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

What It Feels Like

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

Common descriptions:

• 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 worsens after eating or improves with eating

Common Causes

Indigestion (Dyspepsia)

Causes discomfort in upper abdomen, often related to eating.

Signs: Burning or discomfort in upper abdomen, feeling full quickly, bloating and gas, nausea, triggered by fatty/spicy/acidic foods

What helps: Eat smaller, more frequent meals, avoid trigger foods, don't lie down after eating, limit alcohol and caffeine, quit smoking, over-the-counter antacids or acid reducers

GERD (Gastroesophageal Reflux Disease)

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

Signs: Burning in chest or upper abdomen, sour taste in mouth, worse when lying down or bending over, symptoms after eating, chronic cough or hoarseness

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, PPIs or H2 blockers

Gastritis

Inflammation of stomach lining causes pain and nausea.

Signs: Burning or gnawing pain in upper abdomen, nausea and vomiting, feeling full after small amounts, loss of appetite, may be triggered by NSAIDs/alcohol/stress

What helps: Avoid NSAIDs, alcohol, and irritating foods, antacids or acid-reducing medications, antibiotics if H. pylori infection present

Peptic Ulcer

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

Signs: Burning pain in upper abdomen, pain often between meals or at night, pain may improve or worsen with eating, nausea, dark or bloody stools, unintentional weight loss

What helps: Antibiotics for H. pylori, PPIs or H2 blockers, avoid NSAIDs, alcohol, and smoking

Irritable Bowel Syndrome (IBS)

Functional disorder causing abdominal pain and changes in bowel habits.

Signs: Cramping abdominal pain, pain improves after bowel movement, bloating and gas, diarrhea/constipation/alternating, mucus in stool, triggered by stress or certain foods

What helps: Identify and avoid trigger foods (FODMAPs, dairy, gluten), fiber supplementation, probiotics, stress management, regular exercise, medications for specific symptoms

Gastroenteritis (Stomach Flu)

Viral or bacterial infection causes inflammation of stomach and intestines.

Signs: Sudden onset nausea and vomiting, diarrhea (watery), cramping abdominal pain, low-grade fever, muscle aches, usually resolves in 1-3 days

What helps: Stay hydrated (water, electrolyte drinks), rest, bland diet (BRAT: bananas, rice, applesauce, toast), avoid dairy temporarily

Food Intolerance

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

Common intolerances: Lactose (dairy), gluten (celiac disease or sensitivity), fructose, FODMAPs

What helps: Identify trigger foods (elimination diet, food diary), avoid problematic foods, lactase supplements for lactose intolerance, gluten-free diet for celiac disease

Constipation

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

Signs: Fewer than 3 bowel movements per week, hard dry stools, straining, feeling of incomplete evacuation, abdominal bloating and discomfort

What helps: Increase fiber intake, drink plenty of water, regular exercise, don't ignore urge, over-the-counter laxatives if needed (short-term)

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/vomiting, loss of appetite, fever, inability to pass gas

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/vomiting, fever (if infected), pain after fatty meals

Action: Seek medical care promptly.

Pancreatitis

Inflammation of pancreas causes severe upper abdominal pain.

Warning signs: Severe constant pain in upper abdomen, pain radiating to back, nausea/vomiting, fever, rapid pulse, tender abdomen

Action: Seek emergency care.

When to See a Doctor

Schedule appointment if:

• Pain persists 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

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. Recognizing warning signs that require immediate attention is key.

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.

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.