Emergency Care for Severe Abdominal Pain

You should go to the emergency room right away if you have severe stomach pain and:

• Are pregnant
• Have ever had gastric bypass or colon resection
• The pain is specific to your lower right side
• You are a female and the pain is in your lower abdomen on one side or the other
• Your abdomen is swollen, hard, or extremely sensitive to the touch
• You see blood in your vomit or diarrhea
• You have persistent nausea or vomiting
• You have a fever
• You feel pressure or pain in your chest or pain in your neck, shoulders or arms
• You have fainted or feel dizzy

Causes of Severe Abdominal Pain that Requires Emergency Care

Most stomach pain is mild to moderate. Severe pain—the type that makes it difficult to stand, walk, or change positions—is usually cause for concern. Below are the most likely causes of severe abdominal pain and why they should be treated as an emergency.

• Kidney stones. While not life-threatening, kidney stones can cause enough pain to make you think they are. If the pain is unbearable, you may need emergency treatment for pain management.
• Gallbladder inflammation or gallstones. These conditions can lead to gallbladder rupture, in which bile leaks into the abdomen. This leakage can cause infection that can be deadly.
• Appendicitis. This inflammation of the appendix also can lead to rupture, infection and sometimes death if not treated.
• Ovarian torsion. If this twisting of the ovary isn’t treated, it can result in the loss of the organ.
• Heart attack. Sometimes chest pain can feel more like stomach pain. Heart attack is always an emergency. Failure to seek prompt care can lead to disability or death.

Causes of Stomach Pain Requiring Emergency Care

There are many causes of abdominal pain. If you go to the emergency room for treatment, you’ll first be asked about your symptoms, when they started, where the pain is, if it’s constant or intermittent, and what it feels like. Be prepared to say if the pain is dull, sharp, crampy, or burning.

The location of your pain also will help your ER doctor determine what’s causing it. Upper stomach pain might mean gallbladder inflammation, peptic ulcer, indigestion or heart attack. Lower stomach pain is more likely to be caused by appendicitis, ovarian torsion, diverticulitis, kidney stones, or constipation.

These details, along with a physical exam, can help your physician narrow down what might be causing your condition. He or she can then order the right diagnostic tests to confirm a diagnosis. Your ER doctor will likely order blood, urine, and/or imaging tests to diagnose your condition. Treatment will depend on the cause of your pain and may include medication, surgery, or other therapies.