November 5, 2026 — Emergency Care
By Nikki Nisbet, DO
As an emergency medicine physician, I have seen patients arrive doubled over with abdominal pain due to trapped gas being the culprit. However, this same degree of pain can also accompany many more serious abdominal pathologies such as a kidney stone, an inflamed gallbladder or an intestinal obstruction. Additionally, subtle pain or vague discomfort can be the presenting symptom of a serious abdominal problem.
Along with the stomach and intestines, the liver, gallbladder, pancreas, kidneys, bladder, many blood vessels and the reproductive organs can also cause abdominal pain. Occasionally, a condition involving the heart or another part of the body can also feel like a stomach problem.
So, when should you go to the emergency room for abdominal pain?
How the pain began, whether it is changing and what other symptoms appear with it can often provide useful clues to healthcare providers trying to sort out the etiology of your abdominal pain. If the pain that you are experiencing seems new, unusual or especially severe, it might be best to “trust your gut” and seek emergency medical care.
When evaluating a patient, we need to understand where and when the pain began and whether it has moved. A generalized stomachache that becomes concentrated in one spot can signal a more serious problem. For example, pain that moves toward the lower-right abdomen raises the concern for the diagnosis of an appendicitis, a serious condition in which the appendix becomes inflamed and infected and requires treatment by surgical removal.
Another indicator of severity is if you experience a sharp increase in pain when walking, coughing or riding over a bump in the car. This clue suggests the tissue lining the abdominal cavity—the peritoneum—may be irritated. Peritoneal symptoms can occur when there is a perforation or tear in the digestive tract.
These are patterns of concern that should guide you to seek prompt medical care.
Go to the ER for abdominal pain that is severe, persistent, or becoming worse. You should also seek emergency care if the pain occurs with any of the following:
Blood in vomit may be bright red or resemble dark black coffee grounds. Bleeding farther down the digestive tract may produce red, maroon or black tarry stool.
Yellowing of the skin and eyes is called jaundice. It develops when bilirubin, a yellow chemical produced as the body breaks down old red blood cells, builds up in the body. Jaundice can signal a problem involving the liver, gallbladder, bile ducts or pancreas.
Fainting with abdominal pain can indicate internal bleeding, a severe infection, or dehydration causing low blood pressure. Call 911 if someone passes out, becomes confused, has trouble breathing or is too weak or ill to get to an ER on their own. Do not drive yourself in these circumstances.
A heart attack can present as upper abdominal pain. Many patients will present with the symptom of a stomachache or heartburn instead of the classic chest pain radiating to the neck or jaw or left arm. Nausea, vomiting, sweating, and lightheadedness can accompany the pain.
The aorta is the body’s largest artery. It travels from the heart through the chest and abdomen before branching toward the legs. Two serious aortic conditions can cause pain in the chest, back or abdomen:
Young children and other patients who cannot easily describe their symptoms may not be able to explain where the pain is or how it feels. Some children and adults with cognitive or neurodevelopmental conditions such as autism spectrum disorder may experience or communicate pain differently.
In these situations, parents and caregivers should watch for changes in the person’s usual behavior. Vomiting, fever, unusual sleepiness, lack of interest in food or activities, guarding the abdomen or simply “not acting right” can all be meaningful. When the patient cannot clearly explain what is happening, I encourage their parents and caregivers to be quick to seek care: it is better to err on the side of caution.
Children also sometimes report abdominal pain when the illness begins elsewhere. Strep throat, for example, can cause stomach pain, headache, nausea or vomiting in children. I have seen children test positive for strep after arriving with a fever and stomachache but no initial complaint of a sore throat.
Finding the cause begins with understanding your symptoms and medical history. At Physicians PremiER our intake staff are trained to quickly assess your symptoms, ask the right questions and move you to a quiet, private room for further examination.
The emergency physician will ask:
Be prepared to discuss vomiting, bowel changes, fever, bleeding, medications, medical conditions, heart health and any previous abdominal surgeries.
The physical examination may include listening to the abdomen and gently pressing different areas to find swelling, tenderness, an enlarged organ or a hernia. The physician may also check whether movement or a light jarring motion makes the pain worse.
Because of possible cardiac causes, the ER doctor may order heart testing and imaging for an older patient or someone whose history and symptoms raise concern about a heart problem.
Testing depends on the individual patient and the conditions the doctor is considering. Common tests include:
No single blood or urine result explains every case of abdominal pain. Doctors interpret those findings along with the examination and, when needed, utilize imaging to help with uncovering a diagnosis.
Physicians Premier Emergency Room offers on-site diagnostic services, including laboratory testing, CT scans, digital X-rays, ultrasounds and EKGs. Our board-certified emergency physicians can begin evaluating the images without the long delays that are common in crowded hospital ERs.
Appropriate imaging exams depend on the suspected cause of your pain:
If your abdominal pain is severe, will not go away or appears with other warning signs, come to the ER. Do not wait until you are fainting, repeatedly vomiting or turning yellow to seek medical care.
Physicians Premier is open 24 hours a day, 365 days a year and no appointment is required. The quicker we find the cause, the faster you’ll feel like yourself again.
Stay prepared: Find an emergency room near you. If you are experiencing an emergency, call 911.
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