27 Causes of Stomachaches—And How to Get Rid of Each One
Nearly everyone has had a stomachache at some point. But really, any organ in your abdomen (there are many) could be to blame.
Tummy trouble can be short-lived, come and go, or show up only after you eat—all clues to the cause. Doctors can also run a number of tests to narrow it down, says Vivek Kaul, MD, acting chief of the division of gastroenterology and hepatology at the University of Rochester Medical Center in Rochester, N.Y.
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Read more to find out about possible culprits.
Gallstones are stones that form in the gallbladder, a tiny sac that hangs out under the liver, expelling bile as needed to digest fats.
These stones are hard, pebble-like pieces of material, typically made of cholesterol or bilirubin, that develop in your gallbladder, according to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK). They can cause swelling and can block the duct into the intestine, resulting in pain.
Gallstone pain tends to strike the right side of the upper abdomen, particularly after fatty meals. Those types of meals trigger the gallbladder to contract. “If the gallbladder is inflamed, any contraction of that nature will be amplified and typically will cause pain to the patient,” says Dr. Kaul.
Pancreatitis is actually inflammation of the pancreas, and happens when digestive enzymes start digesting the pancreas, according to the US National Library of Medicine. The condition can be acute or chronic, and can cause burning pain in the upper or middle abdomen. Some people even have shooting pain that drives right through to their back, says Dr. Kaul. Other symptoms include nausea and vomiting.
Too much alcohol can be a culprit, says Dr. Kaul, as are gallstones (the gallbladder and pancreas deliver their digestive juices into the intestine via the same duct). Either type of pancreatitis can lead to hospitalization, where symptoms can be managed through intravenous fluids, antibiotics, and pain medications.
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Gastroesophageal reflux disease, or GERD, can cause pain in the upper stomach and lower chest, aka heartburn. It's typically caused by a weak valve that separates the stomach from the esophagus, which allows food and acid from the stomach to splash upwards.
Eating too much food or the wrong type of food (fatty foods or spicy foods, for instance) can make it worse, while losing weight, watching what you eat, and medication like antacids, H2 blockers, and proton pump inhibitors, can help.
The organs of your chest and abdomen are lined with thin layers of tissue called serous membranes. The gastrointestinal serosa makes up the outer lining of your GI tract and the inner lining of the stomach cavity, Dr. Skeans explains. When these linings get inflamed, it causes serositis, which Dr. Skeans describes as a “severely painful condition.” Serositis can also cause bloating, fever, nausea, vomiting, and a low appetite.
Anyone can develop serositis, but it’s linked with certain conditions like lupus, rheumatoid arthritis, inflammatory bowel diseases, and appendicitis.
If you're lactose intolerant, you're not alone: About 65 percent of the entire human population actually has a reduced ability digest lactose after birth, according to the Genetics Home Reference, a division of the US National Library of Medicine.
This type of food intolerance causes mild to severe abdominal pain depending where you place on the tolerance scale, says Patricia L. Raymond, an assistant professor of clinical internal medicine at Eastern Virginia Medical School. "I advise everyone who thinks they have an intolerance to take a lactose tolerance test," she says. "It’s not a yes or no answer because severity comes into play." Symptoms include bloating, diarrhea, burping, gas, and indigestion and vary based on your level of sensitivity.
The solution? Skip the dairy products, like milk and cheese, and be wary of packaged foods. Raymond says packaged foods often contain hidden milk products or whey, a milk-based byproduct found in many protein powder mixes and other nutritional foods. If you're lactose intolrant you can also drink Lactaid milk or take Lactaid pills to prevent stomach aches and pains.
Medication side effects
Medications are a common cause of stomach pain. "A medication itself can be caustic or slow the stomach's emptying, causing pain," says Dr. Raymond.
Pain medications known as NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and aspirin have this caustic property and can cause swelling in the stomach lining and may even lead to ulcers. Oral bisphosphonates, a popular class of drugs that helps preserve bone density and prevent osteoporosis, can cause swelling—and therefore pain—in the lower esophagus, says Dr. Kaul. Also look out for antibiotics, specifically those containing azithromycin, and take them after a meal to give the stomach a proper lining for the drug. Narcotic and blood pressure medications relax the stomach's walls and allow food to sit and ferment in your stomach, contributing to a queasy feeling.
Diverticulitis is an inflammation of “diverticula” or pockets that form in the lining of the intestine, usually the colon, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “These look like punched-out holes in the lining of the colon that tend to get inflamed or obstructed with stool or other foreign material,” says Dr. Kaul.
Symptoms can include cramping in the lower abdomen, which may respond to antibiotics. A high-fiber diet can help. In more severe cases, it can cause abscesses, bleeding, and even perforations, resulting in severe pain, or even the need for surgery or a hospitalization.
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Some people react badly to gluten, a protein found in wheat, barley, and rye. The most severe form of gluten intolerance is called celiac disease.
“The gluten causes damage in the small intestine,” explains Dr. Alaradi. “The small intestine doesn’t work normally, it doesn’t absorb nutrients.” Experts and patients are becoming more aware of gluten intolerance and celiac disease, which causes gas, bloating, mild-to-severe pain, and fatigue.
The small intestine’s inability to absorb nutrients may lead to chronic diarrhea, weight loss, and even malnutrition.
Endometriosis only affects women. It’s a condition that occurs when cells from the lining of the uterus escape and start to grow in other parts of the body, usually somewhere in the pelvis.
Pain, irregular bleeding, and infertility can result. Endometriosis is difficult to diagnose, says Dr. Kaul, and often requires a referral to a gynecologist and a pelvic ultrasound.
If the endometriosis is confined to one small area, surgery may help. Otherwise it is treated with pain medication and hormone therapy, as the menstrual cycle tends to drive painful symptoms.
Even though the thyroid gland is located in the neck, it can cause problems lower down in the body.
“The thyroid regulates several functions in the body and the digestive tract is one of the systems,” explains Dr. Alaradi.
If the thyroid produces too much hormone (hyperthyroidism), it speeds up the digestive tract, resulting in diarrhea and abdominal cramps, he says.
On the other hand, an underactive thyroid (hypothyroidism) slows down the digestive tract, potentially leading to pain from constipation and gas.
No one wants to think that stomach symptoms are due to a parasitic worm or other creature. But it happens. Parasites can attach themselves to your stomach lining or hang out in the small intestine or colon, leading to a host of unwanted symptoms.
There are many types, but the most common in the U.S. are Giardia and Cryptosporidium, which you can get by swimming in contaminated pools or lakes or drinking contaminated water. (Or in some outbreaks, unpasteurized cider). The tiny protozoa cause cramps, diarrhea, and nausea about 2 to 10 days after exposure (for Crypto) or 1 to 3 weeks later (for Giardia). Other types of parasites can be picked up in undercooked or contaminated food. Dr. Raymond says sushi, when obtained from a less than reputable source, could contain parasites.
A hernia is when an internal organ or fatty tissue protrudes through a muscle or connective tissue. There are actually a lot of different types of hernias, and they can be external (which you can see as a protruding bulge) or internal (meaning they happen within the abdominal cavity), says Jacob Skeans, MD, a gastroenterologist at The Ohio State University Wexner Medical Center.
The most common hernias in the abdomen are umbilical hernias (which happen around the belly button) and hiatal hernias (where the stomach pushes in the chest cavity through your diaphragm, Dr. Skeans says. “They are created when repetitive strains (coughing, obesity, pregnancy, straining during constipation) pushes at a weak point of muscle or fascial tissue,” he says.
If you have an external hernia, it will usually feel like a constant, dull, aching pain. But a hiatal hernia feels a little different: It can cause heartburn, indigestion, regurgitation, and upper abdominal or chest pains.
Most people who have appendicitis, an inflammation of the appendix, experience sudden pain that’s bad enough to warrant an emergency room trip.
Appendicitis is more common in children and young adults (though it can happen to older adults) and usually starts with pain in the mid-abdomen, progressing into the lower right part of the abdomen. "A telltale sign is pain when you bend your leg because it’s pulling a muscle near your appendix as you make that motion," says Dr. Raymond. If you think you could have the condition, learn more about 9 Symptoms of Appendicitis.
If the appendix isn’t removed, it can burst, leading to long-term hospitalization and potentially life-threatening peritonitis. Head to the emergency room right away if you think appendicitis is causing your tummy pain. Raymond says it's extremely normal to have your appendix removed and is a routine procedure.
RELATED: 9 Symptoms of Appendicitis
Peptic ulcer disease, or ulcers in the stomach and duodenum (the first part of the small intestine), is a common source of abdominal pain, says Dr. Alaradi.
Pain usually strikes the mid-upper abdominal area and sometimes occurs after meals, he adds. People with duodenal ulcers can wake in the middle of the night due to pain.
NSAID medications and Helicobacter pylori (H. pylori) bacteria are major causes. Antibiotics and acid-suppressing drugs are often used to treat ulcers caused by bacteria.
Cholecystitis is inflammation of the gallbladder, and it usually happens when a gallstone gets caught in the cystic duct, blocking drainage and causing an infection and inflammation of the gallbladder, Dr. Skeans says. It can cause some pretty intense symptoms like right upper abdominal pain, fevers, nausea, and vomiting.
There are a lot of risk factors for developing gallstones (and cholecystitis) like using birth control pills, pregnancy, obesity, chronic liver disease, rapid weight loss, severe illness, and taking certain medications. “When the gallbladder gets this sick and inflamed, it is usually treated with surgical removal,” Dr. Skeans says.
Too much sugarless gum
If you consume too much sorbitol, which is found in some sugar-free products, it can cause pain and diarrhea. According to a 2008 article in BMJ, a 21-year-old woman had an 11-pound weight loss, abdominal pain, and diarrhea (as many as 12 bowel movements a day) from chewing about 16 sticks of gum a day.
A 46-year-old man had similar symptoms after chewing about 20 sticks of sugarless gum and eating sorbitol-containing sweets daily. "Sorbitol goes into your GI tract and since your body can't absorb it, it gets to the bacteria in your colon, which eat it and produce gas and fluids that contribute to diarrhea," explains Dr. Raymond.
To fix the problem, cut back on the amount of sugarless gum you chew.
Stress can cause headaches, high blood pressure, insomnia and, yes, tummy trouble. Depression has been linked with digestive problems (including loss of appetite and weight loss) as well as irritable bowel syndrome. The relationship seems to go both ways, according to a study published in 2012 in the journal Gut.
In other words, depression may be causing the stomach aches but constant abdominal pain may just as easily lead to depression and anxiety. (Feeling Stressed? Why You May Feel It in Your Gut)
Gastritis happens when something causes inflammation in the stomach’s lining. “This is one of the most commonly treated disease processes by gastroenterologists,” Dr. Skeans says. “It is a frequent cause of upper abdominal pain and frequently associated with nausea and vomiting.”
If gastritis is left unchecked, it can cause complications like gastric ulcers and bleeding. There are plenty of things that can cause gastritis, including the bacteria Helicobacter Pylori, non-steroidal anti-inflammatory drugs, alcohol use, smoking, and autoimmune diseases.
Food poisoning from viruses or bacteria can cause abdominal pain, along with diarrhea and vomiting. Many outbreaks of food poisoning have been seen in recent years in the U.S., including 20 people in 7 states who picked up Salmonella from contaminated beef in 2011.
In rare cases, food poisoning can be serious or fatal. In general, the symptoms from food poisoning usually last about 1-2 days, says Dr. Alaradi.
However if you have viral gastroenteritis, a stomach bug from food or another person, it may last a bit longer.
Inflammatory bowel disease
Inflammatory bowel disease (IBD) is an inflammation inside the small or large intestine, Dr. Alaradi explains. It includes Crohn’s disease and ulcerative colitis.
The inflammation from IBD can cause scarring and blockage, which can lead to abdominal pain along with diarrhea and rectal bleeding. Symptoms are chronic, but can flare up and subside in cycles, making it sometimes hard to diagnose.
IBD needs to be monitored closely as it can lead to more serious problems, even cancer, later in life.
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is not the same as inflammatory bowel disease. Although IBS can also lead to chronic abdominal pain and changes in bowel movements (such as alternating constipation and diarrhea), it is not an inflammatory condition and never involves rectal bleeding, says Dr. Alaradi.
It generally affects more women than men, is considered less serious than IBD, and can be managed through treatment of symptoms, such as pain relievers.
And unlike IBD, IBS never progresses into more serious conditions such as cancer, says Dr. Alaradi.
Even though it has the word “migraine” in its name, an abdominal migraine isn’t a headache. “Abdominal migraines are a cause of recurrent episodes of abdominal pain that can be severe in nature and generally are felt in the center of the abdomen,” Dr. Skeans says.
They’re more common in children or young adults, but older adults can also experience them. In addition to stomach pain, abdominal migraines can often cause nausea and vomiting and can last for “hours to several days,” Dr. Skeans says.
Doctors don’t totally know why abdominal migraines happen, but it’s thought to be due to something neurologic or hormonal. “The diagnosis is one made by excluding other more common causes of abdominal pain,” Dr. Skeans says. Abdominal migraines often similar triggers to “regular” migraines like chocolates, certain foods, stress, and anxiety.
Pelvic inflammatory disease
Pelvic inflammatory disease, a bacterial infection of the fallopian tubes, uterus, or ovaries, can cause a low pain under your belly button, says Dr. Raymond. PID can cause scarring of fallopian tubes and risk pregnancy chances, so if you experience other symptoms like fever, vomiting, or signs of fainting, you should see a doctor at the emergency room immediately.
Sexually transmitted diseases like gonorrhea and chlamydia can cause PID and can be prevented by practicing protected sex with condoms. Other less likely but possible causes of PID and the resulting stomach discomfort include IUDs, childbirth, or abortion, since these things can disrupt the cervix and cause bacteria to form.
Kidney stones are crystalized mineral and salt deposits that often form when your urine becomes concentrated. They cause pain when they move through the urinary system, Dr. Skeans says. Usually, the pain happens in your lower back and can radiate to your lower abdomen or groin.
Kidney stones can also cause severe nausea and vomiting, painful urination, and even bloody pee. “Many can pass spontaneously with hydration but rarely more invasive urologic procedures are needed to break up or remove stones,” Dr. Skeans says.
Some people are genetically predisposed to getting kidney stones, but they can also happen due to certain environmental factors like being dehydrated and having too much sodium, and having particular diseases like obesity, gout, and inflammatory bowl disease, Dr. Skeans says.
Constipation causes stomach pain because blocked fecal matter stretches the colon in a manner it doesn't want to be stretched, says Dr. Raymond. If you're experiencing stomach pain and notice you have to strain to have a bowel movement or your trips to the bathroom aren't regular, constipation is a likely culprit for your stomach aches.
To better move stool through your system, drink more water and consume more fiber. However, if you've been constipated for more than a few days or get constipated often, Dr. Raymond suggests eating milk of magnesia. "They're relatively gentle and help when consuming fiber could just give you extremely hard stool." Raymond says her patients with defecation disorders also benefit from the use of squatting toilet devices.
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This happens when your small or large intestines are unable to move things along due to a mechanical or physical blockage, or even a change in the motility function of your bowels, Dr. Skeans says.
Symptoms usually include having abdominal pain, bloating, abdominal distention, nausea, and vomiting. Plenty of things can cause a bowel obstruction, including having a tumor, inflammation, or a surgical complication. You definitely don’t want to let a bowel obstruction slide. “It can be life-threatening if there is a complete obstruction and can even require surgery,” Dr. Skeans says.
It’s uncommon, but cancer in any one of the organs located in the abdomen—the liver, pancreas, stomach, gallbladder, or ovaries—can cause stomach pain, but usually only in the later stages, says Dr. Alaradi.
And there are usually other symptoms, like a loss of appetite, weight loss, persistent vomiting, persistent bloating of the abdomen, and recent changes in bowel habits. “If a person is used to going to the bathroom once a day and it’s changed in the past few weeks to one every three to four days, that deserves attention,” says Dr. Alaradi.
Dr. Raymond agrees. "Unfortunately, cancer pain feels like a lot of the pain of the upper body," she says. "It’s non-specific feeling, so an upper endoscopy or X-ray is best way to tell."
Still, stomach cancer is not common is the United States. According the the American Cancer Society, there is a 1 in 111 risk that someone will develop stomach cancer in their lifetime. Plus, 6 out of 10 cases occur in people ages 65 and up.
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