Stomach pain has dozens of possible causes, ranging from something as simple as trapped gas to conditions that need medical attention. The most useful way to narrow it down is by paying attention to three things: where exactly the pain is, what it feels like, and what else is happening in your body at the same time. Those details point toward very different explanations.
Where the Pain Is Matters
Your abdomen contains organs packed closely together, and pain in one spot often points to a specific one. Upper right pain frequently involves the liver or gallbladder. Upper left pain can stem from the stomach, pancreas, or spleen. Lower right pain is the classic location for appendicitis, since that’s where the appendix sits. Lower left pain in adults over 40 is commonly linked to diverticulitis, a condition where small pouches in the colon wall become inflamed.
Pain that’s hard to pinpoint, or that feels like it’s spread across your whole belly, is more typical of gas, bloating, a stomach virus, or irritable bowel syndrome. Pain that started in one place and migrated is also a useful clue. Appendicitis, for example, often begins as a vague ache near the belly button and then shifts to the lower right side over several hours.
The Most Common Culprits
For most people searching this question, the cause falls into one of a few categories.
Gas and bloating cause sharp, crampy pain that comes and goes, often shifting location as gas moves through the intestines. It can feel surprisingly intense, sometimes mimicking more serious conditions. If you can pass gas or have a bowel movement and the pain eases, gas was likely the issue.
Indigestion typically hits the upper abdomen after eating. It’s a burning or gnawing discomfort, sometimes with nausea. Eating too fast, overeating, or consuming fatty or spicy foods are the usual triggers.
Gastroenteritis (a stomach bug) follows a specific pattern: vomiting comes first, then pain, then diarrhea. It usually resolves within one to three days. If you know others around you have been sick, this is the likely explanation.
Constipation causes a dull, persistent ache, often in the lower left abdomen, that builds over days. You might feel bloated and full without being able to have a normal bowel movement.
Menstrual cramps and other reproductive causes are worth considering if you have a uterus. Lower abdominal pain that lines up with your cycle is often cramping, but pain that’s unusually severe, one-sided, or accompanied by abnormal bleeding could involve an ovarian cyst, endometriosis, or pelvic inflammatory disease. Ovarian cysts tend to cause pain on one side with radiation to the lower back, while endometriosis causes chronic pain that worsens with hormonal cycles.
When Pain Keeps Coming Back
If your stomach hurts frequently, not just today, the explanation shifts toward chronic conditions. Irritable bowel syndrome is one of the most common. IBS is diagnosed when you’ve had recurring abdominal pain at least one day per week for three months, and that pain is connected to bowel habits: it gets better or worse with bowel movements, or it coincides with changes in how often you go or what your stool looks like. IBS doesn’t damage your intestines or show up on imaging. It’s a disorder of how the gut functions, not a structural problem.
Inflammatory bowel disease (Crohn’s disease and ulcerative colitis) is less common but more serious. Unlike IBS, IBD causes visible inflammation and can permanently damage the intestines. The distinguishing symptoms are bleeding, unintentional weight loss, anemia, and fever. If your recurring stomach pain comes with any of those, the explanation is more likely to be IBD than IBS.
Food as a Trigger
If your stomach tends to hurt after eating specific foods, you may be dealing with a food intolerance. Lactose intolerance and gluten intolerance are the most common types, and symptoms (gas, bloating, diarrhea, stomach pain) typically appear within a few hours of eating the trigger food. This is different from a food allergy, which involves the immune system and produces symptoms within minutes to two hours, often including reactions beyond the gut like hives, swelling, or difficulty breathing.
An elimination approach can help you identify the trigger. Remove the suspected food for two to three weeks, then reintroduce it and see if symptoms return. Dairy is a good place to start since lactose intolerance affects a large portion of adults worldwide.
Pain That Isn’t Coming From Your Gut
Not all pain you feel in your stomach actually originates there. Chest problems, including heart issues, can refer pain to the upper abdomen. Kidney stones and urinary tract infections can cause flank pain that wraps around to the front. Pulled muscles in the abdominal wall can produce sharp, localized pain that worsens when you tense your core, like when sitting up from a lying position. If your pain gets worse with movement or muscle engagement rather than with eating or digestion, the abdominal wall itself may be the source.
Signs You Need Emergency Care
Most stomach pain resolves on its own, but certain patterns warrant an ER visit. Go if:
- The pain is severe enough to stop you from functioning normally
- You can’t keep any liquids down due to persistent vomiting
- You’re unable to pass gas or have a bowel movement alongside severe pain, especially if you’ve had abdominal surgery in the past (this pattern suggests a bowel obstruction)
- The pain started near your belly button and moved to your lower right side, is getting worse over hours, and worsens when you move, cough, or take deep breaths (the classic appendicitis pattern)
- You have upper abdominal pain that worsens after eating, along with nausea, fever, and a rapid pulse (which can indicate pancreatitis)
Pain that feels familiar from a previous episode but is noticeably different this time, more intense or accompanied by new symptoms, also justifies being evaluated. The gut instinct that something is wrong is worth acting on.
Figuring Out Your Specific Cause
When you see a doctor for stomach pain, the physical exam is more informative than you might expect. Pressing on specific areas and asking you to tense your muscles can help distinguish between problems in the abdominal wall versus deeper organs. For gallbladder inflammation, a specific test involves pressing under the right rib cage while you breathe in. A sharp catch of pain is a strong indicator, though it’s only present in about 65% of adults with the condition.
Beyond the exam, your doctor will rely heavily on the story you tell. Keeping track of when the pain happens (before meals, after meals, at night, during your period), what makes it better or worse, and any associated symptoms like changes in bowel habits, nausea, or bloating gives them far more to work with than a vague description of “my stomach hurts.” If you’ve been dealing with this for weeks or months, a written log of even a few days can speed up the process considerably.