20 Reasons Why Your Stomach Hurts
Nearly everyone has had a stomachache at some point. But really, any organ in your abdomen (there are many) could be to blame.
Tummy trouble can be short-lived, come and go, or show up only after you eat—all clues to the cause. Doctors can also run a number of tests to narrow it down, says Vivek Kaul, MD, acting chief of the division of gastroenterology and hepatology at the University of Rochester Medical Center in Rochester, N.Y.
RELATED: Here’s the Best Way to Cure an Upset Stomach
Read more to find out about possible culprits.
Gallstones are stones that form in the gallbladder, a tiny sac that hangs out under the liver, disgorging bile as needed to digest fats.
These stones cause swelling and can block the duct into the intestine, resulting in pain. Gallstone pain tends to strike the right side of the upper abdomen, particularly after fatty meals.
Such meals trigger the gallbladder to contract. “If the gallbladder is inflamed, any contraction of that nature will be amplified and typically will cause pain to the patient,” says Dr. Kaul.
Inflammation of the pancreas can cause burning pain in the upper or middle abdomen. Some people even have shooting pain that drives right through to their back, says Dr. Kaul.
You may lean forward or lie on your back to try to relieve the pain, which may subside into a dull ache, nausea, and vomiting, says Osama Alaradi, MD, a gastroenterologist at Henry Ford Hospital in Detroit.
Too much alcohol can be a culprit, says Dr. Kaul, as are gallstones (the gallbladder and pancreas deliver their digestive juices into the intestine via the same duct). It often requires hospitalization.
RELATED: 10 Things That Can Cause Diarrhea
Gastroesophageal reflux disease, or GERD, can cause pain in the upper stomach and lower chest, aka heartburn.
The cause? A valve that separates the stomach from the esophagus is weak, allowing food and acid from the stomach to splash upwards. Ouch!
Eating too much food or the wrong type of food (fatty, for instance) can make it worse. Losing weight, watching what you eat, and medication like antacids, H2 blockers, and proton pump inhibitors, can also help.
Millions of people around the world have lactose intolerance. In fact, in some areas of the world, the lactose intolerant outnumber those who can digest lactose, a sugar found in milk and milk products.
This type of food intolerance causes mild to severe abdominal pain depending where you place on the tolerance scale, says Patricia L. Raymond, an assistant professor of clinical internal medicine at Eastern Virginia Medical School. "I advise everyone who thinks they have an intolerance to take a lactose tolerance test," she says. "It’s not a yes or no answer because severity comes into play." Symptoms include bloating, diarrhea, burping, gas, and indigestion and vary based on your level of sensitivity.
The solution? Skip the dairy products, like milk and cheese, and be wary of packaged foods. Raymond says packaged foods often contain hidden milk products or whey, a milk-based byproduct found in many protein powder mixes and other nutritional foods. If you're lactose intolrant you can also drink Lactaid milk or take Lactaid pills to prevent stomach aches and pains.
Medication side effects
No drug is without side effects and sometimes that includes abdominal pain. "A medication itself can be caustic or slow the stomach's emptying, causing pain," says Dr. Raymond.
Pain medications known as NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and aspirin have this caustic property and can cause swelling in the stomach lining and may even lead to ulcers.
Oral bisphosphonates, a popular class of drugs that helps preserve bone density and prevent osteoporosis, can cause swelling—and therefore pain—in the lower esophagus, says Dr. Kaul. Also look out for antibiotics, specifically those containing azithromycin, and take them after a meal to give the stomach a proper lining for the drug.
Narcotic and blood pressure medications relax the stomach's walls and allow food to sit and ferment in your stomach, contributing to a queasy feeling.
Diverticulitis is an inflammation of “diverticula” or pockets that form in the lining of the intestine, usually the colon.
“These look like punched-out holes in the lining of the colon that tend to get inflamed or obstructed with stool or other foreign material,” says Dr. Kaul.
Symptoms can include cramping in the lower abdomen, which may respond to antibiotics. A high-fiber diet can help. In more severe cases, it can cause abscesses, bleeding, and even perforations, resulting in severe pain, or even the need for surgery or a hospitalization.
RELATED: What Is Diverticulitis?
Some people react badly to gluten, a protein found in wheat, barley, and rye. The most severe form of gluten intolerance is called celiac disease.
“The gluten causes damage in the small intestine,” explains Dr. Alaradi. “The small intestine doesn’t work normally, it doesn’t absorb nutrients.” Experts and patients are becoming more aware of gluten intolerance and celiac disease, which causes gas, bloating, mild-to-severe pain, and fatigue.
The small intestine’s inability to absorb nutrients may lead to chronic diarrhea, weight loss, and even malnutrition.
Endometriosis only affects women. It’s a condition that occurs when cells from the lining of the uterus escape and start to grow in other parts of the body, usually somewhere in the pelvis.
Pain, irregular bleeding, and infertility can result. Endometriosis is difficult to diagnose, says Dr. Kaul, and often requires a referral to a gynecologist and a pelvic ultrasound.
If the endometriosis is confined to one small area, surgery may help. Otherwise it is treated with pain medication and hormone therapy, as the menstrual cycle tends to drive painful symptoms.
Even though the thyroid gland is located in the neck, it can cause problems lower down in the body.
“The thyroid regulates several functions in the body and the digestive tract is one of the systems,” explains Dr. Alaradi.
If the thyroid produces too much hormone (hyperthyroidism), it speeds up the digestive tract, resulting in diarrhea and abdominal cramps, he says.
On the other hand, an underactive thyroid (hypothyroidism) slows down the digestive tract, potentially leading to pain from constipation and gas.