Stomach Problems – Causes, Symptoms, Diagnosis, Treatment

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 14 min read
Patient Tools

Read, save, and share this guide

Use these quick tools to make this medical article easier to read, print, save, or share with a family member.

Patient Mode

Understand this article easily

Switch between simple English and easy Bangla patient notes. This is for education and does not replace a doctor consultation.

Stomach problems that are severe or that do not improve within a day or two can be symptoms of serious medical conditions for severe pain that comes on suddenly, an inability to have bowel movements, bloody stool, vomiting blood, abdominal rigidity, breathing difficulties, or pain in...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Stomach problems that are severe or that do not improve within a day or two can be symptoms of serious medical conditions for severe pain that comes on suddenly, an inability to have bowel movements, bloody stool, vomiting blood, abdominal rigidity, breathing difficulties, or pain in the neck, chest, shoulders, or between the shoulders. You should also seek immediate care if you have stomach problems and...

Key Takeaways

  • This article explains Causes of  Stomach Problems in simple medical language.
  • This article explains Symptoms of Stomach Problems in simple medical language.
  • This article explains Diagnosis of Stomach Problems in simple medical language.
  • This article explains Treatment of in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Before reading

RX Patient Tools

Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.

Start here Choose the right pathway for symptoms, reports, medicines, or urgent warning signs. Disease article roadmap Read this topic step by step: meaning, symptoms, warning signs, diagnosis, treatment, prevention, and follow-up. Treatment planner Prepare questions about treatment choices, benefits, risks, side effects, and follow-up. Family & caregiver guide Organize symptoms, reports, medicines, questions, and follow-up safely. Nutrition & diet guide Prepare food, hydration, supplement, and medicine-timing questions safely. Prevention guide Organize risk factors, protective habits, screening, and warning signs. Recovery guide Prepare a safe plan for activity, rehabilitation, warning signs, and follow-up.
Definition

Stomach problems that are severe or that do not improve within a day or two can be symptoms of serious medical conditions for severe pain that comes on suddenly, an inability to have bowel movements, bloody stool, vomiting blood, abdominal rigidity, breathing difficulties, or pain in the neck, chest, shoulders, or between the shoulders. You should also seek immediate care if you have stomach problems and have cancer or might be pregnant and experience vaginal bleeding or abdominal cramps.

Causes of  Stomach Problems

Stomach problems often originate in the digestive tract, although they can be due to disorders of the circulatory system, urinary tract, reproductive system, respiratory system, nervous system, or body wall.

The digestive tract causes stomach problems

Stomach problems may be caused by conditions of the digestive tract including:

  • Bacterial, parasitic, or viral infection of the gastrointestinal tract
  • Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage)
  • Diverticulitis (infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of an abnormal pocket in the colon)
  • Food intolerance such as lactose intolerance (inability to digest lactose, the sugar in dairy products)
  • Gallbladder disease or stones
  • Gastritis (infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the stomach lining)
  • Gastroesophageal reflux disease (GERD)
  • Inflammatory bowel disease (includes Crohn’s disease, ulcerative colitis)
  • Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease)
  • Liver disease, including hepatitis (infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the liver)
  • Pancreatitis (infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the pancreas)
  • Ulcers of the stomach or duodenum (first section of the small intestine)

Other causes of stomach problems

Stomach problems can also be caused by conditions involving other body systems including:

  • Abdominal or hiatal hernia (weakening in the abdominal wall or diaphragm, through which internal organs can pass)
  • Cancer of an abdominal or pelvic organ
  • Endometriosis (a condition where tissues resembling the uterine lining grow in other areas of the body)
  • Kidney stones
  • Menstrual cramps
  • Pelvic inflammatory disease (PID; infection of a woman’s reproductive organs)
  • Pleurisy (infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the lining around the lungs)
  • Pneumonia
  • Shingles (painful, blistering rash that results from a reactivation of the varicella-zoster, or chickenpox, virus)
  • Urinary tract infection

Serious or life-threatening causes of stomach problems

In some cases, stomach problems may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Abdominal abscess
  • Abdominal, pelvic or testicular trauma
  • Aneurysm of the abdominal aorta (life-threatening bulging and weakening of the wall of the abdominal aorta that can burst and cause severe hemorrhage)
  • Appendicitis
  • Bowel obstruction or perforation
  • Chemical or heavy metal poisoning
  • Colonic volvulus (twisting of the colon) or intussusception (telescoping of the intestines into themselves)
  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
  • Intestinal ischemia (loss of blood supply to the intestines leading to the death of intestinal tissue)
  • Myocardial infarction (heart attack)
  • Peritonitis (infection of the lining that surrounds the abdomen)
  • Torsion of an ovary or a testicle (twisting of an ovary or spermatic cord)

Symptoms of Stomach Problems

Stomach problems may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Stomach problems are often related to the digestive system, but may also be related to other body systems.

Stomach problems may accompany other symptoms affecting the digestive system including:

  • Abdominal pain or cramping
  • Abdominal swelling, distension, or bloating
  • Belching
  • Bloody stool (blood may be red, black, or tarry in texture)
  • Changes in bowel movements
  • Constipation
  • Cramping
  • Diarrhea
  • Gas
  • Indigestion
  • Nausea with or without vomiting
  • Urgent need to pass stool

Other symptoms that may occur along with stomach problems

Stomach problems may accompany symptoms related to other body systems including:

  • Cough
  • Enlarged liver and glands such as the spleen and lymph nodes
  • Fever
  • Pain during sexual intercourse
  • Pain or burning with urination
  • Pain, numbness or tingling
  • Palpable mass in the abdomen or pelvic area
  • Rash
  • Unexplained weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, stomach problems may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bleeding while pregnant
  • Change in level of consciousness or alertness such as passing out or unresponsiveness
  • Chest pain, chest tightness, chest pressure, or palpitations
  • High fever (higher than 101 degrees Fahrenheit)
  • Inability to have bowel movements, especially if accompanied by vomiting
  • Rapid heart rate (tachycardia)
  • Respiratory or breathing problems such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking
  • The rigidity of the abdomen
  • Seizure
  • Severe abdominal pain or sharp abdominal pain that comes on suddenly
  • Trauma to the abdomen, pelvis, or testicles
  • Vomiting blood, rectal bleeding, or bloody stool

Diagnosis of Stomach Problems

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your stomach problems including:

  • How long have you had stomach problems?
  • How would you describe your problems?
  • Does anything make them go away or get worse?
  • Have you had stomach problems like this before?
  • Do you have any other symptoms?
  • What medications are you taking?
  • Is there any possibility you are pregnant?

History and Physical

The typical clinical presentation of stomach problems is heartburn and regurgitation. However, stomach problems can also present with various other symptoms that include dysphagia, odynophagia, belching, epigastric pain, and nausea . Heartburn is defined as a retrosternal burning sensation or discomfort that may radiate into the neck and typically occurs after the ingestion of meals or when in a reclined position. Regurgitation is a retrograde migration of acidic gastric contents into the mouth or hypopharynx. GERD/ stomach problems presentation is considered to be atypical when patients present with extraesophageal symptoms such as chest pain, chronic cough, asthma, laryngitis, dental erosions, dysphonia, and hoarseness and globus sensation.

Lab Test

The diagnosis of stomach problems is imprecise as there is no gold standard test available. The diagnosis of stomach problems is made solely based on presenting symptoms or in combination with other factors such as responsiveness to antisecretory therapy, esophagogastroduodenoscopy, and ambulatory reflux monitoring.

  • Proton pump inhibitor (PPI) trial – Stomach problems can be presumptively diagnosed in most patients presenting with typical symptoms of heartburn and regurgitation . Unless there are no associated alarm symptoms that include dysphagia, odynophagia, anemia, weight loss, and hematemesis, most patients can be initiated on empiric medical therapy with proton pump inhibitors(PPIs) without further investigations with a response to treatment confirming the diagnosis of stomach problems . However, a meta-analysis published literature by Numans et al. refuted the accuracy of this empiric PPI trial diagnostic strategy.
  • Esophagogastroduodenoscopy (EGD) – Patients presenting with typical stomach problems symptoms associated with any one of the alarm symptoms should be evaluated with stomach problems to rule out complications of stomach problems. These include erosive esophagitis, Barrett’s esophagus, esophageal stricture, and esophageal adenocarcinoma or rule out peptic ulcer disease. Distal esophageal biopsies are not routinely recommended to make a diagnosis of stomach problems as per the current American College of Gastroenterology (ACG) guidelines. Patients with a high index of suspicion for coronary artery disease presenting with stomach problems symptoms should undergo evaluation for underlying cardiovascular disease. In contrast, patients presenting with noncardiac chest pain suspected due to stomach problems should have a diagnostic assessment with stomach problems and pH monitoring before initiation of PPIs. Current ACG guidelines recommend against screening for Helicobacter pylori infection in patients with GERD symptoms.
  • Radiographic studies – Radiographic studies like barium radiographs can detect moderate to severe esophagitis, esophageal strictures, hiatal hernia, and tumors. However, their role in the evaluation of stomach problems is limited and should not be performed to diagnose stomach problems .
  • Ambulatory esophageal reflux monitoring – Medically refractory stomach problems are increasingly common, and patients often have normal endoscopy evaluation as PPIs are incredibly effective in healing esophagitis caused by the refluxate. Ambulatory esophageal reflux monitoring can assess the correlation of symptoms with abnormal acid exposure. It is indicated in medically refractory stomach problems and in patients with extraesophageal symptoms suspicious of stomach problems. Ambulatory reflux (pH or in combination with impedance) monitoring employs the utility of a telemetry pH capsule or a transnasal catheter. It is the only available test that detects pathological acid exposure, frequency of reflux episodes, and correlation of symptoms with reflux episodes. Current practice guidelines recommend mandatory preoperative ambulatory pH monitoring in patients without evidence of erosive esophagitis.

Treatment of

The goals of managing stomach problems are to address the resolution of symptoms and prevent complications such as esophagitis, BE, and esophageal adenocarcinoma. Treatment options include lifestyle modifications, medical management with antacids and antisecretory agents, surgical therapies, and endoluminal therapies.

Lifestyle modifications

Lifestyle modifications are considered to be the cornerstone of any stomach problems therapy. Counseling should be provided about the importance of weight loss given that underlying obesity is a significant risk factor for the development of stomach problems, and studies have shown that weight gain in individuals with a normal BMI has been associated with the development of stomach problem symptoms . Individuals should also be counseled about avoiding meals at least 3 hours before bedtime and maintaining good sleep hygiene as it has been shown that minimal disturbances in sleep are associated with suppression of TLESRs, resulting in decreased reflux episodes . Studies have also shown improvement in stomach problems symptoms and pH monitoring studies with the elevation of the head end of the bed. Diet modification with the elimination of chocolate, caffeine, and spicy foods, citrus, and carbonated beverages in stomach problems is controversial and is not routinely recommended as per current ACG guidelines.

Medical Therapy

Medical therapy is indicated in patients who do not respond to lifestyle modifications. Medical therapy is comprised of antacids antisecretory agents like histamine (H2) receptor antagonists (H2RAs) or PPI therapy and prokinetic agents. Currently, there are two US Food and Drug Administration (FDA) approved H2RAs (famotidine and cimetidine) available in the US and are available over-the-counter. The other commonly used H2RA known as ranitidine has been recalled as a potential health hazard or safety risk due to an unexpected impurity in the active ingredient. The less commonly known prescription-only H2RA nizatidine has also been recalled as well due to similar concerns. In the US, there are six PPIs that are currently available, of which three (omeprazole, lansoprazole, and esomeprazole) are available over-the-counter, and the remaining three (pantoprazole, dexlansoprazole, and rabeprazole) are prescription-only medications. Of the available medical options, PPI therapy is considered to be the most effective for both erosive and non-erosive stomach problems based on multiple large-scale studies. These studies have also shown improved symptom control, healing of underlying esophagitis, and decreased relapse rates compared to H2RAs . ACG guidelines recommend PPI therapy to be initiated at once a day dosing before the first meal of the day. Patients with incomplete responses to once-daily dosing can be treated with twice-daily dosing or adjustment of dose timing, specifically in patients with nighttime symptoms . As needed, bedtime administration of H2RAs is recommended for individuals with nighttime symptoms not optimized with maximal PPI therapy. The role of prokinetic agents such as metoclopramide and domperidone in stomach problems is limited due to lack of data and also due to their profound adverse effects on the central nervous system and cardiovascular system.

Antibiotic therapy

Not every patient, even with a known bacterial etiology, should be given antibiotic therapy, especially with Shiga toxin-producing E. coli. Empiric antibiotic therapy with azithromycin or fluoroquinolones can be indicated in severe illness (e.g., greater than 6 stools in a day, fever, need for hospitalization), specific host factors (e.g., age greater than 70 years, immunocompromised host, having co-morbidities), and features suggesting of the invasive organisms (e.g., blood or mucus in stool) but should be discontinued if EHEC is isolated. Tetracyclines have the greatest efficacy for Vibrio. For pregnant patients with the suspicion of Listeria, ampicillin is the drug of choice. For C. difficile infection (CDI), discontinuation of the causative antibiotic and antibiotic therapy should be initiated. It should be noted that recent Centers for Disease Control and Prevention guidelines changed in March 2018 and now recommend either oral vancomycin or fidaxomicin for nonsevere over oral metronidazole for severe CDI. Combination therapy of oral vancomycin with IV metronidazole should be used for fulminant CDI.

Symptomatic therapy

Loperamide can be given carefully in patients who are afebrile and have non-bloody diarrhea.

Surgical therapy

Patients who present with either medically refractory stomach problems, noncompliance, or experience side effects with medical therapy, underlying large hiatal hernia, or individuals who desire to discontinue long-term medical treatment can be considered for surgical management. The available surgical options for stomach problems are laparoscopic Nissen fundoplication, Laparoscopic anterior 180° fundoplication (180° LAF), or bariatric surgery in obese patients. Laparoscopic Nissen fundoplication has been the gold standard surgical treatment in the management of stomach problems patients. However, given the rapid prevalence of obesity in the United States, gastric bypass surgery is becoming the most common surgical treatment for stomach problems . It should be considered in obese patients with symptoms of stomach problems who prefer surgical therapy. Current ACG guidelines recommend performing preoperative ambulatory pH monitoring in patients without erosive esophagitis and esophageal manometry to rule out achalasia or undiagnosed scleroderma-like esophagus prior to surgical therapy . Two large meta-analyses comparing medical therapy with surgical therapy reported contrary conclusions with one reporting improvement of symptoms of stomach problems after surgery compared with medical therapy and others reporting considerable uncertainty in the benefits of surgical therapy compared to medical therapy . However, patients undergoing fundoplication are at risk for developing postoperative adverse events that include bloating, which is seen in 15 to 20% of patients, dysphagia, and belching. The most common bariatric surgeries performed are Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banded plication (LAGP), and sleeve gastrectomy. Studies have shown that the resulting weight loss from surgical management of obesity has had positive effects on stomach problems. Of all the bariatric surgeries available, RYGB has proven to be the most effective bariatric surgery for reducing stomach problems symptoms. It is recommended as the bariatric procedure of choice in patients with severe stomach problems npreoperatively.

Endoluminal Therapy

In the era of minimally invasive surgery techniques, many different types of endoscopic therapies have been developed for stomach problem management. Most of them were discontinued after failing to demonstrate long-term efficacy. The current available endoluminal therapies include magnetic sphincter augmentation (MSA) and transoral incision-less fundoplication using the EsophyX (EndoGastric Solutions, Redmond, WA, United States).  A recent meta-analysis by Gerson et al. that included data from 233 patients demonstrated that subjects who underwent TIF 2.0 procedure had improved esophageal pH, decreased need for PPIs, and significant improvement in the quality of life at three years after the TIF 2.0 procedure . Another prospective study by Testoni et al. demonstrated TIF with EsophyX as an effective long-term treatment option for patients with symptomatic stomach problems with associated hiatal hernia less than 2 cm. A meta-analysis comparing Nissen fundoplication and magnetic sphincter augmentation that included data from patients who underwent MSA and the rest who were treated with Nissen fundoplication concluded that MSA was an effective therapeutic option for stomach problems as short-term outcomes with magnetic sphincter augmentation appeared to be comparable to Nissen fundoplication.

Avoid the Following Foods

There are certain foods that can worsen bloating and cause gassiness. These include the following:

  • Lentils and beans contain indigestible sugars which are broken down by bacteria, resulting in the generation of gas
  • Fruits and vegetables like carrots, cabbage, Brussel sprouts,  prunes, and apricots also cause gassiness
  • Artificial sweeteners like sorbitol are not easy to digest and hence are broken down by bacteria to produce gas.
  • Patients with meteorism should avoid dairy products, as they can worsen the bloating sensation.
  • Wheat contains a protein called gluten which may cause bloating. Gluten should be included in the elimination diet to rule out gluten sensitivity.
  • Finally, people prone to meteorism should become physically active as this can also lead to increased peristalsis and emptying of gas from the intestine.

What are the potential complications of stomach problems?

Because stomach problems can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Bowel infarction (severe injury to an area of the bowel due to decreased blood supply)
  • Infertility
  • Internal hemorrhage
  • Intestinal obstruction and rupture of the intestinal wall
  • Organ failure or dysfunction
  • Ruptured appendix
  • Spread of cancer
  • Spread of infection

References

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician
Tests to discuss with doctor
  • Temperature chart and hydration assessment
  • CBC with platelet count if fever persists or dengue/other infection is possible
  • Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Stomach Problems – Causes, Symptoms, Diagnosis, Treatment

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Causes of  Stomach Problems Stomach problems often originate in the digestive tract, although they can be due to disorders of the circulatory system, urinary tract, reproductive system, respiratory system, nervous system, or body wall. The digestive tract causes stomach problems Stomach problems may be caused by conditions of the digestive tract including: Bacterial, parasitic, or viral infection of the gastrointestinal tract Celiac disease (severe sensitivity to gluten from wheat and other grains that causes intestinal damage) Diverticulitis (inflammation of an abnormal pocket in the colon) Food intolerance such as lactose intolerance (inability to digest lactose, the sugar in dairy products) Gallbladder disease or stones Gastritis (inflammation of the stomach lining) Gastroesophageal reflux disease (GERD) Inflammatory bowel disease (includes Crohn’s disease, ulcerative colitis) Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease) Liver disease, including hepatitis (inflammation of the liver) Pancreatitis (inflammation of the pancreas) Ulcers of the stomach or duodenum (first section of the small intestine) Other causes of stomach problems Stomach problems can also be caused by conditions involving other body systems including: Abdominal or hiatal hernia (weakening in the abdominal wall or diaphragm, through which internal organs can pass) Cancer of an abdominal or pelvic organ Endometriosis (a condition where tissues resembling the uterine lining grow in other areas of the body) Kidney stones Menstrual cramps Pelvic inflammatory disease (PID; infection of a woman’s reproductive organs) Pleurisy (inflammation of the lining around the lungs) Pneumonia Shingles (painful, blistering rash that results from a reactivation of the varicella-zoster, or chickenpox, virus) Urinary tract infection Serious or life-threatening causes of stomach problems In some cases, stomach problems may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include: Abdominal abscess Abdominal, pelvic or testicular trauma Aneurysm of the abdominal aorta (life-threatening bulging and weakening of the wall of the abdominal aorta that can burst and cause severe hemorrhage) Appendicitis Bowel obstruction or perforation Chemical or heavy metal poisoning Colonic volvulus (twisting of the colon) or intussusception (telescoping of the intestines into themselves) Ectopic pregnancy (life-threatening pregnancy growing outside the uterus) Intestinal ischemia (loss of blood supply to the intestines leading to the death of intestinal tissue) Myocardial infarction (heart attack) Peritonitis (infection of the lining that surrounds the abdomen) Torsion of an ovary or a testicle (twisting of an ovary or spermatic cord) Symptoms of Stomach Problems Stomach problems may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Stomach problems are often related to the digestive system, but may also be related to other body systems. Stomach problems may accompany other symptoms affecting the digestive system including: Abdominal pain or cramping Abdominal swelling, distension, or bloating Belching Bloody stool (blood may be red, black, or tarry in texture) Changes in bowel movements Constipation Cramping Diarrhea Gas Indigestion Nausea with or without vomiting Urgent need to pass stool Other symptoms that may occur along with stomach problems Stomach problems may accompany symptoms related to other body systems including: Cough Enlarged liver and glands such as the spleen and lymph nodes Fever Pain during sexual intercourse Pain or burning with urination Pain, numbness or tingling Palpable mass in the abdomen or pelvic area Rash Unexplained weight loss Serious symptoms that might indicate a life-threatening condition In some cases, stomach problems may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including: Bleeding while pregnant Change in level of consciousness or alertness such as passing out or unresponsiveness Chest pain, chest tightness, chest pressure, or palpitations High fever (higher than 101 degrees Fahrenheit) Inability to have bowel movements, especially if accompanied by vomiting Rapid heart rate (tachycardia) Respiratory or breathing problems such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking The rigidity of the abdomen Seizure Severe abdominal pain or sharp abdominal pain that comes on suddenly Trauma to the abdomen, pelvis, or testicles Vomiting blood, rectal bleeding, or bloody stool Diagnosis of Stomach Problems To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your stomach problems including: How long have you had stomach problems? How would you describe your problems? Does anything make them go away or get worse? Have you had stomach problems like this before? Do you have any other symptoms? What medications are you taking? Is there any possibility you are pregnant? History and Physical The typical clinical presentation of stomach problems is heartburn and regurgitation. However, stomach problems can also present with various other symptoms that include dysphagia, odynophagia, belching, epigastric pain, and nausea [rx]. Heartburn is defined as a retrosternal burning sensation or discomfort that may radiate into the neck and typically occurs after the ingestion of meals or when in a reclined position[rx]. Regurgitation is a retrograde migration of acidic gastric contents into the mouth or hypopharynx[rx]. GERD/ stomach problems presentation is considered to be atypical when patients present with extraesophageal symptoms such as chest pain, chronic cough, asthma, laryngitis, dental erosions, dysphonia, and hoarseness and globus sensation[rx][rx]. Lab Test The diagnosis of stomach problems is imprecise as there is no gold standard test available. The diagnosis of stomach problems is made solely based on presenting symptoms or in combination with other factors such as responsiveness to antisecretory therapy, esophagogastroduodenoscopy, and ambulatory reflux monitoring. Proton pump inhibitor (PPI) trial - Stomach problems can be presumptively diagnosed in most patients presenting with typical symptoms of heartburn and regurgitation [rx]. Unless there are no associated alarm symptoms that include dysphagia, odynophagia, anemia, weight loss, and hematemesis, most patients can be initiated on empiric medical therapy with proton pump inhibitors(PPIs) without further investigations with a response to treatment confirming the diagnosis of stomach problems [rx]. However, a meta-analysis published literature by Numans et al. refuted the accuracy of this empiric PPI trial diagnostic strategy[rx]. Esophagogastroduodenoscopy (EGD) - Patients presenting with typical stomach problems symptoms associated with any one of the alarm symptoms should be evaluated with stomach problems to rule out complications of stomach problems. These include erosive esophagitis, Barrett's esophagus, esophageal stricture, and esophageal adenocarcinoma or rule out peptic ulcer disease. Distal esophageal biopsies are not routinely recommended to make a diagnosis of stomach problems as per the current American College of Gastroenterology (ACG) guidelines[rx]. Patients with a high index of suspicion for coronary artery disease presenting with stomach problems symptoms should undergo evaluation for underlying cardiovascular disease. In contrast, patients presenting with noncardiac chest pain suspected due to stomach problems should have a diagnostic assessment with stomach problems and pH monitoring before initiation of PPIs[rx]. Current ACG guidelines recommend against screening for Helicobacter pylori infection in patients with GERD symptoms[rx]. Radiographic studies - Radiographic studies like barium radiographs can detect moderate to severe esophagitis, esophageal strictures, hiatal hernia, and tumors. However, their role in the evaluation of stomach problems is limited and should not be performed to diagnose stomach problems [rx]. Ambulatory esophageal reflux monitoring - Medically refractory stomach problems are increasingly common, and patients often have normal endoscopy evaluation as PPIs are incredibly effective in healing esophagitis caused by the refluxate. Ambulatory esophageal reflux monitoring can assess the correlation of symptoms with abnormal acid exposure. It is indicated in medically refractory stomach problems and in patients with extraesophageal symptoms suspicious of stomach problems. Ambulatory reflux (pH or in combination with impedance) monitoring employs the utility of a telemetry pH capsule or a transnasal catheter. It is the only available test that detects pathological acid exposure, frequency of reflux episodes, and correlation of symptoms with reflux episodes[rx]. Current practice guidelines recommend mandatory preoperative ambulatory pH monitoring in patients without evidence of erosive esophagitis[rx]. Treatment of The goals of managing stomach problems are to address the resolution of symptoms and prevent complications such as esophagitis, BE, and esophageal adenocarcinoma. Treatment options include lifestyle modifications, medical management with antacids and antisecretory agents, surgical therapies, and endoluminal therapies. Lifestyle modifications Lifestyle modifications are considered to be the cornerstone of any stomach problems therapy. Counseling should be provided about the importance of weight loss given that underlying obesity is a significant risk factor for the development of stomach problems, and studies have shown that weight gain in individuals with a normal BMI has been associated with the development of stomach problem symptoms [rx]. Individuals should also be counseled about avoiding meals at least 3 hours before bedtime and maintaining good sleep hygiene as it has been shown that minimal disturbances in sleep are associated with suppression of TLESRs, resulting in decreased reflux episodes[rx] [rx]. Studies have also shown improvement in stomach problems symptoms and pH monitoring studies with the elevation of the head end of the bed. Diet modification with the elimination of chocolate, caffeine, and spicy foods, citrus, and carbonated beverages in stomach problems is controversial and is not routinely recommended as per current ACG guidelines[rx]. Medical Therapy Medical therapy is indicated in patients who do not respond to lifestyle modifications. Medical therapy is comprised of antacids antisecretory agents like histamine (H2) receptor antagonists (H2RAs) or PPI therapy and prokinetic agents. Currently, there are two US Food and Drug Administration (FDA) approved H2RAs (famotidine and cimetidine) available in the US and are available over-the-counter. The other commonly used H2RA known as ranitidine has been recalled as a potential health hazard or safety risk due to an unexpected impurity in the active ingredient. The less commonly known prescription-only H2RA nizatidine has also been recalled as well due to similar concerns. In the US, there are six PPIs that are currently available, of which three (omeprazole, lansoprazole, and esomeprazole) are available over-the-counter, and the remaining three (pantoprazole, dexlansoprazole, and rabeprazole) are prescription-only medications. Of the available medical options, PPI therapy is considered to be the most effective for both erosive and non-erosive stomach problems based on multiple large-scale studies. These studies have also shown improved symptom control, healing of underlying esophagitis, and decreased relapse rates compared to H2RAs [rx][rx]. ACG guidelines recommend PPI therapy to be initiated at once a day dosing before the first meal of the day[rx]. Patients with incomplete responses to once-daily dosing can be treated with twice-daily dosing or adjustment of dose timing, specifically in patients with nighttime symptoms [rx]. As needed, bedtime administration of H2RAs is recommended for individuals with nighttime symptoms not optimized with maximal PPI therapy[rx]. The role of prokinetic agents such as metoclopramide and domperidone in stomach problems is limited due to lack of data and also due to their profound adverse effects on the central nervous system and cardiovascular system. Antibiotic therapy Not every patient, even with a known bacterial etiology, should be given antibiotic therapy, especially with Shiga toxin-producing E. coli. Empiric antibiotic therapy with azithromycin or fluoroquinolones can be indicated in severe illness (e.g., greater than 6 stools in a day, fever, need for hospitalization), specific host factors (e.g., age greater than 70 years, immunocompromised host, having co-morbidities), and features suggesting of the invasive organisms (e.g., blood or mucus in stool) but should be discontinued if EHEC is isolated. Tetracyclines have the greatest efficacy for Vibrio. For pregnant patients with the suspicion of Listeria, ampicillin is the drug of choice. For C. difficile infection (CDI), discontinuation of the causative antibiotic and antibiotic therapy should be initiated. It should be noted that recent Centers for Disease Control and Prevention guidelines changed in March 2018 and now recommend either oral vancomycin or fidaxomicin for nonsevere over oral metronidazole for severe CDI. Combination therapy of oral vancomycin with IV metronidazole should be used for fulminant CDI. Symptomatic therapy Loperamide can be given carefully in patients who are afebrile and have non-bloody diarrhea.[rx] Surgical therapy Patients who present with either medically refractory stomach problems, noncompliance, or experience side effects with medical therapy, underlying large hiatal hernia, or individuals who desire to discontinue long-term medical treatment can be considered for surgical management[rx]. The available surgical options for stomach problems are laparoscopic Nissen fundoplication, Laparoscopic anterior 180° fundoplication (180° LAF), or bariatric surgery in obese patients[rx]. Laparoscopic Nissen fundoplication has been the gold standard surgical treatment in the management of stomach problems patients. However, given the rapid prevalence of obesity in the United States, gastric bypass surgery is becoming the most common surgical treatment for stomach problems [rx]. It should be considered in obese patients with symptoms of stomach problems who prefer surgical therapy[rx][rx][rx][rx][rx]. Current ACG guidelines recommend performing preoperative ambulatory pH monitoring in patients without erosive esophagitis and esophageal manometry to rule out achalasia or undiagnosed scleroderma-like esophagus prior to surgical therapy [rx]. Two large meta-analyses comparing medical therapy with surgical therapy reported contrary conclusions with one reporting improvement of symptoms of stomach problems after surgery compared with medical therapy and others reporting considerable uncertainty in the benefits of surgical therapy compared to medical therapy [rx][rx][rx]. However, patients undergoing fundoplication are at risk for developing postoperative adverse events that include bloating, which is seen in 15 to 20% of patients, dysphagia, and belching. The most common bariatric surgeries performed are Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banded plication (LAGP), and sleeve gastrectomy[rx]. Studies have shown that the resulting weight loss from surgical management of obesity has had positive effects on stomach problems. Of all the bariatric surgeries available, RYGB has proven to be the most effective bariatric surgery for reducing stomach problems symptoms[rx]. It is recommended as the bariatric procedure of choice in patients with severe stomach problems npreoperatively[rx]. Endoluminal Therapy In the era of minimally invasive surgery techniques, many different types of endoscopic therapies have been developed for stomach problem management. Most of them were discontinued after failing to demonstrate long-term efficacy. The current available endoluminal therapies include magnetic sphincter augmentation (MSA) and transoral incision-less fundoplication using the EsophyX (EndoGastric Solutions, Redmond, WA, United States)[rx].  A recent meta-analysis by Gerson et al. that included data from 233 patients demonstrated that subjects who underwent TIF 2.0 procedure had improved esophageal pH, decreased need for PPIs, and significant improvement in the quality of life at three years after the TIF 2.0 procedure [rx]. Another prospective study by Testoni et al. demonstrated TIF with EsophyX as an effective long-term treatment option for patients with symptomatic stomach problems with associated hiatal hernia less than 2 cm. A meta-analysis comparing Nissen fundoplication and magnetic sphincter augmentation that included data from patients who underwent MSA and the rest who were treated with Nissen fundoplication concluded that MSA was an effective therapeutic option for stomach problems as short-term outcomes with magnetic sphincter augmentation appeared to be comparable to Nissen fundoplication[rx]. Avoid the Following Foods There are certain foods that can worsen bloating and cause gassiness. These include the following: Lentils and beans contain indigestible sugars which are broken down by bacteria, resulting in the generation of gas[rx] Fruits and vegetables like carrots, cabbage, Brussel sprouts,  prunes, and apricots also cause gassiness Artificial sweeteners like sorbitol are not easy to digest and hence are broken down by bacteria to produce gas. Patients with meteorism should avoid dairy products, as they can worsen the bloating sensation. Wheat contains a protein called gluten which may cause bloating[rx]. Gluten should be included in the elimination diet to rule out gluten sensitivity. Finally, people prone to meteorism should become physically active as this can also lead to increased peristalsis and emptying of gas from the intestine. What are the potential complications of stomach problems?

Because stomach problems can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including: Bowel infarction (severe injury to an area of the bowel due to decreased blood supply) Infertility Internal hemorrhage Intestinal obstruction and rupture of the intestinal…

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

More from this topic
  1. Isolated Congenital Elbow Dislocation

    DefinitionIsolated congenital? elbow dislocation is a very rare condition present from birth. In most medical papers, the more exact name is congenital? radial head dislocation, because...

    April 2, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  2. Alacrimia-Choreoathetosis-Liver Dysfunction Syndrome

    DefinitionAlacrimia-choreoathetosis-liver dysfunction syndrome is a very rare inherited disease. It is now usually called NGLY1 deficiency or NGLY1-related congenital? disorder of deglycosylation. In this condition, the...

    April 1, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  3. Congenital Diarrhea Caused by Mutation in DGAT1

    DefinitionCongenital? diarrhea? caused by mutation in DGAT1 is a very rare inherited disease. It usually starts in the newborn period or in early infancy. The baby...

    April 1, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  4. Congenital Chronic Diarrhea with Protein-Losing Enteropathy

    DefinitionCongenital? chronic? diarrhea? with protein-losing enteropathy is not usually one single disease name. It is a clinical description for a baby or young child who has...

    April 1, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  5. Congenital Chronic Diarrhea with Exudative Enteropathy

    DefinitionCongenital? chronic? diarrhea? with exudative enteropathy is a rare inherited early-life intestinal disease in which the gut does not handle nutrients, fluids, and proteins normally, so...

    April 1, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  6. Congenital Diarrhea 7 with Exudative Enteropathy

    DefinitionCongenital? diarrhea? 7 with exudative enteropathy is a very rare inherited intestinal disease. It usually starts in the newborn period or early infancy. The baby has...

    March 31, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  7. Chronic Infantile Diarrhea Due to Guanylate Cyclase 2C Overactivity

    DefinitionChronic? infantile diarrhea? due to guanylate cyclase 2C overactivity is a very rare inherited bowel disease. It usually starts very early in life, often in infancy,...

    March 31, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  8. Tufting Enteropathy

    DefinitionTufting enteropathy is a very rare inherited bowel disease. It usually starts in the first days, weeks, or months of life. The baby has severe watery...

    March 31, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  9. Secretory Diarrhea Caused by Mutation in EPCAM

    DefinitionSecretory diarrhea? caused by mutation in EPCAM is usually called congenital? tufting enteropathy or intestinal epithelial dysplasia. It is a very rare inherited disease that starts...

    March 31, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)
  10. Intestinal Epithelial Dysplasia

    DefinitionIntestinal epithelial dysplasia, also called tufting enteropathy or congenital? tufting enteropathy, is a very rare inherited disease of the gut lining. In this condition, the cells...

    March 31, 2026 • Gastrointestinal, Pelvic & Liver Disease, (A - Z)