When to Go to the ER for Stomach Pain

When you’re really not feeling well, it’s natural to wonder when to go to the ER for stomach pain. Since stomach pain is so common, however, many people struggle to make this call. 

So, how do you know when stomach pain is serious enough for a trip to the ER? 

Complete Care to help answer this question. No more second-guessing when to go to the ER for stomach pain. Learn exactly which scenarios might necessitate a trip to the emergency room and which you can likely handle at home. 

6 definitive reasons you should go to the ER for stomach pain 

Before we get into cases that require some interrogation of whether or not you should go to the ER, it’s important to cover those cases of stomach pain that, without question, require emergency medical assessment and treatment. If you meet any of the following conditions and you’re experiencing severe stomach pain, seek medical attention immediately. 

1. You have undergone certain procedures 

After certain types of surgical procedures, moderate to severe stomach pain could indicate a serious complication. These procedures include:

• Abdominal surgery (if you experience pain within a week of the surgery) 
• Bowel resection (any time post-surgery, including years after the procedure) 
• Colostomy (any time post-surgery, including years after the procedure) 
• Gastric bypass (any time post-surgery, including years after the procedure) 
• Gastrointestinal procedures (if you experience pain within a week of the surgery) 

If you are experiencing stomach pain after one of these procedures, do not hesitate. Head to the emergency room as soon as possible.

2. You are pregnant

Experiencing stomach pain during pregnancy is scary. If you are pregnant and experiencing stomach pain, it’s important to keep in mind that some types of pain are normal, and may be caused by the growth of your uterus, Braxton Hicks contractions, or even constipation and gas. Severe pain during pregnancy, however, may be a sign of complications, including:

• Ectopic pregnancies: Pregnancy occurring in the fallopian tube. The stomach pain is often accompanied by excessive bleeding. Complications begin between 6-10 weeks of pregnancy.
• Placental abruption: Early separation of the placenta from the wall of the uterus. The stomach pain is often accompanied by excessive bleeding, severe back pain, tenderness, and contractions. Typically occurs in the 3rd trimester.
• Preeclampsia: A condition that causes high blood pressure and excess protein in your urine. The stomach pain is often accompanied by sudden weight gain, excessive swelling, and severe headaches. Occurs after 20 weeks of pregnancy.
• Preterm labor: Labor that begins before 37 weeks of pregnancy. Stomach pain is often accompanied by regular contractions. Immediate action can drastically improve outcomes for your baby. 

If you are pregnant or could be pregnant and you’re experiencing moderate to severe stomach pain, call your ob-gyn or go to the emergency room ASAP. 

3. Your abdomen is suddenly expanding/swelling, is bruised in appearance, or feels hard

Sometimes changes in the look and feel of your stomach are enough to tell you when to go to the ER for stomach pain. These symptoms go beyond the more common discomfort of swelling and bloating due to gas, and include: 

• Swelling / expanding: Sudden expansion or swelling of your belly couple with severe stomach pain may indicate acute pancreatitis, a blocked intestine, bowel perforation, or other serious complications.
• Bruising: If you are experiencing severe stomach pain and notice sudden bruising of the belly (not related to trauma), seek immediate medical treatment. There are two main types of bruising that occur during pancreatitis and a hemorrhagic ectopic pregnancy: Grey Turner’s sign (on the flanks) and Cullen’s sign (around the belly button).
• Hard stomach: In patients over 40, a hard stomach in addition to stomach pain and other symptoms can indicate diverticulitis (inflammation/infection of the digestive tract), among other conditions.

If you are experiencing any of these symptoms in addition to severe stomach pain, they may be a sign of a life-threatening condition. In these cases, it’s much better to be safe than sorry and take a trip to the ER.

4. You have experienced severe abdominal trauma 

You see this phrase — abdominal trauma — thrown around a lot when discussing when to go to the ER for stomach pain, but rarely is it explained. Abdominal trauma typically occurs as a result of an accident, such as a car crash or a sports injury. It can involve a severe compression or displacement of the internal organs, such as when a seatbelt strains against your stomach in a car accident. 

This type of abdominal trauma can also be caused by physical abuse. Finally, abdominal trauma can also be the result of penetrating wounds to the stomach, including knife and gun wounds. 

If you have recently been the victim of abdominal trauma and are experiencing stomach pains, now is not likely the best time to question when to go to the ER for abdominal pain. Seek treatment immediately. 

5. You can’t stand up

This indicator may seem a little arbitrary, but it’s honestly one of the simplest ways to tell when to go to the ER for stomach pain. The operative word here is can’t.All of us are familiar with the more typical, run-of-the-mill stomach pain caused by eating spicy food or indulging in too much candy. These stomach aches aren’t fun, and they may make you uncomfortable enough that you do not want to stand up. But if the pain is so bad that you physically can’t stand upright, that’s different; it is time to go to the emergency room. 

Of course, if you find yourself in severe pain but are able to force yourself to stand up, that doesn’t mean you should skip seeking treatment. Have you experienced severe pain for 24-48 hours, despite being able to stand up? Is the pain so bad that you cannot focus on work or other activities, even if you can stand up? If yes, then you should still go to the ER. 

6. Your stomach pain is accompanied by other severe symptoms 

When severe stomach pain isn’t your only symptom, that increases the likelihood that you are suffering from a serious medical condition. Symptoms to be concerned about include but are not limited to:

• Bloody diarrhea 
• Bloody or burning urine 
• Bowel movements accompanied by vomiting 
• Chest pain or pressure (especially if you are over 45, as this may be a sign of an impending heart attack)
• Coughing up or vomiting blood 
• Diarrhea lasting more than 5 days 
• Difficulty Breathing 
• Dizziness 
• Excessive vaginal bleeding 
• Fever above 100 degrees 
• Fainting 
• Inability to pass a stool (severe constipation)
• Neck pain
• Pains in the shoulders or between shoulder blades
• Persistent vomiting and/or inability to keep food down for 2 days
• Vision changes 

If you or someone you love is experiencing any of these symptoms in addition to severe stomach pain, this is cause enough to go to the ER. If you are experiencing chest pain, please make sure you know when to go to the ER for chest pain. 

Causes of severe stomach pain that sends you to the ER

Now that you know when to go to the ER for stomach pain, you may be wondering what illnesses and conditions might be sending you there. Stomach pain can be caused by a seemingly infinite number of diseases, disorders, and injuries. However, not all of these causes will send you to the ER. What follows are the top stomach pain causes that will likely merit an ER visit. 

Please note that this list is not exhaustive. Also, note that the stomach flu and food poisoning can both present stomach pain and some of the additional symptoms listed above. In some cases, both of these ailments can warrant a trip to the ER, but not always. If you are concerned,  read up on stomach flu vs. food poisoning symptoms to understand more about when these issues can turn serious.

Appendicitis

Appendicitis is caused by a blockage of the appendix, typically by feces. Pain typically begins near the belly button then moves to the lower right-hand side of the abdomen. Appendicitis is one of the most common causes of emergency surgery; treatment typically involves the removal of the appendix. 

For more information, read our article: What Does Appendicitis Feel Like?

Bleeding or ruptured blood vessels

Internal bleeding can be caused by an array of conditions and injuries, from colitis to ectopic pregnancy and from bleeding disorders to trauma. The cause of the bleeding will need to be determined before appropriate treatment can be applied. 

Blocked intestines and diverticulitis 

Your intestines play an important role in moving food and liquid through your body. They can be blocked by impacted feces, hernias, inflammation (Crohn’s disease), colon cancer, the growth of fibrous tissues, and diverticulitis (inflamed, infected pouches in your intestines). Typically, blockages such as these require immediate attention. If you suspect your pain is caused by blocked intestines, this is definitely an instance of when to go to the ER for stomach pain.   

For more information, read our article: When to Go to the ER for Diverticulitis 

Gallbladder issues

Gallstones are small, hardened deposits, typically made of cholesterol. While they typically do not cause symptoms, they can lead to intense pain in your stomach if they get trapped in the opening of the gallbladder. If the duct of your gallbladder is frequently obstructed (by gallstones or another source), this can lead to a painful inflammation of the gallbladder called cholecystitis. Treatment depends on the severity of the issue; your gallbladder can be removed if necessary. 

Kidney stones 

Kidney stones form in your urine. There are many types of stones that vary depending on what creates them, although most kidney stones are calcium stones. If a kidney stone passes into the ureters (the tube that carries urine from the kidneys to the bladder) it can create severe stomach pain, discolored urine that burns, and a persistent need to urinate. 

For more information, read our article: When to go to the ER for Kidney Stones

Pancreatitis

Pancreatitis is the inflammation of the pancreas, typically caused by gallstones and heavy alcohol use. While both acute and chronic pancreatitis can occur, the former is more likely to send you to the ER. Acute pancreatitis typically results in severe upper abdominal pain, nausea, and vomiting. Treatment typically includes IV fluids and pain medications and removal of gallstones, if necessary. In very extreme cases, the pancreas is removed. 

Ulcers

Peptic ulcers occur as a result of an infection by H. pylori bacteria, the overuse of certain medications, and lifestyle factors, including stress. The perforation of an ulcer may cause internal bleeding, blood in your stool, vomiting with a coffee-ground-type consistency, and can be life-threatening without surgical treatment

For more information on stress reduction, read our article: The Signs and Symptoms of Stress

How do I get admitted to the ER for stomach pain? 

When you arrive at the ER, your doctor will review your health history and give you pain medication to relieve your discomfort. They’ll also conduct a variety of tests to determine the root cause and rule out other possibilities.

Common tests you may receive when you go to the ER for stomach pain include:

• Physical examination
• Blood test
• Liver function test
• CT scan
• Ultrasound

During the physical examination, the location of your severe stomach pain can provide insight into what may be causing issues. For example, pain 2 inches left of the belly button can be a sign of a few different ailments, including appendicitis and constipation. However, blood tests and tests of organ functions are much more reliable at diagnosing conditions than the placement of pain.

Once your doctor has diagnosed the source of your pain, they can provide treatment options to get you on the road to recovery. Your treatment plan will depend on the cause of your severe stomach pain, and will likely include a prescription for pain medication to help relieve your symptoms. 

You should always talk to your doctor about your options before beginning any treatment plans.

What to do if you decide your stomach pain is not serious

If none of the above information seems to match up with your current situation, then it could be possible that this is not one of those times when you should go to the ER for your abdominal pain. If the pain is bearable and you have no secondary symptoms, then your body could just need a little time to work through things. 

Here’s some simple guidance on what could help alleviate this pain from home:

• Take an antacid 
• Use a heating pad
• Avoid spicy food, caffeine, and fried foods 
• Avoid overeating (learn more about methods of portion control)
• Use the restroom (but don’t force it)
• Drink plenty of water
• Take a warm bath

Diet changes and regular light exercise can alleviate regular stomach aches. However, If your stomach pain is recurrent, consider scheduling an appointment with your doctor to rule out issues such as irritable bowel syndrome (IBS) and other chronic stomach ailments. 

Experiencing severe stomach pain? Complete Care can help.  

At Complete Care, we understand that self-diagnosing yourself is tricky, and knowing when to go to the ER for stomach pain can be complicated. We hope that this guide has provided you with some answers. 

If you are experiencing stomach pain, Complete Care is open 24/7 and welcomes walk-ins that can typically be seen within a few minutes, not hours. Our stand-alone emergency room facilities are able to offer our patients the same level of care as an emergency room attached to a hospital but without the wait time. 

If you or a loved one is experiencing severe stomach pain, visit your nearest Complete Care location for professional, award-winning, patient-centered care.

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