Tummy ache

A stomach ache usually refers to cramps or a dull ache in the belly (abdomen). It is normally short lived and caused by a minor upset or bug.

Severe abdominal pain is a greater cause for concern. If it starts suddenly and unexpectedly, it should be regarded a medical emergency, especially if the pain is concentrated in a particular area, such as the lower right side of your abdomen (this could be your appendix - see below for more information). Call your GP as soon as possible or go to your nearest hospital accident and emergency department if this is the case.

This topic covers the most common reasons for:

• sudden stomach cramps
• sudden, severe abdominal pain in a particular area of your belly
• abdominal pain that has lasted a long time or that keeps returning

If you feel pain higher up, in the area above your ribs, see the Health A-Z section on Chest pain.

Stomach cramps due to trapped wind

Stomach cramps are often due to trapped wind and bloating. This is an extremely common problem that can be embarrassing but is easily dealt with - your chemist will be able to recommend a product, such as charcoal tablets, which can be bought over the counter to relieve the wind.

Sudden stomach cramps with diarrhoea

If your stomach cramps have started recently and you also have diarrhoea, the cause is probably a tummy bug (gastroenteritis). This means you have a viral or bacterial infection of the stomach and bowel, which your immune system will usually fight off after a few days. A common cause of gastroenteritis is a norovirus.

Severe stomach cramps and diarrhoea that make you feel very ill (for example, causing chills or a fever) could be due to a more serious infection, such as food poisoning. This also usually gets better on its own without treatment.

If your stomach cramps and diarrhoea continue, you may have a long-term condition, such as irritable bowel syndrome (see below).

Sudden, severe abdominal pain

If you have sudden, agonising pain in a particular area of your belly, call your GP immediately or go to your nearest hospital accident and emergency department. It may be a sign of a serious illness that will rapidly get worse without treatment.

The most common causes of sudden, severe abdominal pain include:

• a perforated peptic ulcer - an open sore that develops on the inside lining of your stomach or duodenum (upper small intestine) that has broken through the lining
• gallstones - small stones that form in the gallbladder (the gallbladder may need to be removed)
• appendicitis, which is a medical emergency - the pain will be agonising and your appendix will need to be removed
• an infection of the stomach and bowel (gastroenteritis) - most people get better without treatment after a few days
• kidney stones - small stones may be passed out in your urine, but larger stones may block the kidney tubes and you will need to go to hospital to have these broken up
• diverticulitis - inflammation of the small pouches that are part of the bowel

Click on the links above for more information on these conditions. If your GP suspects that you have appendicitis, they will refer you to hospital immediately.

Long-term or recurring abdominal pain

Adults who have persistent or repeated episodes of abdominal pain should see their GP. However, there is no need to panic as the cause is often not serious and can be easily managed.

Common causes in adults include:

• irritable bowel syndrome - a common condition where the muscle in the bowel wall tends to go into spasm (tightens); pain is often relieved when you go to the toilet
• a urinary tract infection that keeps returning (you will usually feel a burning sensation when you urinate)
• a long-term peptic ulcer - an open sore that develops on the inside lining of your stomach or duodenum (upper small intestine)
• constipation
• heartburn and acid reflux - stomach acid leaks from the stomach and up into the oesophagus, the tube that runs from the mouth to the stomach

There is an even wider range of possible causes in children. The most common include:

• periodic syndrome (similar to irritable bowel syndrome in adults) - children have recurring episodes of tummy pain
• constipation
• a urinary tract infection that keeps returning
• anxiety and depression
• heartburn and acid reflux

Click on the links above for more information on these conditions.