Tummy pain is very common and usually not serious. Where it hurts, what it feels like and what brings it on give useful clues. Here is a guide to the common causes, and the signs that mean you should see a doctor or specialist.
Almost everyone has tummy pain from time to time. Most of it settles by itself. But the place, the type and the pattern of the pain can point to the cause, and some features mean it should be checked promptly.
Where it hurts
Tap an area of the tummy to see what pain there can mean. The picture faces you, so your right side is on the left.
Upper right, under the ribs
- Gallstones and gallbladder inflammation, often after a fatty meal
- Liver conditions such as hepatitis or a swollen liver
- Sometimes a duodenal ulcer
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Upper middle, below the breastbone
- Indigestion (dyspepsia) and gastritis
- Stomach or duodenal ulcer
- Acid reflux
- Gallstone pain (biliary colic), a steady pain lasting hours, often after a fatty meal
- Pancreatitis, often spreading to the back
- Occasionally the heart: pain with breathlessness or sweating needs urgent care
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Upper left, under the ribs
- Stomach: gastritis or dyspepsia
- Trapped wind at the bend of the colon
- Less often the pancreas or spleen
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Right side (flank)
- Kidney stone or kidney infection, often spreading to the groin
- Bowel: constipation or IBS
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Around the navel
- Early appendicitis, before the pain moves to the lower right
- Gastroenteritis
- Small bowel problems
- Irritable bowel syndrome
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Left side (flank)
- Kidney stone or kidney infection
- Bowel: constipation or IBS
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Lower right
- Appendicitis
- Diverticulitis, which in Asians is often on the right side
- Crohn’s disease
- Ovary problems in women
- Hernia in the groin
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Lower middle, above the pubic bone
- Bladder infection or difficulty passing urine
- Period pain, womb or ovary problems
- IBS
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
Lower left
- Constipation and IBS
- Diverticulitis
- Colitis, including inflammatory bowel disease
- Ovary problems in women
- Hernia in the groin
Pain in any area needs urgent care if it is sudden and severe, or comes with fever, vomiting blood, black stools or a hard, tender tummy.
The same information as a table:
| Area | Common causes |
|---|---|
| Upper middle, below the breastbone | Indigestion (dyspepsia), gastritis, stomach or duodenal ulcer, acid reflux, gallstone pain (biliary colic), pancreatitis. Occasionally the heart. |
| Upper right, under the ribs | Gallstones and gallbladder inflammation, liver conditions such as hepatitis |
| Around the navel | Early appendicitis, small bowel problems, irritable bowel syndrome |
| Lower right | Appendicitis, diverticulitis (in Asians this is often on the right side), Crohn’s disease, ovarian problems, kidney stone |
| Lower left | Constipation, IBS, diverticulitis, colitis |
| Lower middle | Bladder infection, period pain, womb or ovary problems |
| All over, or moving around | Gastroenteritis, trapped wind, IBS, constipation; rarely a blocked bowel |
Pain does not always stay where it starts. Appendicitis often begins around the navel and moves to the lower right. Gallbladder pain can spread to the right shoulder blade, and pancreatitis to the back.
What it feels like
- Burning or gnawing in the upper tummy: often from the stomach, such as gastritis, an ulcer or reflux. Ulcer pain may ease or worsen with food, and can wake you at night.
- Cramping that comes and goes: often from the bowel, such as gastroenteritis, IBS or constipation. It is often eased by passing wind or opening the bowels.
- Severe, steady pain building over 30 minutes or more: typical of gallstone pain (often after a fatty meal, lasting hours) or kidney stones.
- Sharp pain that is worse when moving or coughing: can mean inflammation inside the abdomen, such as appendicitis. This needs urgent attention.
- Bloating and fullness: common in functional dyspepsia, IBS and constipation.
Clues from the pattern
- Linked to meals: stomach, gallbladder or pancreas
- Linked to bowel movements: IBS, constipation or colitis
- Linked to periods: gynaecological causes
- Anti-inflammatory painkillers or blood thinners: raise the risk of ulcers and bleeding
- Heavy drinking: pancreatitis, gastritis and liver disease
- Stress and poor sleep: often make IBS and dyspepsia worse, though they are rarely the only cause
When to see a specialist
Make an appointment with a doctor or gastroenterologist if you have:
- Pain that keeps coming back, or lasts more than a few weeks
- New tummy symptoms after the age of about 45
- Weight loss you cannot explain, or a poor appetite
- Difficulty swallowing, or persistent vomiting
- Black stools, blood in the stools, or anaemia (low blood count)
- A lasting change in bowel habit
- Pain that wakes you from sleep
- A family history of stomach or bowel cancer, or of inflammatory bowel disease
- Symptoms that do not improve with simple treatment
What happens at the visit
Most causes can be found with a careful history and examination. Depending on the likely cause, tests may include blood tests, a test for H. pylori, an ultrasound scan, a gastroscopy or colonoscopy, or a CT scan. Many people with ongoing pain have a functional condition such as dyspepsia or IBS. These are real, common and treatable, and the tests help to rule out other causes first.
Simple measures in the meantime
- Eat smaller meals and avoid lying down for 2 to 3 hours after eating
- Cut down on alcohol, very fatty or spicy food if they trigger pain
- Avoid anti-inflammatory painkillers unless a doctor advises them
- Drink enough water and include fibre if you are constipated
Do not keep taking indigestion medicine for weeks without seeing a doctor, as it can hide the symptoms of an ulcer or other condition.
General information only. Reviewed by Dr Chia Chung King, 2026-11-07. Book a consultation.