Stomach Pain

Your stomach hurts … a lot. Clearly, this isn’t an ordinary upset stomach. Should you tough it out, or call the doctor? The truth is, many things -- ranging from heartburn to appendicitis, irritable bowel syndrome (IBS) and inflammatory bowel disease -- can cause stomach pain. “That’s one of our major challenges -- to distinguish something that won’t progress in a serious way from something that requires immediate attention,” says Dr. Silvia Degli Esposti, a gastroenterologist, associate professor of medicine at Brown University School of Medicine and director of the Center for Women’s Gastrointestinal Disorders at Women & Infants Hospital in Providence, R.I.

If stomach pain is mild and resolves within 24 hours, or if pain occurs only when you consume certain foods (such as those containing lactose), there’s no need to call your doctor, says Degli Esposti. She adds, “We all have abdominal cramps occasionally when we have to go to the bathroom, or we might get pain with indigestion or heartburn from eating a big hamburger.” These situations aren’t cause for concern. But “any abdominal pain that presents with some regularity or persists should be discussed with your doctor,” she says.

Here are five red-flag stomach symptoms that always warrant an immediate call to your doctor:

1. Stomach pain with rectal bleeding.

This could indicate something as simple as hemorrhoids accompanied by a run-of-the-mill stomachache or as serious as ulcerative colitis or colorectal cancer, says Degli Esposti.

2. Severe, unrelenting abdominal pain.

Intense stomach pain that does not let up can signal a range of conditions, some very serious. Possible culprits: appendicitis (which may require emergency surgery), inflammatory bowel disease or a viral illness. If you’re a woman, it may also suggest ovarian torsion (twisting of the ovary), an abscess in the fallopian tubes or pelvic inflammatory disease, adds Degli Esposti.

3. Stomach pain with unexplained weight loss.

While it may sound great to lose weight as if by magic, unexplained weight loss is not something to take lightly, says Degli Esposti. When combined with stomach pain, it could suggest inflammatory bowel disease, celiac disease or any cancer affecting the gastrointestinal tract, including that of the pancreas, stomach, colon or lymphoma.

4. Stomach pain with repeated vomiting.

If it lasts more than 48 hours, stomach pain with vomiting could suggest a gallbladder problem, an ulcer, intestinal obstruction, pancreatitis or inflammatory bowel disease with an obstruction, Degli Esposti says. If you’re vomiting blood, it may indicate an ulcer, a tear in the lining of the esophagus, or gastritis (inflammation of the stomach lining).

5. Upper abdominal pain with difficulty swallowing.

This could indicate a complication of heartburn, such as inflammation of the esophagus (esophagitis), a stricture (narrowing) in the esophagus or a form of esophageal cancer.

Everyone gets an occasional stomachache, but “regular or persistent abdominal pain is never normal,” says Degli Esposti. While your stomach pain might be something relatively benign, like IBS, it could also be something life-threatening, like cancer. Your best bet: When in doubt, get your symptoms checked out by a doctor.

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