While simply saying “my tummy hurts” might’ve served you well as a kid, use that phrase with Dr. Google today, and you’re likely to be faced with a lot of possibilities and follow-up questions.
That’s because what people describe as “stomach pain” can indicate all sorts of different conditions—and might not actually be related to your stomach at all. Sounds confusing, right?
Well, the pain may be caused by other parts of your digestive system that feel kind of close to your stomach. When trying to get a diagnosis for your abdominal pain, it helps to get as specific as possible. By collecting clues about where the pain’s occurring, what type of pain it is, any other symptoms you’re having, and what you were doing leading up to the discomfort, you’re more likely to figure out the culprit and get the treatment you need.
Read on to learn more about precisely what you should be paying attention to, and what it might mean for your gut health.
Speaking of childhood, let’s hop on the Magic School Bus for a quick rundown of everything that’s involved in your gastrointestinal (GI) tract, along with a few organs that help make up the whole digestive system (because it’s so much more than just your stomach).
You know, the thing you use to enjoy that delicious meal in front of you. The digestion process starts in your mouth where teeth and saliva help start the process of breaking down food. While rarely involved in abdominal pain, some GI issues can present with oral symptoms, so it’s worth checking that nothing is awry in this area.
After you’ve chewed your food, it quickly passes through the throat—which has some nifty features to help prevent food from going down the wrong pipe. Again, the throat rarely comes up when talking about abdominal pain, but can present with symptoms related to acid reflux (or GERD).
Up next is the esophagus, the tube responsible for getting food from your throat to your stomach using a combination of gravity and muscle contractions (basically, squeezing it down). The esophagus also has two ring-shaped muscles called sphincters that open to allow food to pass through and then close to prevent stomach acid from coming back up. When these don’t work properly, it leads to acid reflux (or GERD), which can cause heartburn.
Finally we’ve made it to the actual stomach! It uses digestive enzymes to continue breaking down the food you eat. The stomach sits higher than most people think, around the middle of your torso between your rib cage, which is helpful to know when identifying pain.
Sometimes called “accessory organs” to the digestive process, these three organs are nestled around the stomach and are responsible for creating and storing the bile and enzymes that the small intestine needs to continue digestion. Because of their placement, it can be easy to confuse pain in one of these organs with stomach pain.
Next we’re onto your small intestine, which sits in the middle of your abdominal area and takes care of absorbing the nutrients from food while continuing to digest it before passing off the waste to the large intestine. As part of this process, it’s home to all that gut bacteria that’s been the talk of the town in recent years.
When your food waste reaches the large intestine, it’s in liquid form—the large intestine absorbs the water and electrolytes to form solid stool, and then pushes it out. It wraps around your small intestine and includes the appendix, colon, and rectum, ending in the anus. It’s also home to a slew of gut bacteria, so an imbalance can cause issues here.
Now that you have a general sense of who’s who in your digestive system, the first thing you’ll want to pay attention to when dealing with abdominal or GI pain is precisely where it’s happening. This can help give clues to which organ you’re actually dealing with. While this list is by no means exclusive, here are a few common issues certain locations might point to:
Pain in the upper region of your abdominal may point to an actual issue with your stomach, such as food poisoning, a stomach virus, ulcers, or even just general dyspepsia (indigestion) from things like eating too much or taking medication on an empty stomach. If the upper pain is extending up into your chest, too, it could indicate heartburn from acid reflux or GERD.
Pain in the upper area of the abdomen can also point to issues with those organs surrounding the stomach, such as gallstones (especially sudden and severe pain in the upper right portion) or pancreatitis.
Pain in the central or lower area of the abdomen may point to more of an issue with your intestinal tract than your stomach: things like inflammatory bowel disease (IBD), irritable bowel disease (IBS), hernias, or even your everyday gas, bloating, or constipation.
Lower abdominal pain could also have nothing to do with your digestive system at all. Bladder infections like UTIs, menstrual cramps, endometriosis, or prostatitis could also cause pain in the same area.
Some conditions are often very localized to one side of your body. For instance, pain from appendicitis is typically focused on the lower right side of your abdomen while pain on the lower left side can indicate diverticulitis (inflammation in your digestive track). Pain in the central right or left side could point to kidney stones. Many general digestive issues—like IBS, gas, or constipation—can also cause pain on either side of the body, so pain on a specific side does not immediately point to something serious, but it’s worth noting.
It’s also valuable to pay attention to any activities that you may have been doing leading up to your abdominal pain. Some examples include:
If it seems like your pain happens within a few hours of eating, it could be a few things. If it’s a one-off affair accompanied by symptoms like gas, cramps, nausea, or diarrhea you may have just eaten something that disagreed with you or even have mild food poisoning, but it should pass.
If it seems to happen every time you eat, or when you eat specific foods, it may point to a more chronic condition like food allergies, acid reflux (GERD) or IBS.
If your digestive pain follows a long night, you could just be hungover. That said, drinking alcohol makes your stomach produce more acid than usual, which could cause an acid reflux flareup or irritate an ulcer. However, if you have a history of alcohol abuse, you should talk to your doctor about whether this could indicate a condition called gastritis.
The most likely culprit if you have abdominal pain after exercising is a stomach cramp caused by eating too soon before your workout. In some cases, exercise can also trigger acid reflux or GERD symptoms, so if you’re noticing heartburn or a sour taste in your mouth after working out, that can be an avenue to explore.
A lot’s going on in your abdominal area when you’re pregnant, so pain in that area is common and generally harmless. This can include increased gas and constipation, round ligament pain (a sharp pain caused by your growing uterus), and Braxton Hicks contractions. If the pain is severe or persistent, or is accompanied by other symptoms, it’s probably a good idea to check with your obstetrician.
We know describing your pain is hard, but understanding the severity can help pinpoint what’s going on. For instance, is it a sharp pain that feels stabbing like a knife, or a more dull pain that’s kind of gnawing in the background? Is it sudden or more constant? Does it seem localized to a specific area, or more general? Is it staying put or moving around? Get specific—all of this can help you and your doctor better understand what’s going on.
Finally, it’s worth noting any symptoms that are happening along with your pain. Changes in bowel habits, gas or bloating, nausea, and heartburn are just a few things to look out for so you can discuss them with your doctor, but any other symptoms you’re noticing may help find the culprit.
Obviously all stomach and abdominal pain feels urgent to you because you want to feel better ASAP. But sometimes, the pain really might be pointing to an urgent health issue. If your pain is accompanied by fever, rapid weight loss, difficulty or pain swallowing, blood in stool or dark black stool, yellowing of skin, persistent vomiting, or you have recently had abdominal surgery, you’ll want to call your doctor ASAP as it could point to a more severe issue. Additionally, if you have shortness of breath, lightheadedness, dizziness, chest pain, persistent vomiting, or severe tenderness or swelling of the abdomen, we recommend you stop reading and call 911.
As you can see, there’s a lot that could be going on here—and this is far from a comprehensive overview of everything a pang in your gut could mean. The good news is, a lot of abdominal pain is related to gas or eating something a little off, and will pass within a few hours.
But if the pain persists or seems to be chronically returning, it’s good to get an expert involved. Try this simple formula when talking to your doc—my [area of my abdomen] hurts when I [activity] and it feels like [type of pain] and is accompanied by [other symptoms you have]—and you’re much more likely to quickly figure out what’s going on and get started on a treatment plan, stat.
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
Photo by Christin Hume on Unsplash