Persistent Stomach Pain: When Should You See a Doctor?

Stomach pain is common and may be caused by something temporary, such as indigestion, constipation, trapped wind or a mild stomach infection. However, pain that persists, repeatedly returns or becomes more severe should not simply be ignored, particularly when it occurs with other symptoms.

At Hout Bay Family Medical Clinic, our doctors can assess ongoing abdominal discomfort, investigate possible causes and advise whether blood tests, imaging, treatment or specialist referral may be required.

What Is Persistent Stomach Pain?

“Stomach pain” is a general term often used to describe discomfort anywhere between the chest and pelvis. Doctors usually refer to this as abdominal pain, because the discomfort may come from the stomach, bowel, liver, gallbladder, pancreas, kidneys, bladder or reproductive organs.

Pain may be considered persistent when it:

• Continues for several days or longer
• Keeps returning over a period of weeks or months
• Does not improve with simple measures
• Gradually becomes more frequent or severe
• Begins affecting eating, sleeping, work or daily activities

The location, timing and nature of the pain can provide important clues, but symptoms alone are not always enough to identify the cause.

What Can Cause Ongoing Abdominal Pain?

There are many possible causes of persistent stomach pain. Some are relatively minor, while others require medical investigation.

Common possibilities include:

• Indigestion or acid reflux
• Constipation
• Food intolerance
• Irritable bowel syndrome
• Gastritis or a stomach ulcer
• Gallstones
• Urinary tract or kidney problems
• Inflammatory bowel disease
• Coeliac disease
• Medication side effects
• Menstrual or gynaecological conditions
• Stress and anxiety
• Persistent infection

More serious conditions can also cause abdominal pain, which is why it is important not to rely on online symptom lists for a diagnosis.

Does the Location of the Pain Matter?

The location of the discomfort can help guide a medical assessment.

Upper abdominal pain

Pain in the upper abdomen may be associated with indigestion, reflux, gastritis, stomach ulcers, gallbladder problems or pancreatic conditions.

Lower abdominal pain

Lower abdominal discomfort may occur with constipation, bowel conditions, urinary infections, menstrual problems or other pelvic conditions.

Right-sided pain

Pain on the upper right side may be related to the gallbladder or liver, while lower-right pain may occur with appendicitis or bowel-related conditions.

Left-sided pain

Pain on the left may be associated with the bowel, constipation, kidney problems or other abdominal structures.

The precise location does not always identify the cause, as pain can move or be felt in a different area from where the problem originates.

When Should You Book a Doctor’s Appointment?

Arrange a medical consultation when stomach pain:

• Persists for more than a few days
• Keeps returning
• Becomes progressively worse
• Wakes you during the night
• Is associated with ongoing bloating
• Occurs regularly after eating
• Is accompanied by persistent nausea or vomiting
• Causes a noticeable change in bowel habits
• Is associated with unexplained tiredness or weakness
• Interferes with normal activities
• Has not improved despite reasonable self-care

Official patient guidance recommends contacting a healthcare professional when mild abdominal pain lasts a week or longer, or when pain is accompanied by additional symptoms.

Warning Signs That Require Prompt Medical Assessment

Certain symptoms may indicate that the pain needs more urgent investigation.

Contact a doctor promptly if abdominal pain occurs with:

• Blood in the stool
• Black, tar-like stools
• Blood in the urine
• Repeated vomiting
• Difficulty swallowing
• Persistent diarrhoea
• Ongoing constipation
• Fever
• Unexplained weight loss
• Loss of appetite
• Yellowing of the skin or eyes
• Pain or burning when urinating
• A new abdominal swelling or lump
• Unusual vaginal bleeding or discharge
• Possible pregnancy
• Increasing abdominal tenderness

You should also seek medical advice when symptoms change significantly or feel different from previous digestive problems.

When Is Stomach Pain an Emergency?

Seek urgent medical assistance when abdominal pain:

• Starts suddenly and is severe
• Becomes rapidly worse
• Occurs with a hard, swollen or very tender abdomen
• Is accompanied by severe difficulty breathing or chest pain
• Occurs with fainting, confusion or extreme weakness
• Is associated with vomiting blood
• Occurs with large amounts of blood in the stool
• Follows a significant injury
• Is accompanied by an inability to pass stool or gas
• Occurs during pregnancy with bleeding, dizziness or severe pain

Severe pain when the abdomen is touched, or pain that worsens when pressure is released, may require emergency assessment.

Do not wait for a routine appointment when symptoms are severe or rapidly worsening.

Could It Be Indigestion or Acid Reflux?

Indigestion can cause upper abdominal discomfort, bloating, nausea, belching or a feeling of fullness after eating. Acid reflux may cause burning behind the breastbone, an acidic taste or discomfort after meals or when lying down.

Occasional symptoms may improve with dietary changes or short-term treatment. However, arrange a consultation when symptoms:

• Occur frequently
• Persist despite treatment
• Cause difficulty swallowing
• Are accompanied by vomiting
• Result in unexplained weight loss
• Begin for the first time later in life
• Occur with black stools or vomiting blood

Persistent symptoms may require investigation for reflux disease, gastritis, an ulcer or another condition.

Could It Be Irritable Bowel Syndrome?

Irritable bowel syndrome, commonly called IBS, can cause recurring abdominal pain together with bloating, constipation, diarrhoea or alternating bowel habits.

Symptoms often improve or change after passing stool, and they may be influenced by certain foods, stress or hormonal changes. IBS can be uncomfortable, but it does not explain every case of persistent abdominal pain.

A doctor may need to exclude other causes, particularly when symptoms are new or accompanied by bleeding, fever, weight loss, anaemia or night-time symptoms.

Stomach Pain After Eating

Pain after meals can have several possible causes, including indigestion, reflux, food intolerance, gallbladder problems, gastritis or an ulcer.

Keeping a short symptom record may help. Note:

• What you ate
• When the pain began
• Where the pain was located
• How long it lasted
• Whether you experienced bloating, diarrhoea or nausea
• Whether any particular food repeatedly triggered symptoms

Avoid removing multiple food groups from your diet without medical advice, as restrictive diets can cause nutritional problems and may make the underlying issue harder to identify.

Abdominal Pain and Changes in Bowel Habits

A persistent change in bowel habits should be discussed with a doctor, especially when it lasts for several weeks.

Changes may include:

• New constipation
• Persistent diarrhoea
• Alternating constipation and diarrhoea
• Narrower stools
• A feeling that the bowel has not emptied fully
• Mucus or blood in the stool
• Increased urgency
• Pain during bowel movements

Although many bowel changes have non-serious causes, persistent symptoms may require examination and testing.

Abdominal Pain in Women

Abdominal or pelvic pain in women may sometimes be linked to:

• Menstruation
• Ovulation
• Endometriosis
• Ovarian cysts
• Pelvic infection
• Pregnancy-related conditions
• Urinary problems
• Menopause-related changes

Arrange a consultation when pelvic or abdominal pain is severe, persistent or accompanied by abnormal bleeding, pain during intercourse, fever, faintness or possible pregnancy.

Sudden severe pain during pregnancy, particularly with bleeding or dizziness, requires urgent medical attention.

Abdominal Pain in Children

Children frequently experience stomach aches, often due to constipation, mild infections, anxiety or dietary changes. However, younger children may find it difficult to describe where the pain is or how severe it feels.

Have a child assessed when pain:

• Continues or repeatedly returns
• Prevents normal play or activity
• Wakes the child from sleep
• Occurs with persistent vomiting
• Is accompanied by fever
• Causes the child to refuse fluids
• Occurs with blood in the stool
• Is associated with a swollen or very tender abdomen
• Causes unusual sleepiness or weakness

Severe, localised or rapidly worsening abdominal pain in a child requires prompt medical assessment.

What Will the Doctor Ask?

To understand the possible cause, your doctor may ask:

• Where the pain is located
• When it started
• Whether it is constant or intermittent
• What the pain feels like
• Whether food makes it better or worse
• Whether it changes after passing stool
• Whether there is nausea, vomiting or bloating
• Whether bowel habits have changed
• Whether there are urinary symptoms
• Whether any medication could be contributing
• Whether pregnancy is possible
• Whether there is a family history of digestive disease

Your abdomen may also be examined for tenderness, swelling, masses or other clinical signs.

What Tests May Be Needed?

Not every patient with stomach pain requires extensive testing. Investigations are selected according to the symptoms, medical history and examination findings.

Possible tests may include:

• Blood tests
• Urine testing
• Stool testing
• Pregnancy testing
• Ultrasound
• X-ray or other imaging
• Testing for Helicobacter pylori
• Gastroscopy
• Colonoscopy
• Referral to a gastroenterologist or another specialist

Sometimes the cause is not immediately clear, and symptoms may need to be monitored or reassessed if they continue.

What Can You Do Before Your Appointment?

A symptom diary can help your doctor identify patterns. Record:

• When the pain occurs
• Where it is located
• How severe it feels
• What you ate beforehand
• Changes in bowel movements
• Associated symptoms
• Medication or supplements taken
• Menstrual timing where relevant

Avoid repeatedly taking anti-inflammatory pain medicines such as ibuprofen for unexplained stomach pain unless advised by a healthcare professional, as these medicines can irritate the stomach and contribute to ulcers in some people.

Persistent Stomach Pain in Hout Bay

Hout Bay Family Medical Clinic provides medical assessment for patients experiencing persistent abdominal pain, indigestion, bloating, altered bowel habits and other digestive concerns.

A consultation may include a review of your symptoms, diet, medication, medical history and relevant risk factors. Where appropriate, your doctor can arrange investigations, recommend treatment or refer you for specialist assessment.

Book a Medical Consultation

Persistent or recurring stomach pain should not be ignored. Contact Hout Bay Family Medical Clinic to arrange a consultation and determine whether further investigation is needed.

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This article provides general health information and does not replace an individual medical consultation, examination, diagnosis or treatment plan.