The hospital I work in has a General Surgery ward of 60 beds. Every month, our highest number of admissions are for patients with a “stomach ache”. Among them, 10% will need an operation immediately. Another 5% will end up needing an operation after further tests. The rest are discharged home after a period of observation. 

It is not surprising that many patients with a “stomach ache" are over-treated or commonly misdiagnosed. After all, when a doctor hears the words “stomach ache”, it brings to mind at least 50 different things that could be wrong. Some are absolute emergencies, but most are not. 

emergency department

So, when should you be worried about your stomach ache?

1. The pain does not subside with an adequate amount of painkillers at home

This is an obvious warning sign that, first, you need to get to the hospital to get something stronger and, second, that what you have is probably something more sinister than just a normal stomach ache.

2. You feel the pain radiate upwards to your chest or right through towards the centre of your back 

We would be worried about causes of stomach ache that involve your heart, lungs, major blood vessels and pancreas.

3. You are short of breath or feel like fainting, have missed your monthly period and are sexually active

This could be a sign of bleeding internally. Specifically, something called a ruptured ectopic pregnancy.

4. You have a spiking fever and your skin or eyes are yellowish

Most likely, there an infection involving your liver and gallbladder system. This is an emergency!

5. The pain is so severe it makes you vomit or you are unable to eat properly

This could be from a variety of things but being unable to eat for a prolonged amount of time will obviously lead to fatigue and to an imbalance of the salts in your body. You might need special fluids to be given through your veins. 

6. You see blood in your urine or in your stools

Blood in the urine can be due to a kidney stone or an infection, among other things. Blood in the stool can also indicate a variety of things from a simple hemorrhoid to cancer of the large bowel. So, it's best to have it checked out.

7. You are unable to pass urine or stool

This doesn't really have to be on the list as people who have this as in so much pain that they will come running to the hospital anyway. But, it's there for completeness' sake.

8. The pain started after a fall or accident

What you thought was a simple fall in the bathroom where you hit your stomach on the edge of the sink or a child who hit their stomach on the handlebars of their bicycle can actually have disasterous consequences. Sometimes these only manifest after a day or two. Please don't forget to inform the doctor who treats you if you have such relevant history.

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9. You have a strange, weak or numb feeling in your legs

This could be caused by a tear in one of the major blood vessels in your body and your legs are not getting adequate blood supply as a result. 

10. You have just come back from a tropical vacation

Different countries have their own resident funny bugs and if your doctor is not aware that you have been to an exotic location recently, they might overlook it.


If you experience any of the above warning signs, it is best to see your doctor and make sure you do not have something serious. Be prepared that your doctor will want to examine you, take some blood or possibly do a scan. 

Don't wait until it's too late!

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