There are clues to diagnosing the cause and severity of abdominal pain. See abdominal pain for a detailed discussion of the potential causes and what to do for your symptoms.

Abdominal pain can represent many different types of problems besides a simple stomachache. It can even be from pain in the pelvis (like menstrual cramps), back (like kidney stones), or chest (like a heart attack or heartburn). Some of the key information to diagnose abdominal pain includes:

• What makes it feel worse?
• What makes it feel better?
• When did it begin?
• How long does it last when you have it? Is the pain constant or does it come and go?
• What does the pain feel like? Is it sharp, dull, or crampy?
• Do you also have nausea, vomiting, diarrhea, constipation, blood in your stool?

Two common conditions that you may worry about if you have abdominal pain are appendicitis or an ulcer. An inflamed appendix generally starts with pain in the center of the abdomen, around the belly button, followed by loss of appetite, nausea, and fever. As appendicitis worsens, the pain generally moves to the right lower abdomen. An inflamed appendix can rupture and should be treated as a medical emergency.

Ulcers often produce pain in the upper, central abdomen, a few hours after eating or during the night. Taking antacids may relieve the pain. The risks from an ulcer include bleeding or rupture.

Call your local emergency room (such as 911) if:

• Your pain is severe, sudden and sharp
• You have a fever along with your pain
• You are vomiting blood or have bloody diarrhea
• You have a rigid, hard abdomen that is tender to touch
• You are unable to pass stool, especially if you are also vomiting
• You have chest, neck, or shoulder pain
• You are dizzy or light-headed

Call your doctor if:

• You have nausea and lack of appetite.
• You have yellowing of your eyes or skin.
• You have bloating for more than 2 days.
• You have diarrhea for more than 5 days, or if your infant or child has had diarrhea for 2 days or vomiting for 12 hours. (Call right away if your newborn [under 3 months] has diarrhea or vomiting.)
• You have had abdominal discomfort for more than one week.
• You have burning with urination or you are urinating more often than usual.
• You have painful menstrual periods.
• You may be pregnant.
• Your pain gets worse when you take antacids or eat something.
• You are unintentionally losing weight.

Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: WB Saunders; 2006.

Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 17th ed. St. Louis, Mo: WB Saunders; 2004.

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006.