Your stomach is a complicated neighborhood. It’s packed with organs, nerves, and about 30 feet of intestines all trying to do their jobs without getting in each other’s way. When things go south, it’s rarely just "a stomach ache." It’s your body screaming for a specific kind of help. So, what should I do if my stomach hurts and I can’t tell if I need an antacid or an ambulance?
Honestly, most of the time, it's just something you ate. Or maybe you're stressed. But sometimes, it's your appendix deciding it’s done with this life. You have to be a detective. You have to look at the clues—the location, the "flavor" of the pain, and what else is happening in your body—to figure out the next move.
The First Rule of Thumb: Location Matters
Where does it hurt? This is the first thing a doctor at a place like the Mayo Clinic or Johns Hopkins is going to ask you. If the pain is high up, right under your ribs, that’s usually a different beast than pain way down by your hips.
Upper Abdominal Pain
If the pain is burning and sits right in the "V" of your ribs, you’re likely looking at GERD (Gastroesophageal Reflux Disease) or maybe a peptic ulcer. It feels like a literal fire. Sometimes it’s just indigestion, but if it happens every time you eat spicy food or lie down, your esophagus is getting irritated by stomach acid.
On the other hand, if that pain is sharp and moves toward your right shoulder blade? That could be your gallbladder. Gallstones are notoriously painful. People often describe it as a "squeezing" or "gripping" sensation that hits after a heavy, fatty meal. It’s not fun. It’s actually miserable.
Lower Right Quadrant: The Big Red Flag
This is the one everyone worries about. If you’re asking what should I do if my stomach hurts specifically on the lower right side, stop reading and go poke that spot. Does it hurt more when you release the pressure than when you press down? That’s called rebound tenderness, a classic sign of appendicitis. If you have a fever and you’re vomiting along with that right-side pain, the emergency room is your next stop. Do not wait for it to "go away."
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When to Actually Freak Out (The Red Flags)
Most stomach pain is "functional," meaning everything is physically fine, but the system is just glitching. But there are "red flags" that medical professionals like those at the American Gastroenterological Association (AGA) watch for. These aren't "maybe" symptoms. These are "act now" symptoms.
If you see blood, that’s an immediate issue. Whether it’s in your stool or you’re vomiting something that looks like coffee grounds (which is actually digested blood), you need a doctor. Dark, tarry stools are another sign of internal bleeding.
Fever is another big one. A "stomach bug" might give you a low-grade fever, but a high fever combined with intense abdominal pain often points to an infection or inflammation like diverticulitis or peritonitis.
Then there’s the "Board-Like Abdomen." If your stomach feels rock hard to the touch and you can't even stand up straight, that’s a surgical emergency. Your body is "guarding" the organs because something—like an ulcer—might have perforated. It’s rare, but it’s serious.
Common Culprits: Why You’re Probably Fine
Let’s breathe for a second. Most of the time, the answer to what should I do if my stomach hurts involves a heating pad and some patience.
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- Gas and Bloating: It can feel like someone is sticking a knife in your gut. But then you burp or pass gas, and suddenly the "emergency" is over. This is usually caused by fiber-rich foods, carbonated drinks, or swallowing too much air.
- Constipation: If you haven’t gone in three days, your nerves are going to be unhappy. It causes a dull, heavy ache that migrates around the lower belly.
- The Stomach Flu (Gastroenteritis): This is usually a 24-to-48-hour nightmare of cramping, diarrhea, and nausea. It’s viral. Antibiotics won’t touch it. Your main job here is staying hydrated.
A Note on IBS and Stress
We often forget that the gut is the "second brain." The Enteric Nervous System (ENS) is a massive network of neurons lining your digestive tract. When you’re stressed, your brain sends signals that can literally slow down or speed up your digestion. Irritable Bowel Syndrome (IBS) is a real, documented condition where this communication goes haywire. It’s not "all in your head," but your head is definitely involved.
What Should I Do If My Stomach Hurts Right Now?
If you aren't experiencing the "Red Flags" mentioned earlier, you can try some home-based triage.
1. Track the Pain
Does it come in waves? (Usually gas or contractions). Is it a steady, dull ache? (Inflammation or constipation). Does it get better after you eat or worse? Ulcer pain often gets better when you eat because the food buffers the acid.
2. The Liquid Test
Try small sips of water or clear broth. If you can’t keep even a teaspoon of water down for more than a few hours, dehydration becomes a bigger threat than the stomach pain itself. This is especially true for kids and the elderly.
3. Position Yourself
Sometimes moving helps. If it's gas, walking around can help move the bubbles along. If it's reflux, propping yourself up on pillows is a game-changer. Avoid lying flat on your back if you’re feeling nauseous.
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4. Check Your Meds
Be careful with Ibuprofen (Advil/Motrin) or Aspirin. These are NSAIDs, and they are notorious for irritating the stomach lining. If you already have an ulcer or gastritis, taking these will make the pain significantly worse. Acetaminophen (Tylenol) is generally safer for the stomach, but it won’t help with gas or acid.
The Nuance of Chronic vs. Acute
There is a massive difference between "my stomach hurts today" and "my stomach has hurt every Tuesday for six months."
Chronic pain requires a specialist. You might be dealing with Crohn’s Disease or Ulcerative Colitis. These are autoimmune issues where your body attacks your own digestive tract. Or it could be Celiac Disease, where your body reacts violently to gluten. These aren't things you fix with a Ginger Ale. You need blood work, maybe an endoscopy, and a real management plan from a gastroenterologist.
Let's Talk About Food Intolerances
Lactose intolerance is the classic example. As we age, many of us lose the enzyme (lactase) needed to break down milk sugar. You might have spent thirty years eating pizza with no problem, and suddenly, you're bloated and cramping every Friday night. It happens. Keep a food diary. It’s boring, it’s tedious, but it’s the only way to find patterns that a doctor can actually use to help you.
Actionable Steps for Relief
When you're sitting on the couch wondering what should I do if my stomach hurts, follow this progression to find relief or decide to seek help.
- Audit your last 24 hours. Did you eat something "off"? Did you skip a bowel movement? Are you starting a new medication? Identifying the trigger is 90% of the battle.
- Apply gentle heat. A heating pad or a warm bath can relax the smooth muscles of the gut. This is incredibly effective for menstrual cramps or gas-related spasms.
- Try the BRAT diet... maybe. Traditionally, people suggested Bananas, Rice, Applesauce, and Toast. Modern research suggests you don't have to be that strict, but sticking to "bland" foods for 24 hours gives your system a break. Avoid dairy, caffeine, and alcohol until the pain is 100% gone.
- Check your temperature. If you have a fever over 101°F (38.3°C) along with the pain, call your primary care doctor.
- Monitor your "output." If the pain is accompanied by persistent diarrhea or a total lack of gas/bowel movements (which could indicate a bowel obstruction), you need professional evaluation.
If the pain is "the worst pain of your life," or if it started suddenly like a light switch being flipped, don't wait. Go to urgent care. It’s always better to be told "it’s just a bad case of gas" than to sit at home with a ruptured appendix. Listen to your gut—literally. Your body is usually pretty good at telling you when something is a "home fix" versus a "doctor fix." Trust that instinct.