Stomach Pain: Common Causes from Indigestion to Ulcers

At-a-Glance

• Stomach pain is extremely common, with causes ranging from minor indigestion to serious conditions
• Location, timing, and character of pain help identify the underlying cause
• Most stomach pain is from benign causes like indigestion, gas, or viral gastroenteritis
• Severe, sudden abdominal pain or pain with concerning symptoms requires immediate evaluation
• Chronic or recurrent stomach pain warrants medical evaluation to identify treatable causes

What It Feels Like

Stomach pain (abdominal pain) can vary widely in location, intensity, and character depending on the underlying cause.

Common descriptions include:

• Dull, aching pain
• Sharp, stabbing, or cramping pain
• Burning sensation in upper abdomen
• Bloating or fullness
• Gnawing or hunger-like pain
• Pain that comes and goes (colicky)
• Constant, steady pain
• Pain that worsens after eating or improves with eating

The pain may be localized to one area or diffuse throughout the abdomen.

Common Causes

Indigestion (Dyspepsia)

Indigestion causes discomfort in the upper abdomen, often related to eating.

Signs it might be indigestion:

• Burning or discomfort in upper abdomen
• Feeling full quickly when eating
• Bloating and gas
• Nausea
• Symptoms triggered by certain foods (fatty, spicy, acidic)
• Symptoms worse after large meals
• No alarm symptoms (weight loss, vomiting blood)

What helps:

• Eat smaller, more frequent meals
• Avoid trigger foods
• Don't lie down immediately after eating
• Limit alcohol and caffeine
• Quit smoking
• Over-the-counter antacids or acid reducers
• Stress management

Gastroesophageal Reflux Disease (GERD)

Acid reflux causes burning pain in upper abdomen and chest (heartburn).

Signs it might be GERD:

• Burning sensation in chest or upper abdomen
• Sour taste in mouth
• Symptoms worse when lying down or bending over
• Symptoms after eating
• Chronic cough or hoarseness
• Difficulty swallowing

What helps:

• Elevate head of bed
• Avoid trigger foods (spicy, fatty, acidic, chocolate, caffeine)
• Eat smaller meals
• Don't eat within 3 hours of bedtime
• Lose weight if overweight
• Proton pump inhibitors (PPIs) or H2 blockers
• Antacids for quick relief

Gastritis

Inflammation of the stomach lining causes pain and nausea.

Signs it might be gastritis:

• Burning or gnawing pain in upper abdomen
• Nausea and vomiting
• Feeling full after eating small amounts
• Loss of appetite
• May be triggered by NSAIDs, alcohol, or stress
• H. pylori infection (common cause)

What helps:

• Avoid NSAIDs, alcohol, and irritating foods
• Antacids or acid-reducing medications
• Antibiotics if H. pylori infection present
• Eat smaller, frequent meals
• Stress management

Peptic Ulcer

Open sores in stomach or small intestine lining cause burning pain.

Signs it might be an ulcer:

• Burning pain in upper abdomen
• Pain often occurs between meals or at night
• Pain may improve or worsen with eating
• Nausea and vomiting
• Dark or bloody stools
• Unintentional weight loss
• Caused by H. pylori infection or NSAID use

What helps:

• Antibiotics for H. pylori
• Proton pump inhibitors or H2 blockers
• Avoid NSAIDs
• Avoid alcohol and smoking
• Eat regular meals
• Stress management

Irritable Bowel Syndrome (IBS)

Functional disorder causing abdominal pain and changes in bowel habits.

Signs it might be IBS:

• Cramping abdominal pain
• Pain improves after bowel movement
• Bloating and gas
• Diarrhea, constipation, or alternating
• Mucus in stool
• Symptoms triggered by stress or certain foods
• Chronic, recurring symptoms

What helps:

• Identify and avoid trigger foods (FODMAPs, dairy, gluten)
• Fiber supplementation (for some types)
• Probiotics
• Stress management
• Regular exercise
• Medications for specific symptoms (antispasmodics, laxatives, anti-diarrheals)
• Cognitive behavioral therapy

Gastroenteritis (Stomach Flu)

Viral or bacterial infection causes inflammation of stomach and intestines.

Signs it might be gastroenteritis:

• Sudden onset of nausea and vomiting
• Diarrhea (watery)
• Cramping abdominal pain
• Low-grade fever
• Muscle aches
• Recent exposure to sick contacts or contaminated food
• Usually resolves in 1-3 days

What helps:

• Stay hydrated (water, electrolyte drinks)
• Rest
• Bland diet (BRAT: bananas, rice, applesauce, toast)
• Avoid dairy temporarily
• Anti-nausea or anti-diarrheal medications if needed
• Antibiotics only if bacterial and severe

Food Intolerance

Inability to digest certain foods causes abdominal pain and digestive symptoms.

Common intolerances:

• Lactose (dairy)
• Gluten (celiac disease or sensitivity)
• Fructose
• FODMAPs

Signs it might be food intolerance:

• Symptoms occur after eating specific foods
• Bloating, gas, and cramping
• Diarrhea
• Nausea
• Symptoms improve when avoiding trigger foods

What helps:

• Identify trigger foods (elimination diet, food diary)
• Avoid problematic foods
• Lactase supplements for lactose intolerance
• Gluten-free diet for celiac disease
• Low-FODMAP diet for IBS

Constipation

Infrequent or difficult bowel movements can cause abdominal pain and bloating.

Signs it might be constipation:

• Fewer than 3 bowel movements per week
• Hard, dry stools
• Straining during bowel movements
• Feeling of incomplete evacuation
• Abdominal bloating and discomfort
• Pain improves after bowel movement

What helps:

• Increase fiber intake (fruits, vegetables, whole grains)
• Drink plenty of water
• Regular exercise
• Don't ignore urge to have bowel movement
• Over-the-counter laxatives if needed (short-term)
• Establish regular bathroom routine

Serious Causes Requiring Immediate Attention

Appendicitis

Inflammation of the appendix is a surgical emergency.

Warning signs:

• Pain starting around navel, moving to lower right abdomen
• Pain worsens over hours
• Nausea and vomiting
• Loss of appetite
• Fever
• Inability to pass gas
• Pain worsens with movement or coughing

Action: Seek emergency care immediately.

Gallstones/Cholecystitis

Gallstones or gallbladder inflammation cause severe upper right abdominal pain.

Warning signs:

• Sudden, severe pain in upper right abdomen
• Pain radiating to right shoulder or back
• Nausea and vomiting
• Fever (if infected)
• Pain after fatty meals
• Yellowing of skin or eyes (jaundice)

Action: Seek medical care promptly.

Pancreatitis

Inflammation of the pancreas causes severe upper abdominal pain.

Warning signs:

• Severe, constant pain in upper abdomen
• Pain radiating to back
• Nausea and vomiting
• Fever
• Rapid pulse
• Tender abdomen
• Often related to alcohol use or gallstones

Action: Seek emergency care.

Bowel Obstruction

Blockage in intestines prevents passage of food and waste.

Warning signs:

• Severe, cramping abdominal pain
• Inability to pass gas or stool
• Severe bloating
• Vomiting
• Loud bowel sounds or complete silence

Action: Seek emergency care immediately.

When to See a Doctor

Schedule a doctor's appointment if:

• Pain persists for more than a few days
• Pain is worsening
• Unintentional weight loss
• Changes in bowel habits lasting more than a week
• Persistent nausea or vomiting
• Difficulty swallowing
• Pain interferes with daily activities

Diagnosis

Your doctor may perform:

• Medical history: Location, timing, character of pain, associated symptoms
• Physical examination: Palpation of abdomen, checking for tenderness, masses
• Blood tests: Check for infection, inflammation, liver/pancreas function
• Urinalysis: Rule out urinary tract infection or kidney stones
• Stool tests: Check for blood, infection, parasites
• Imaging:
  • Ultrasound (gallstones, appendicitis)
  • CT scan (detailed abdominal imaging)
  • X-rays (obstruction, perforation)
• Endoscopy: Visualize stomach and intestines
• H. pylori testing: Breath, stool, or biopsy test

Treatment and Management

Treatment depends on the underlying cause:

For Indigestion/GERD

• Lifestyle modifications
• Antacids, H2 blockers, or PPIs
• Avoid trigger foods

For Gastritis/Ulcers

• Acid-reducing medications
• Antibiotics for H. pylori
• Avoid NSAIDs and alcohol

For IBS

• Dietary modifications
• Fiber supplements or laxatives
• Antispasmodics
• Stress management

For Infections

• Hydration and rest
• Antibiotics if bacterial
• Anti-nausea medications

General Self-Care

• Eat smaller, more frequent meals
• Avoid trigger foods
• Stay hydrated
• Manage stress
• Regular exercise
• Adequate sleep
• Avoid smoking and excessive alcohol

Frequently Asked Questions

The Bottom Line

Stomach pain is one of the most common medical complaints, with causes ranging from minor indigestion to serious conditions requiring emergency care. The key is recognizing warning signs that require immediate attention versus symptoms that can be managed at home or evaluated non-urgently.

Most stomach pain results from benign causes like indigestion, gas, viral infections, or stress. These typically improve with simple measures: dietary modifications, over-the-counter medications, stress management, and time.

However, certain symptoms—severe pain, fever, vomiting blood, or inability to pass stool—require immediate medical attention. Chronic or recurrent stomach pain warrants evaluation to identify treatable causes like GERD, ulcers, or IBS.

Don't ignore persistent stomach pain or rely solely on over-the-counter medications without medical evaluation. Early diagnosis and treatment can prevent complications and significantly improve quality of life.

Remember: This information is educational and doesn't replace professional medical advice. If you're experiencing persistent or severe stomach pain, consult a healthcare provider for proper evaluation and treatment.