When severe stomach pain occurs, it can be difficult to decide whether to see a doctor, go to the emergency room, or wait. If the pain is severe or debilitating, a person may need to seek medical help immediately.

Stomach pain is the most common reason for emergency room visits. When a person is unsure about what to do, it may be best to call a doctor or nurse helpline to decide the best course of action.

In this article, learn about the causes of severe stomach pain, including which ones require prompt medical treatment.

Some types of stomach pain are a medical emergency. Many types at least require a doctor's treatment.

People should see a doctor or call an advice line if they experience the following:

Liver, gallbladder, or pancreas issues

Woman on the sofa holding her stomach due to severe stomach painShare on Pinterest
A person may have severe stomach pain due to gallstones.

When a person experiences pain in the upper right abdomen, just under the ribs, it could signal a problem with the liver, gallbladder, or pancreas.

Gallstones are one of the most common culprits. Without treatment, gallstones can block the bile duct and cause liver function problems or an infection in the pancreas called pancreatitis. The gallbladder may even rupture.

Typically, gallstones cause intense pain in the upper right abdomen that lasts for 4–6 hours. Some people may also vomit.

Gallstones are not usually a medical emergency, but they do warrant a visit to the doctor. This is because the complications of gallstones, such as pancreatitis, can be life-threatening.

Other conditions, such as porcelain gallbladder, can also cause pain in the upper right abdomen. Porcelain gallbladder occurs when calcium deposits build up in the gallbladder.

If the pain comes with a fever, vomiting, yellow eyes or skin, white or pale stools, or feelings of intense illness, a person should go to the emergency room.

Diverticular disease

Diverticular disease develops when small pouches form in the colon. Sometimes, these pouches may become inflamed or infected, causing a painful condition called diverticulitis.

Diverticular disease is not a medical emergency but does require a visit to the doctor. Symptoms include:

Kidney stones

Kidney stones are very painful, but they are not typically dangerous. A person may have a kidney stone if they develop intense pain in the lower abdomen that radiates to the mid-back.

Other symptoms of a kidney stone include:

  • dizziness
  • lightheadedness
  • pain that radiates to the groin

If the pain is intense, a person can go to the hospital for immediate pain relief.

If the pain is manageable, it may be best to call a doctor. The doctor can diagnose the kidney stone and assess whether an underlying medical condition caused it to develop.

Dehydration

Stomach conditions that cause vomiting or diarrhea can lead to dehydration, especially in children and older adults.

If a person cannot keep down fluids, they may need intravenous fluids from a doctor or at the hospital.

Immediately call a doctor or go to the hospital for symptoms of dehydration such as very dry skin, dry mouth, not urinating, chapped lips, or a rapid heart rate.

Appendicitis

Appendicitis is an infection of the appendix. Without treatment, the appendix can rupture.

Sudden intense pain that begins in the middle of the stomach and slowly moves to the right side of the abdomen may be a sign of appendicitis. However, the pain can vary, sometimes starting as a dull ache around the umbilical area and intensifying as it moves to the right side of the abdomen.

People should seek emergency medical treatment for symptoms of appendicitis. Typically, a doctor will advise the removal of the appendix and prescribe antibiotics.

Bleeding and ruptured blood vessels

The stomach is full of blood vessels, including the aorta, which is the body's largest blood vessel.

A ruptured aortic aneurysm occurs when a bulge in the aorta breaks. An aortic dissection happens when something cuts or punctures the aorta. Sustaining any tear or rupture in the stomach's blood vessels is a life-threatening emergency.

The main symptom of a ruptured blood vessel in the stomach is sudden, unexplained, extreme pain. Some people also experience shortness of breath, a racing heart, and dizziness.

People who know they have an abdominal aneurysm should treat any stomach pain as an emergency. On arrival at the emergency room, they must tell the physician about the aneurysm.

Blocked intestines

A blockage in the intestines can make it difficult or impossible for the body to expel waste. Although some blockages may only partially block the intestines, others block them completely. A complete blockage can become life-threatening.

Several conditions, including tumors, inflammatory bowel disease, and hernias, can block the intestines.

One of the most dangerous causes of a blocked intestine is a volvulus. A volvulus develops when the colon twists around itself. Without treatment, the volvulus can tear the intestine or cause tissue death.

Symptoms of a blocked intestine include:

  • abdominal pain
  • cramping
  • a swollen stomach
  • a fever
  • a rapid heartbeat
  • bloody diarrhea

Some people develop a life-threatening infection called sepsis. Sepsis typically causes additional symptoms, such as:

  • a high fever
  • weakness
  • fatigue
  • vomiting
  • other symptoms of severe illness

A blocked intestine is usually a medical emergency, but it is hard to distinguish it from other conditions based on the symptoms alone.

People who think they have an intestinal blockage, especially those with risk factors for one, such as tumors or hernias, should go to the emergency room.

man concerned about diabetic diarrheaShare on Pinterest
A person can treat pain from gas and indigestion at home.

Many types of stomach pain are safe to treat at home. These include:

  • indigestion
  • gas pain
  • bloating from overeating
  • stomach pain from food sensitivities

Stomach viruses, such as norovirus, can often cause nausea, bloating, and diarrhea. They can also cause intense pain, but vomiting usually offers temporary relief.

These viruses tend to go away without treatment within a couple of days. It is essential to stay hydrated during this time.

Children, older adults, and medically vulnerable people are especially prone to dehydration.

It is safe to treat stomach viruses at home, but a person should call their doctor if symptoms last longer than a few days, or if they cannot keep down any fluids for longer than 12 hours.

If a newborn baby develops symptoms of a stomach virus, call a doctor or take them to the emergency room.

Stomach pain can feel very uncomfortable, but it often signals a minor illness. However, having sudden stomach pain or stomach pain that occurs alongside other symptoms can point to a more serious medical issue.

It is not possible to diagnose stomach pain based on symptoms alone. The severity of a person's stomach pain does not necessarily correlate with the severity of the illness. For example, some gas pain can be severe but will pass without causing any lasting harm.

It is best to err on the side of caution and see a doctor for any stomach pain that does not go away, or if the cause is unclear.