Stomach pain: possible causes and what different types of pain mean

Abdominal pain has many possible causes, and the stomach is only one of them. Let's figure out how the types of pain differ, what they mean, and when "I'll tough it out until morning" should become "I need a doctor."

Where the stomach is and where the pain actually comes from

The abdomen stretches from the chest to the groin, and the stomach occupies only its upper part. Nearby are the liver, gallbladder, pancreas, intestines, and kidneys — so "stomach pain" more often means "pain in the upper abdomen," and a completely different organ may be to blame. Sometimes the source of pain is outside the abdomen altogether, for example in the chest.

The mechanics of the sensations also differ. Visceral pain originates in the organ itself: oppressive, vague, often with nausea, sweating, and pallor, and the person points to the middle of the abdomen. Somatic pain comes from irritation of the peritoneum: intense, with clear localization, and it can be pointed to with a finger. There is also referred pain — it is felt not where the organ is. Distension of a hollow organ produces cramping, intermittent pain, while the upper digestive tract, including the stomach and bile ducts, more often hurts in the epigastrium.

Pain after eating: what it may mean

After eating, pain may be accompanied by a feeling of fullness, bloating, heartburn, and nausea — this set of symptoms is called dyspepsia.

It is not always something serious: some episodes resolve on their own within a few days. If the pain does not go away or returns, that is a reason to see a doctor.

Sharp, stabbing pain and spasms: how they differ

Colic and spasms are cramping, intermittent pain: it comes in waves, and it is hard to point to a spot. Pain lasting up to three months is considered acute, longer-lasting pain is chronic, and recurrent pain is that which recurs at least three times within three months.

And my favorite myth: that severe pain means catastrophe, while tolerable pain guarantees everything is fine. MedlinePlus says the opposite: severe pain does not always indicate a serious problem, and mild pain does not mean there is no problem. You should see a doctor if mild pain lasts a week or longer or if the pain is accompanied by other symptoms.

Common causes of stomach pain

• Dyspepsia — fullness after eating, heartburn, nausea.
• Gas accumulation — bloating and frequent passing of gas.
• Constipation — difficulty having a bowel movement or less often than usual.
• Intestinal infection and food poisoning — loose stools, nausea, vomiting.
• Gallstones — severe pain lasting up to 8 hours in the center of the abdomen or under the ribs on the right; kidney stones — pain radiating to the groin, nausea, pain when urinating.

The list also includes irritable bowel syndrome with spasms, bloating, and alternating diarrhea and constipation, appendicitis with pain in the lower right, painful periods, and endometriosis.

How the cause is determined: examination, tests, and investigations

The doctor asks where exactly it hurts, when it started, whether it is related to food, and what else is happening — fever, stools, vomiting. Next, a complete blood count may be done to assess inflammatory changes, a plain abdominal X-ray in the upright position, and an ultrasound of the abdominal organs. Esophagogastroduodenoscopy is performed if bleeding from the upper gastrointestinal tract is suspected.

Warning signs: when urgent medical help is needed

You should see a doctor if pain, bloating, or indigestion does not go away or returns, or if a lump can be felt in the abdomen. More urgently — if the pain has sharply intensified, during pregnancy, with blood in the stool, unusual bloody discharge, diarrhea or vomiting that does not stop for several days, with mild pain lasting longer than a week or together with other symptoms.

Abdominal pain by itself is not a reason to call an ambulance. 103 or 112 — if the pain started suddenly and is very severe, the abdomen is rigid and tender to touch, vomiting with blood or greenish or coffee-ground material, a lot of blood from the rectum or black and sticky stool, inability to urinate, no bowel movements or passing of gas, a rash that does not blanch when pressed, difficulty breathing.

This material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer