A hard stomach can be uncomfortable and painful. Many different conditions can bring on a hard stomach, but once people know the cause, they can treat it.

In this article, we will discuss common causes of hard stomachs, symptoms, treatment options, and when to see a doctor.

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A number of conditions may cause the stomach to feel hard.

Constipation is a condition where people find it difficult or painful to pass stools.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), constipation is a common condition that affects 16% of people in the United States.

Symptoms

Many people with constipation experience bloating. This might be because hard and lumpy stools affect gut motility, and increase bacterial fermentation.

People may experience:

  • fewer than three bowel movements a week
  • passing stools that are hard, dry, or lumpy
  • pain or difficulty when passing stools
  • a feeling that not all stools have passed

Treatment

People can usually treat constipation at home. The NIDDK suggest a person should eat foods high in fiber and drink plenty of liquids. They should also take part in more physical activity.

A doctor may recommend someone train their bowels by going to the toilet at the same time every day. Doctors can also advise taking laxatives if the constipation is severe and other treatments do not work.

If people find home remedies ineffective, doctors may prescribe medications that soften stools, or refer them for surgery in severe cases.

According to a 2020 article, IBS is one of the most common gastrointestinal conditions.

Scientists are not sure how people develop IBS, but believe that several factors, such as motility, how the body interacts with the brain and gut, and distress, play a part.

IBS is more common in females than males, and becomes less common as people get older.

There are three different types of IBS:

  • IBS-D, where diarrhea accompanies IBC
  • IBS-C, where constipation accompanies IBC
  • IBS-M, where mixed bowel patterns accompany IBC

People with IBS in the U.S. are not more likely to have one type of IBS over another.

Symptoms

Common symptoms of IBS include:

  • pain or discomfort in the stomach
  • constipation, diarrhea, or both
  • bloating and enlargement of the stomach
  • pain that may change location
  • a change in stool pattern and frequency

Treatment

Treatment for IBS mainly focuses on easing symptoms. Doctors can help relieve pain, bloating, cramping, and a person’s bowel patterns.

Medical professionals may recommend fiber supplements and laxatives for people who have IBS with constipation.

For people with diarrhea, a doctor may recommend loperamide or probiotics.

A person who increases their amount of physical activity could improve their IBS symptoms.

Doctors could also prescribe a low dose of tricyclic antidepressants (TCAs), such as doxepin, or serotonin reuptake inhibitors (SSRIs), such as citalopram, to help constant and severe stomach symptoms.

A person can also avoid certain foods to help manage IBS. Some people find that cutting out wheat products, fruits and vegetables, and dairy containing carbohydrates known as FODMAPs, could improve their symptoms.

Learn more about what foods to avoid here.

Inflammatory bowel disease is where the gastrointestinal tract becomes inflamed due to the body’s immune system reacting to microflora in the gut.

The two conditions that a person might have with IBD are ulcerative colitis and Crohn’s disease.

People with ulcerative colitis experience an inflammation of the inner lining of the colon and rectum.

People with Crohn’s disease experience ulcers in the gastrointestinal gut. However, most ulcers appear in the colon and the terminal ileum. This is the part of the small intestine that attaches to the large intestine.

Symptoms

One 2020 article states that symptoms of ulcerative colitis and Crohn’s disease are so similar that doctors cannot initially diagnose one condition over the other.

According to the Crohn’s & Colitis Foundation, symptoms of ulcerative colitis include:

  • loss of appetite
  • weight loss
  • nausea and fever
  • fatigue
  • anemia
  • diarrhea
  • bloody stools
  • cramps and pains in the abdomen

Crohn’s disease has very similar symptoms to ulcerative colitis. People with Crohn’s disease may experience all or a few of the above, along with:

  • dehydration
  • abscesses
  • a fistula, which is an abnormal connection of the intestine and other organs

Treatment

Doctors will aim to help people with IBD go into remission. This means that their symptoms either go away or become manageable.

Both ulcerative colitis and Crohn’s disease can have flare-ups, where symptoms can get worse.

Doctors will prescribe aminosalicylates, such as mesalamine. People can take this medication as a suppository, which they insert into the rectum. Alternatively, doctors may prescribe oral medication.

Doctors may also prescribe corticosteroids if a person does not respond well to mesalamine. Corticosteroids help reduce inflammation. However, doctors may prescribe immune-modifying agents, such as anti-tumor necrosis factor drugs, if corticosteroids are ineffective.

Once the initial symptoms are under control, doctors usually prescribe corticosteroids to deal with any flare-ups.

In severe cases, medical professionals may refer a person for total colectomy, a surgery that removes the entire colon.

According to the National Cancer Institute, gastric cancer is a form of cancer that affects the stomach lining.

Gastric cancer begins in the mucosa layer of the stomach, the innermost layer, before it spreads through the different layers as it grows.

Symptoms

Early signs of gastric cancer are similar to other conditions. Symptoms include:

People who have a more advanced stage of gastric cancer may experience:

  • blood in the stool
  • vomiting and unintended weight loss
  • stomach pain
  • jaundice, which is a yellowing of the eyes and skin
  • a build-up of fluid in the stomach
  • trouble swallowing

Doctors can diagnose gastric cancer through a variety of tests, which include physical exams, blood tests, X-rays, and scans. Once a doctor diagnoses gastric cancer, they also know at what stage the disease is.

Treatment

There are seven standard treatments a doctor may recommend.

A doctor may refer a person with gastric cancer for surgery. During this procedure, a surgeon will try to remove the cancerous parts of the stomach. In some cases, they can remove much of the tissues and organs near the cancer cells to prevent it from spreading.

Alternatively, a doctor may refer a person for an endoscopic mucosal resection. This procedure removes early-stage cancer without the need for surgery.

Other treatments involve different kinds of therapy. These include:

  • chemotherapy, wherein a person takes drugs to stop cancer growth
  • radiation therapy, wherein medical professionals attack cancer with X-rays or other types of radiation
  • chemoradiation, a combination of chemotherapy and radiation therapy
  • target therapy, wherein a person takes drugs that attack specific cancer cells
  • immunotherapy, wherein medical professionals boost a person’s immune system to fight cancer

A hard stomach during pregnancy may be the result of Braxton-Hicks contractions.

According to a 2020 article, these contractions are irregular, and some people may know them as false labor pains. They occur when muscle fibers in the uterus tighten and then relax.

They can start as early as 6 weeks into a pregnancy, but most people do not feel them until the second or third trimester.

The table below highlights the differences between Braxton-Hicks contractions and labor contractions.

Braxton-Hicks contractionsLabor contractions
Contractions that are irregular and unpredictable in lengthContractions that increase in frequency and strength
Uncomfortable contractionsPainful contractions
Contractions do not become more intenseContractions become more intense
Does not cause cervix dilationCauses cervix dilation

Learn more about how to tell if contractions are real here.

People with Braxton-Hicks contractions can change their position or their activity level to help ease discomfort.

For example, if a person is usually sedentary, a walk may be helpful, whereas a more physically active person may benefit from sitting down. It could also help to relax and drink water.

Other causes of a hard stomach in pregnancy may include gas and constipation.

It is important to see a doctor if someone with a hard stomach experiences more severe symptoms. These include:

  • blood in the stool
  • vomiting
  • unintended weight loss
  • excessive pain in the stomach

A person should also see a doctor if home treatments for conditions do not ease symptoms.

A hard stomach can have many different causes.

People may have issues that are simple to treat, such as constipation, or they could have a more serious condition, such as IBS or IBD.

While a person can treat some conditions at home, it is important to seek medical advice if symptoms become more serious, or do not respond to home treatments.