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The Many, Many Causes of “Stomach” Pain

Think about all the organs, muscles, blood vessels and tissue that are in the area we all commonly call our “stomach” (even though we know it’s a lot more than that): Your liver, spleen, diaphragm, bowels, sex organs, and more. Really, it’s at least a third of your body. An injury, infection or disease to any one of these areas can cause pain of varying degree. Most of those don’t require a trip to the emergency room. But here are a few that might:

  • Heart attack
  • Indigestion
  • Acid reflux
  • Constipation
  • Diarrhea
  • Food poisoning
  • Stomach virus
  • Ectopic pregnancy
  • Irritable bowel syndrome (IBS)
  • Inflammatory bowel disease
  • Ulcer
  • Hernia
  • Gallstones
  • Appendicitis
  • Pancreatitis
  • Lactose intolerance
  • Gluten intolerance
  • Diverticulitis
  • Muscle strain
  • Menstrual cramps
  • Endometriosis
  • Urinary tract infection
  • Thyroid problems
  • Stress
  • Hepatitis
  • Pelvic inflammatory disease
  • Ovarian cysts
  • Bowel obstruction
  • Abdominal aortic aneurysm
  • Ischemic bowel
  • Cancer

What Will the ER Team Want to Know About Your Stomach Pain?

Here are some questions you should be prepared to answer if you head to the ER with stomach pain:

  • How did the pain begin, what were you doing?
  • Is the pain steady/constant? Or does it come and go?
  • Have you had similar pain before?
  • Is the pain in one place or does it move?
  • What makes it worse (e.g., sneezing, coughing)?
  • What makes it better (e.g., lying still, changing position, vomiting, taking antacids)?
  • What is the frequency of nausea or diarrhea, if any?
  • Did you take any medications to relieve the symptoms? What medications did you take and at what time? What was the dose of the medication?
  • Did you take anything for these symptoms? If so, what amount?
  • Do you have blood in your urine or stool?
  • Are you pregnant?

How to identify stomach pain in babies and toddlers

Stomach pain is harder to identify when children are too young to talk. Here are some things to look for:

  • Fussier than normal
  • Curling their legs up toward their belly
  • Eating poorly
  • Listless and not interested in toys
  • Diarrhea
  • Vomiting

Causes of stomach pain in kids

Kids get tummy aches, often for no apparent reason. But here are some tips on what might be causing stomach pain in kids, based on their main symptoms. Of course, you should seek a pediatrician or go to the ER to treat your child's particular concerns:

  • Nausea or lack of appetite - indigestion or a stomach virus
  • Pain over all or most of their belly - indigestion, constipaation, stomach virus or gas
  • Cramping pain (often followed by diarrhea) - food poisoning, gas or bloating
  • Pain localized to one area (one side or the other, above or below the belly button) - may be related to the appendix, gallbladder or a stomach ulcer
  • None of the above - if your child can only describe the pain vaguely, like it's all over but doesn't get worse," they may be experiencing stress or anxiety

What Tests May Be Used to Evaluate Abdominal Pain?

Diagnosing the causes of stomach pain starts with the typical battery of blood tests and physical exams (including a pregnancy test and pelvic exam for women). It all depends on your symptoms and what doctors find from their exams. Testing may also include:

  • X-ray
  • Ultrasound
  • CAT scan
  • MRI
  • Endoscopy