If someone isn’t feeling well and you ask what’s wrong, there’s a good chance they’ll say their stomach hurts. But really, there’s a good chance that their discomfort is coming from somewhere else.
According to Dr. Kevin Ashby, a gastroenterologist at Saddleback Memorial Medical Center in Laguna Hills, California, people often refer to their abdominal region as their stomach, when in fact, the stomach makes up only part of the abdomen.
So why does this happen? Most people aren’t educated in anatomy, he said, so it has become conventional to refer to the entire abdomen as "the stomach."
For those who need a quick anatomy refresher, the stomach is actually located in the area just left of the mid-upper abdomen, with part just under the rib cage, Dr. Ashkan Farhadi, a gastroenterologist at Orange Coast Memorial Medical Center in Fountain Valley, California explained.
But what about all the other types of pain and discomforted lumped into the “stomach ache” category? Here’s a quick breakdown of some of the other possibilities, which could come in handy the next time your doctor asks where it hurts.
Location is key
When you see a doctor about abdominal pain, he or she will a generally ask if the pain is located above or below the belly button and if it is on the right or left side in order to get an idea of the cause, Ashby said. There are other organs within the abdomen, including the liver, pancreas, spleen, small intestine and large intestine, so explaining both the location and the type of abdominal pain that the patient is having helps the doctor to figure out which organ may be causing the symptom.
There are many, many possible causes of abdominal pain, ranging from the common (irritable bowel syndrome, for instance) to very rare causes such as obstruction of the small intestine from a polyp (growth),” Ashby said. Other causes of abdominal pain include peptic ulcer disease, gallbladder disease, poor blood flow to the intestine and inflammatory bowel disease.
The abdominal cavity is filled with visceral organs — internal organs of the body within the chest and the abdomen — such as the liver, pancreas, stomach or intestines, Farhadi explained.
“Often, when we use the word ‘visceral,’ we mean it is felt ‘down deep’ or is a ‘feeling in the gut,’” he said. “Any damage or issues with the visceral organs within the abdominal cavity are being felt as an abdominal pain.”
But there are occasional cases were visceral pain in one area translates to a problem in a different part of the body. For example, a gallbladder disease may be felt in the left shoulder.
On the other hand, the pain from several visceral organs within the abdominal cavity may be felt at the same region of the abdomen, Farhadi said. For example, the pain from the stomach, lower esophagus, upper intestine, liver, pancreas, gallbladder or liver may all be felt at the mid-upper abdomen while pain of the female reproductive organ, urinary bladder, colon and appendix may all be felt in the mid-lower area of the abdomen.
Types of pain
The types of pain that people experience can vary from patient to patient, but often the pain quality will give the physician a clue as to what is causing the pain.
Here are a few examples of what some types of pain mean from Farhadi (but these should, by no means, be used for self-diagnosis):
Ulcer disease: typically causes a gnawing or burning pain in the mid upper abdomen.
Irritable bowel syndrome: typically causes a crampy-type pain in the lower abdomen.
Gastrointestinal organs: typically intermittent pain and associated with food intake or bowel movement.
Pancreas: typically constant and would radiate to back.
Gallbladder: could occur after meals in the right upper corner or mid-upper area of the abdomen and would typically radiate to the right side of the abdomen.
Urinary bladder: usually in the mid-lower part of the abdomen and can radiate to both sides of the abdomen.
Urinary tract: usually associated with urination or other urinary symptoms such as frequent urination.
Appendicitis: starts as a vague pain at the center of the abdomen, but later it localizes itself as a sharp pain at the right lower corner of the abdomen that aggravates with cough or body movement.
It’s important to note, however, that not all abdominal pain is actually due to an abdominal source, Ashby said. In some rare cases, ovarian or testicular disease, or even rheumatologic conditions such as lupus or vasculitis, can cause abdominal pain.
Do not self-diagnose
While these examples are general illustrations of a few causes of abdominal pain, it is important not to diagnose yourself, Ashby stresses. If something in that general area doesn’t feel right, go see your doctor right away.