Why does your stomach hurt? It’s a good question — and a common one. Millions of Americans have at least one type of digestive problem. Some problems come and go, while others can upset your whole life.

There are many different kinds of digestive problems, and that’s part of why it isn’t always easy to get to the cause of them. 

What’s the Trouble?

It’s important to know what’s causing the issue so you can treat it. But the answer may not be so simple to find.

To get to the bottom of what’s causing the problem, you may need to play detective. Paying attention to how you feel — and when — can help. What symptoms are you having and when are you having them? What have you been doing when you have them? What and how much have you been eating or drinking when you have symptoms? Are you stressed out? What medicines are you taking?

Once you have some information gathered about your symptoms, your doctor can help you figure out the problem and what to do.

Two common causes of stomach issues are peptic (stomach) ulcers and acid reflux.

Peptic ulcers are sores on the lining of your stomach. The most common symptom is a dull or burning pain in the stomach or upper abdomen, especially when your stomach is empty. Symptoms may also include bloating, nausea, vomiting and low appetite.

Ulcers are usually caused by long-term use of certain medicines or by the H. pylori bacteria. Smoking can also contribute to ulcers and make symptoms worse. Food and drinks cannot cause ulcers, but they can make symptoms worse. Avoid drinking alcohol if you have an ulcer.

Ulcer pain can last for a few minutes or a few hours at a time. The pain will come and go over a period of weeks or months. Eating or taking antacids can briefly lessen the pain.

If you think you may have an ulcer, even if your symptoms are mild, you need to see your doctor. If not treated, an ulcer will continue to get worse. Tests are needed to find out for sure if you have an ulcer.

Ulcers are usually treated with medicine. There are many different medicines that may be prescribed, depending on the type of ulcer you have.

Heartburn, or acid reflux, is one of the most common stomach issues. It happens when the acid in your stomach meant to break down food comes back up your esophagus and irritates the lining. In many cases, it may be caused by GERD, or gastroesophageal reflux disease.

A mild case of GERD isn’t generally a cause for worry, and many find relief with over-the-counter (OTC) drugs. Here are some other things you can try on your own:

• Quit smoking.
• Lose weight.
• Cut back on alcohol and carbonated drinks.
• Get more exercise.
• Take steps to lower your stress level.
• Avoid foods or drinks that make your symptoms worse. Try skipping spicy foods, for example.
• Try to wait two or three hours after eating before you lie down.

If your symptoms are severe or happen often, see your doctor. If it doesn’t get better in a month or two after treatment, it may be time for testing to look for other underlying issues. Two red flags are losing weight and swollen lymph nodes in the neck, belly or shoulders. Tell your doctor right away if you have problems swallowing or have a lot of pain.

Maybe It Isn’t Your Stomach

Sometimes tummy trouble isn’t even happening in your stomach.

Irritable Bowel Syndrome (IBS) is one of the most common “stomach” issues, but the problem isn’t your stomach. IBS can cause pain, bloating and alternating constipation and diarrhea. About 10 to 15 percent of adults in the U.S. suffer from IBS symptoms.

Pain from IBS may become worse after you eat a meal or if you are stressed. Making changes to your diet,  like avoiding some foods and adding fiber, may help. Getting more sleep, more activity and learning techniques to manage stress relief may also help your symptoms.

But if that doesn’t help, see your doctor. Your doctor may suggest taking OTC or prescription drugs or probiotics to get relief for your symptoms. Your doctor may also discuss mental health therapy or relaxation training.

Some other common problems that may cause abdominal pain include:

• Constipation: You may feel sharp gas pains throughout the abdomen area or have a feeling of being bloated and full. If OTC remedies don’t work or you have long-term symptoms, see your doctor.
• Pancreatitis: Abdominal pain caused by inflammation in the pancreas is severe and sharp. You may also feel pain in your back or chest. It may cause nausea, vomiting and fever. If you have these symptoms, see your doctor.
• Diverticular disease: Severe pain in the lower left abdomen area may be caused by diverticulitis. It happens when the small pouches inside the large intestine become infected or inflamed. Fever, nausea, vomiting or constipation can be additional symptoms. If you have these symptoms, especially if you see blood in your stool, see your doctor.

Learn more about the many digestive diseases  from the National Institutes of Health.

Don’t suffer in silence. If your symptoms are impacting your quality of life, talk to your doctor. Don’t put it off, especially if you are losing weight without trying or seeing blood when you use the toilet.

Sources: What’s Causing Your Lower Abdominal Pain?,  Cleveland Clinic, 2019; Why Does My Stomach Hurt?,  Johns Hopkins Medicine; Definition & Facts for GER & GERD,  National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD), 2020; Digestive Diseases,  NIDDKD; Digestive diseases,  National Institutes of Health, U.S. National Library of Medicine, 2021; Common GI Symptoms,  American College of Gastroenterology; Digestive Disorders,  U.S. Department of Agriculture