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April 15, 2025

Stomach pain is common and a leading cause of emergency room visits, affecting about 10–12% of people worldwide.1,2

It has a lot of different causes and most of the time, these are not serious:1,2

  • Constipation
  • Irritable bowel syndrome
  • Food allergies
  • Lactose intolerance
  • Food poisoning
  • Stomach virus
But sometimes, it can result from an issue that needs medical attention.2 So, if it’s accompanied by some signs or symptoms, then it can be a sign of worry.

Signs your Stomach Pain might be a sign of worry
If you experience any of the following, it’s best to seek medical attention:

1. Sudden or Persistent Pain

Sudden stomach pain can be a sign of a serious problem like a perforated ulcer, a burst colon pouch (diverticulum), or a swallowed object. It can also happen with a ruptured ectopic pregnancy, blocked blood flow in the abdomen, or a torn aortic artery. 3

If pain starts quickly and worsens over minutes, it may be due to gallbladder issues, pancreatitis, a blocked intestine, appendicitis, kidney stones, or a deep ulcer. Some pain develops slowly, which can still be serious if it becomes severe or doesn’t go away.3

2. Pain with Fever

Stomach pain with fever may signal an infection in your digestive system or nearby organs like the liver, kidneys, or gallbladder. Widespread pain could mean peritonitis, while pain in one spot may point to conditions like appendicitis or cholecystitis.4

3. Unexplained Weight Loss

If you are experiencing stomach pain along with unexplained weight loss, it could be a sign of an underlying health issue that needs attention. Conditions such as Crohn’s disease, ulcers, or even certain types of cancer can cause these symptoms.5

4. Blood in Stool or Vomit

If you notice blood in your stool or vomit, it could be a sign of serious internal bleeding. Blood in vomit (hematemesis) or black, tarry stool (melena) often points to issues in the upper digestive tract, like ulcers, liver disease, or inflammation.6

Bright red blood in the stool (hematochezia) usually comes from the lower digestive tract, and could be caused by conditions like diverticulosis, hemorrhoids, or even cancer.6

5. Pain with Difficulty Breathing or Chest Pain

Sometimes heart conditions like coronary artery disease can show up with unusual symptoms, such as stomach pain.  Since the heart and digestive system share some of the same nerve pathways, it can be hard to tell where the pain is coming from. If you have stomach pain and difficulty breathing, it’s important to get checked out to rule out heart issues.7

6. Pain with Nausea or Vomiting

Stomach pain, nausea, and vomiting can be signs of serious conditions like pneumonia, heart failure, or an adrenal crisis. Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) can also cause these symptoms, especially in people with diabetes. Additionally, an overactive thyroid (thyrotoxicosis) may lead to similar issues.7

Conclusion

Most stomach pain is not serious and resolves on its own. However, if you experience severe, persistent, or unusual symptoms, it’s best to seek medical advice. Paying attention to your body and recognizing warning signs can help you get the care you need before a minor issue turns into a serious health problem.

References:

  1. Mehta H. Abdominal Pain. Clinical Pathways in Emergency Medicine. 2016;329-345. Published 2016 Feb 22. doi:10.1007/978-81-322-2710-6_26
  2. Mount Sinai. Abdominal pain. Mount Sinai Health Library. Available from: https://www.mountsinai.org/health-library/symptoms/abdominal-pain. Accessed 3 February 2025
  3. Sherman R. Abdominal Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 86. Available from: https://www.ncbi.nlm.nih.gov/books/NBK412/
  4. Antimicrobe.org. Empiricism—Philosophy and Practice. Antimicrobe.org. Accessed February 3, 2025. http://www.antimicrobe.org/e18.asp
  5. Shim KN, Kim YS, Kim KJ, et al. Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: a Korean multicenter study. Scand J Gastroenterol. 2006;41(8):983-988. doi:10.1080/00365520600548974
  6. Wilson ID. Hematemesis, Melena, and Hematochezia. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 85. Available from: https://www.ncbi.nlm.nih.gov/books/NBK411/
  7. Murali N, El Hayek SM. Abdominal Pain Mimics. Emerg Med Clin North Am. 2021;39(4):839-850. doi:10.1016/j.emc.2021.07.003