Stomach pain is one of the most common symptoms people experience. It can range from mild discomfort caused by indigestion or gas, to severe pain caused by conditions such as appendicitis, gallstones, pancreatitis or intestinal obstruction.

Doctors say the site, severity, onset, duration and progression of the pain, along with other symptoms, can provide important clues about its cause. However, the intensity of pain alone does not always indicate how serious the underlying problem is.

“Some people with a serious condition may have only mild discomfort, while others with a less serious problem may experience severe pain,” says S. Jennie, professor, department of general Medicine, SRM Medical College Hospital and Research Centre, Chennai.

Where it hurts

The location of abdominal pain can sometimes point to the organ involved. Burning or discomfort in the upper abdomen or lower chest may occur with acid-peptic disorders. Pain in the right upper abdomen, particularly after meals, can occur with gallbladder disease. Severe upper abdominal pain that radiates to the back may be seen in pancreatitis.

Pain that begins around the navel and later moves to the lower right side may occur with appendicitis. Pain in the lower abdomen or side may also occur with kidney stones.

However, these patterns are only clues and should not be used for self-diagnosis, says Arul Prakash, gastroenterologist, SRM Prime Hospital, Chennai. “It is difficult to differentiate between a minor and major problem based only on pain,” he says.

Mild, short-lived pain that improves after passing stools or gas, resting or drinking fluids is generally less concerning. In contrast, sudden, severe, localised, persistent or progressively worsening pain should be assessed by a doctor.

Watch for warning signs

The symptoms accompanying abdominal pain often provide a better indication of urgency than the pain alone. Persistent vomiting can cause dehydration and may also occur with intestinal obstruction. Fever may suggest infection or inflammation.

Blood in vomit or stools should never be ignored. Black, tar-like stools or coffee-ground-like vomit can indicate bleeding in the digestive tract. Severe diarrhoea, particularly with high fever, severe pain or blood in stools, also requires medical assessment.

Increasing abdominal swelling, especially when accompanied by vomiting or an inability to pass stools or gas, can indicate bowel obstruction. Yellowing of the eyes or skin may point to a problem involving the liver, gallbladder or bile ducts.

The SHARP warning signs

Dr. Jennie suggests remembering the SHARP warning signs: sudden or severe pain; associated symptoms such as vomiting, fever, bleeding, jaundice or confusion; advanced age, particularly with chronic illnesses; rigidity or marked tenderness of the abdomen; and pain during pregnancy or after surgery.

Chest pain or difficulty breathing along with upper abdominal pain also warrants urgent assessment, as some heart conditions can mimic abdominal discomfort. Dr. Arul Prakash notes that patients have occasionally mistaken heart attack symptoms for acidity and treated themselves with over-the-counter medicines.

Avoid self-treatment

A common mistake is to assume that every episode of abdominal pain is due to ‘gas’ or acidity. Repeatedly taking medicines without establishing the cause can delay diagnosis.

Painkillers such as ibuprofen, diclofenac and aspirin can irritate the stomach and increase the risk of gastrointestinal bleeding in susceptible people. They should not be taken casually for unexplained abdominal pain.

An antacid may provide temporary relief for occasional, familiar acidity or heartburn. But symptoms that persist for several days, keep returning or become progressively worse need medical evaluation. Antibiotics should also not be started without medical advice, particularly for diarrhoea, as many common gastrointestinal infections are viral and do not require them.

Children, older adults and pregnant women need particular caution. Children may have difficulty describing their symptoms, while older adults can have serious abdominal conditions with relatively mild or atypical pain. During pregnancy, abdominal pain may have benign causes but can also indicate pregnancy-related or surgical emergencies.

People with previous abdominal surgery, gallstones, inflammatory bowel disease or chronic liver, kidney or other major illnesses should also seek medical advice sooner when they develop new or unusual pain.

Doctors say, is not to judge abdominal pain only by how much it hurts. A new, persistent or worsening pain, particularly when accompanied by warning signs, should not be dismissed as acidity or gas.

Published - August 17, 2026 08:38 pm IST