinary tract infection, Crohn's disease or irritable bowel syndrome
- Upper abdomen: GERD, gallstones, pancreatitis or heart attack
- Middle abdomen: Pancreatitis, appendicitis, intestinal blockage or thoracic aortic aneurysm
- Lower abdomen: Lower abdominal pain can be a result of diverticulitis, appendicitis, ectopic pregnancy or inflammation of the fallopian tubes (salpingitis)
- Upper left abdomen: Shingles, spleen infection, heart attack or hiatal hernia
- Lower left abdomen: Crohn’s disease, diverticulitis, ulcerative colitis or kidney stone disease
- Upper right abdomen: Cholangitis (inflammation of the bile duct), hepatitis, fecal impaction (hardened stools) or peptic ulcer
- Lower right abdomen pain: Cholecystitis (inflammation of the gallbladder), ovarian cysts, appendicitis or stomach flu
Tests for abdominal pain
Your doctor may order urine, blood and stool tests. Imaging tests are also helpful for detecting abnormalities inside your digestive system and other organs. These tests may include X-rays, CT scan, ultrasound, double-contrast barium enema or endoscopy.
Abdominal pain treatment
Depending on the cause of your abdominal pain, your doctor may prescribe medications.
Over-the-counter medications for stomach pain
- Medications with simethicone: Gas pain or bloating
- Antacids and acid-reducing medications: Belching, stomach fullness or acid reflux
- Laxatives or stool softeners: Bloating from constipation
Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) because they can irritate the stomach.
Prescription medications for stomach pain
Some conditions also may benefit from prescription medication.
- Steroids: Reduce pain and inflammation from conditions like Crohn's disease and ulcerative colitis
- Proton pump inhibitors: Disorders that are worsened by stomach acid like ulcers and gastroesophageal reflux
- Antibiotics:Bacterial conditions or ulcers related to H. pylori
Surgery for stomach pain
If testing shows your pain is related to gastrointestinal conditions such as gallstones, kidney stones, duct or intestinal blockage or appendicitis, you may need surgery. Female abdominal pain related to reproductive issues such as ovarian cysts, uterine fibroids or blocked fallopian tubes may also require surgery.
Ways to prevent stomach pain
Some stomach pains are unavoidable because they can be a symptom of a serious medical condition that’s developed over time. But when that’s not the case, and you know your pain is related to eating or physical activity, you can take steps to prevent it in the future.
Change your eating habits
- Eat more slowly
- Take smaller bites
- Have several small meals throughout the day instead of one or two large meals
- Avoid eating things that upset your stomach such as spicy foods, dairy products or foods that cause gas
- Drink plenty of clear fluids, especially if you’re prone to urinary tract infections, constipation or kidney stones
Use good judgment when you exercise
- See your doctor before beginning any new exercise program
- Always stretch before and after physical activity
- Start slow and know your physical limitations
- Build up your pace and intensity gradually over time
- Stay hydrated before, during and after exercise
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