What is a stomach ache?
Often, pain or discomfort anywhere in the abdomen is described as a stomach ache, although the stomach may not actually be the source of the pain. Stomach aches are often caused by conditions of the digestive tract, but can also be caused by conditions of the body wall, blood vessels, urinary tract, reproductive organs, or organs of the chest.
Localized pain may be due to the organs near the site of the pain, such as the gallbladder or stomach in the upper abdomen or the appendix in the lower abdomen. Generalized stomach aches may be associated with diet, inflammation, or infection. Obstruction occurring anywhere along the intestinal tract can manifest as stomach ache. Menstrual cramps, endometriosis (in which tissues resembling the uterine lining grow in other areas of the body), and pelvic inflammatory disease are known to cause generalized stomach aches or lower abdominal pain in women.
Pain originating in the stomach can be due to heartburn, gastroesophageal reflux disease (GERD), hiatal hernias (weakening in the diaphragm that allows the stomach to protrude into the chest), gastritis (inflammation of the stomach lining), or peptic ulcers. Symptoms may be brought on by certain foods and may worsen when lying flat. Pain from gas, abdominal cramps, or bloating may arise from the intestines, and can also be related to food intake or may be related to intestinal infection or inflammation.
Pain associated with shingles, a reactivation of the chickenpox virus, may be attributed to stomach problems until the characteristic blistering rash becomes apparent. Abdominal trauma, poisoning, heart attack, lung problems, conditions of the reproductive organs, and stones or infections of the urinary tract can also cause symptoms that are perceived as stomach problems.
Stomach aches that are severe or that do not improve within a day or two can be symptoms of serious medical conditions. Seek immediate medical care (call 911) for severe pain that comes on suddenly, an inability to have bowel movements, bloody stool, vomiting blood, abdominal rigidity, breathing difficulties, or pain in the neck, chest, shoulders, or between the shoulders. You should also seek immediate care if you have a severe stomach ache and have cancer or might be pregnant.
If your stomach ache is persistent or causes you concern, seek prompt medical care.
What other symptoms might occur with a stomach ache?
A stomach ache may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Stomach aches are often related to the digestive system, but may also be related to other body systems.
Digestive tract symptoms that may occur along with a stomach ache
Stomach aches may accompany other symptoms affecting the digestive system including:
Abdominal pain or cramping
Abdominal swelling, distension or bloating
Bloody stool (blood may be red, black, or tarry in texture)
Changes in bowel movements
Nausea with or without vomiting
Urgent need to pass stool
Other symptoms that may occur along with a stomach ache
Stomach aches may accompany symptoms related to other body systems including:
Enlarged liver and glands such as the spleen and lymph nodes
Pain during sexual intercourse
Pain or burning with urination
Palpable mass in the abdomen or pelvic area
Serious symptoms that might indicate a life-threatening condition
In some cases, a stomach ache may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
Bleeding while pregnant
Change in level of consciousness or alertness such as passing out or unresponsiveness
High fever (higher than 101 degrees Fahrenheit)
Inability to have bowel movements, especially if accompanied by vomiting
Rapid heart rate (tachycardia)
Rigidity of the abdomen
Severe abdominal pain or sharp abdominal pain that comes on suddenly
Trauma to the abdomen, pelvis or testicles
What causes a stomach ache?
Stomach aches often originate in the digestive tract, although they can also be due to disorders of the circulatory system, urinary tract, reproductive system, respiratory system, or body wall.
Digestive tract causes of a stomach ache
A stomach ache may be caused by conditions of the digestive tract including:
Bacterial, parasitic or viral infection of the gastrointestinal tract
Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)
Diverticulitis (inflammation of an abnormal pocket in the colon)
Food intolerance such as lactose intolerance (inability to digest lactose, the sugar in dairy products)
Gallbladder disease or stones
Gastritis (inflammation of the stomach lining)
Gastroesophageal reflux disease (GERD)
Inflammatory bowel disease (includes Crohn’s disease, ulcerative colitis)
Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease)
Pancreatitis (inflammation of the pancreas)
Ulcers of the stomach or duodenum (first section of the small intestine)
Other causes of a stomach ache
Stomach aches can also be caused by conditions involving other body systems including:
Abdominal or hiatal hernia (weakening in the abdominal wall or diaphragm, through which internal organs can pass)
Cancer of an abdominal or pelvic organ
Endometriosis (condition where tissues resembling the uterine lining grow in other areas of the body)
Pelvic inflammatory disease (PID; infection of a woman’s reproductive organs)
Pleurisy (inflammation of the lining around the lungs)
Shingles (painful, blistering rash, often forming a stripe, that results from a reactivation of the varicella-zoster, or chickenpox, virus)
Serious or life-threatening causes of stomach ache
In some cases, stomach ache may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:
Aneurysm of the abdominal aorta (life-threatening bulging and weakening of the wall of the abdominal aorta that can burst and cause severe hemorrhage)
Bowel obstruction or perforation
Chemical or heavy metal poisoning
Colonic volvulus (twisting of the colon) or intussusception (telescoping of the intestines into themselves)
Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
Intestinal ischemia (loss of blood supply to the intestines leading to death of intestinal tissue)
Peritonitis (infection of the lining that surrounds the abdomen)
Significant abdominal, pelvic or testicular trauma
Torsion of an ovary or testicle (twisting of the ovary or spermatic cord)
Questions for diagnosing the cause of a stomach ache
To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your stomach ache including:
How long have you had a stomach ache?
Where do you feel the pain?
How would you describe your pain?
Does anything make it go away or make it worse?
Have you had pain like this before?
Do you have any other symptoms?
What medications are you taking?
Is there any possibility you might be pregnant?
Because stomach aches can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:
Bowel infarction (severe injury to an area of the bowel due to decreased blood supply)
Intestinal obstruction and rupture of the intestinal wall
Organ failure or dysfunction
Spread of cancer
Spread of infection