9 signs your stomach pain isn't normal

This article was updated in March, 2022 to reflect recent information and research.

[5 MIN READ]

In this article: 

  • Nine types of stomach pain and what it could mean for you.

  • Stomach pains aren't always a serious issue, but some acute or sudden onset pains can be signs of emergency conditions like appendicitis or a heart attack.

  • When in doubt about your abdominal pain, physicians say it’s best to call your doctor or head to the ER.

The egg salad didn't taste quite right, but you were hungry. Or maybe your craving for cheesecake outweighed the punishment you knew your lactose intolerance would inflict. You expect stomach distress in situations like these, but other times, abdominal pain can come out of nowhere. Sometimes it's severe enough or lasts for so long that you know it's not simply a matter of eating something that didn't agree with you.

Digestive system issues account for 45.1 million visits to doctors' offices and emergency departments yearly, according to the Centers for Disease Control and Prevention (CDC). The severity of the pain, its location within your abdominal area, and accompanying symptoms may provide clues to the origin of the pain — and if you should seek help immediately. Here are some of the most common signs your tummy troubles need more than an over-the-counter remedy.

1. Severe stomach pain after eating a fatty meal

If you find yourself doubled over after eating a high-fat meal, you may be experiencing a gallbladder attack. "Women are especially prone to gallbladder disease," says Hardeep Singh, MD, gastroenterologist from St. Joseph Hospital, Orange, CA. "Overweight women in their 40s are at highest risk." The pain becomes worse after eating, lasts 30 to 60 minutes, and may come and go, becoming more constant and severe over time, says Singh.

Get ahead of your abdominal pain (and boost your gut health) with a diet that's rich in nutrients and fiber and low in fatty foods.

2. Crampy pain with diarrhea or constipation

Lower "crampy" abdominal pain accompanied by bloating and diarrhea or constipation can be signs of irritable bowel syndrome (IBS), says Singh. "It's exceptionally common and affects 15% of the U.S. population, particularly younger women, although it can happen at any age." Symptoms of IBS can usually be controlled by managing diet, lifestyle, and stress. Medication and counseling may be needed in some cases.

3. Upper abdominal pain between the ribcage

If you develop an aching or stabbing pain or pressure in the upper abdominal area just under the ribs, this may indicate a heart-related problem. Physicians say this pain is often accompanied by shortness of breath and is concerning if the pain persists. People often assume this type of pain is indigestion, and while that may be the case, anyone with risk factors such as diabetes or hypertension should see a doctor as soon as possible.

If you do struggle with acid reflux, it may be time to talk to a gastroenterologist. They can help you manage your symptoms through medications, lifestyle changes and diet.

4. Severe, acute pain in the lower right side of the abdomen

Sudden pain in the lower part of the abdomen may be a sign of appendicitis. It may also be accompanied by a fever. Pain often begins around the belly button area and becomes worse with time. Vomiting or constipation or diarrhea along with the pain also indicate it's time to go to the emergency room.

Appendicitis mostly affects kids and teens between the ages of 5 and 20. While there are many digestive health issues that can cause stomach pain in kids, it's important to talk to your child's doctor immediately if you suspect appendicitis - especially if the pain comes on suddenly over several hours or is persistent. Appendicitis often requires surgery. If left untreated, a ruptured appendix can be deadly.

5. ​Vague upper abdominal pain associated with nausea and belching

Sometimes stomach pain is hard to identify or comes with multiple symptoms. Vague pain in the upper and mid-abdominal area that is linked to nausea, burping, or belching could be signs of a heart attack, particularly in older individuals. Physicians say tests like an ECG or cardiac markers can be lifesaving. They also warn that vomiting with back or jaw pain and shortness of breath can also be a sign of a life-threatening emergency.

Women are also more likely to experience abdominal pain or digestive issues during a heart attack. It's important to learn how heart disease, including heart attacks, can affect women differently.

6. Sudden and severe onset stomach pain

When mid-abdominal pain occurs suddenly — especially in people with a history of peptic ulcer disease or in those who take excessive amounts of aspirin or NSAIDs — it may be a sign of a perforation that could require emergency surgery. A tear could leak air and gastric content which can lead to a condition called peritonitis, and eventually, septic shock. Surgery would be required to seal the perforation.

If you're experiencing chronic stomach pain, take steps now to head off any bigger problems down the road. Your primary care provider can help get to the bottom of what's causing your issues and create a plan to help improve your gut health. Your plan may include medication, lifestyle changes, a healthier diet and stress management techniques. (Believe it or not, stress can have a major impact on your digestive health.)

7. Right or left lower abdominal pain in women

Sudden onset of right lower abdominal pain or left lower abdominal pain can indicate a ruptured ovarian cyst in a woman who is in the middle of her menstrual cycle. This kind of pain could also be a sign of ovarian torsion, which is the rotation of the ovary and part of the fallopian tube, or possibly a twisting of the ovary due to reduced blood supply. Seek treatment immediately at the nearest emergency department. Surgery to remove the ovary may be required.

8. Knife-like pain in the lower abdomen

Pain that wraps around the lower stomach area, commonly accompanied by nausea, vomiting, fever, and chills, may be a sign of kidney stones. Kidney stones are diagnosed by ultrasound or CT scans and NSAIDs are often recommended for pain relief. Physicians say in cases of persistent pain, rescue narcotics may be prescribed for immediate relief or alpha-blockers which can relax blood vessels allowing larger stones to pass. 

9. Belly pain in the lower left side that's worse when you move

Abdominal pain in the left lower area of the abdomen may signify diverticulitis, small pockets in the colon that can become obstructed and tear. Traditional treatment includes antibiotics and stool softeners to reduce the risk of abscess formation. Physicians say according to recent research, antibiotics may no longer be needed in this scenario, and they recommend acetaminophen instead.

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Find a doctor

If you have ongoing digestive issues or stomach pain, Providence has an expert gastroenterology team to help. Find the physician that's right for you in our  provider directory. Through Providence Express Care Virtual, you can also access a full range of healthcare services. 

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Related resources

Long-term stress and your health

Maintain a healthy gut: Three reasons to see a gastroenterologist

When should you be concerned about your child’s stomach pain?

Coping with diverticulitis

Spread the word: Heart disease affects women differently

Managing irritable bowel syndrome (IBS) with diet

Keeping your digestive tract happy and healthy with a colon-friendly diet

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

About the Author

The Providence Body & Mind Team is dedicated to providing medically-sound, data-backed insights and advice on how to reach and maintain your optimal health through a mixture of exercise, mindfulness, preventative care and healthy living in general.

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