Ask The Doctor

Abdominal Pain Has Many Causes

Dear Dr. Garner,

For the past month, I have been having stomach pains. It usually starts off as diarrhea and then ends up with constipation. I haven’t had any fevers. It doesn’t seem to be related to any specific types of food.

It does get worse when I am under increased stress at work. The pain is intermittent and located over my stomach. It is beginning to bother me. Could you help me?

Stomach pain in Seagate


Dear Stomach Pain,

I was just talking with my friend and colleague, Dr. Antonio Mascatello, about this. Stomach pain, or abdominal pain, is very common with many causes. The pain, however, can be a sign that there is a serious underlying illness present. It is important to know when to call the doctor.

Since this topic can be a little dry, to make it more interesting, I have included a quiz about abdominal pain. The answers can be found at the end of this article. (Note: There may be more than one correct answer.)

  1. What are two types of pain that may feel like a stomachache but originate from other organs elsewhere?
  2. What animal (often mistaken for an insect) causes severe stomach pain when it bites its victim?
  3. What painful rash often makes a person feel like he has a bad stomachache?

The most common causes of abdominal pain include indigestion, constipation, menstruation, stomach virus, Crohn’s disease, acid reflux, kidney stones, gallstones and ulcers.

When is it time to worry? It is important to seek help if your abdominal pain is severe, or accompanied by fever and an inability to keep food in your stomach for a couple of days, frequent urination or severe constipation. If the abdomen is tender to touch or the pain lasts for several days, it is important to seek help. Your doctor will want to know about the pain you are experiencing.

When does the pain occur? Is it only after eating or is it after drinking alcohol? Does the pain spread to your back or groin? Are you pregnant? These are some of the questions your doctor will ask. Crampy pain may be due to gas and bloating, and is often followed by diarrhea. The doctor can often tell the type of stomach pain you are having from where it occurs and where it radiates. An example of this is appendicitis, which can radiate to the groin and cause pain over the right lower abdomen.

You can try the following at home to ease mild abdominal pain:

  1. Sip small amounts of water or other clear fluids.
  2. Avoid solid food for the first few hours.
  3. If you have been vomiting, wait six hours and then eat a small amount of light food such as rice.
  4. Avoid dairy products.

Avoid aspirin and Motrin as these may irritate an already inflamed stomach or intestines.

Tests that your doctor may order include blood, urine and stool tests, ultrasound, upper GI series or X-ray of the abdomen, barium enema, CT scan or colonoscopy.

Many causes of abdominal pain, such as gas pain or pulled muscles, are not serious, while others require immediate medical intervention.

Most abdominal pain is not serious. There are certain types, however, particularly if accompanied by fever, that need immediate attention.

For pain that lasts more than two or three days, it is necessary to see a doctor who may order blood tests, X-rays, or do a physical examination to help determine where the pain originates. Most of us will experience multiple episodes of abdominal pain in our lifetime.

Finally, stomach pain is a misnomer most of the time. It only originates in the stomach a small percentage of the time. It is just that people call any pain near the belly a “stomachache.”

I hope this helps you understand more about your problem, and that you seek medical attention to make sure there are no serious underlying medical issues.

(The answers to my quiz: 1. A heart attack and pneumonia; 2. A black widow spider; 3. Shingles.)

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.

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