What causes a stomach ache, and when should you worry?

A stomach ache is one of the most common complaints a GP hears, and one of the most common reasons people search for answers online. In the vast majority of cases, it is caused by something temporary and manageable: something you ate, trapped wind, constipation, or a stomach bug doing the rounds.

That said, stomach pain can occasionally be a sign of something that needs medical attention. Knowing the difference between a stomach ache that will pass and one that needs a doctor can save you both unnecessary worry and a missed warning sign.

Common causes of stomach ache

The NHS lists the following as common causes of stomach ache in adults:

• Trapped wind (flatulence). Feeling bloated, gassy and uncomfortable, often with cramping. Usually resolves on its own or with movement.
• Indigestion. A burning or heavy feeling in the upper stomach after eating, sometimes with heartburn and nausea. Often triggered by eating too quickly, rich or fatty food, or stress.
• Constipation. Cramping or aching in the lower abdomen when you have not been able to pass a stool for several days. Common after changes in diet, reduced fluid intake, or when taking certain medicines (including iron supplements).
• Stomach bug or food poisoning. Cramps with watery diarrhoea, nausea and sometimes vomiting. Usually caused by a viral or bacterial infection. Most cases resolve within a few days with fluids and rest.

The NHS also lists some less common but important causes:

• Period pain. Cramping in the lower abdomen during menstruation.
• Irritable bowel syndrome (IBS). Ongoing cramps, bloating, diarrhoea or constipation that come and go over weeks or months.
• Appendicitis. Sudden pain that starts near the belly button and moves to the lower right side. This needs urgent medical attention.
• Kidney stones. Severe pain that may radiate to the groin, with nausea and pain when peeing.
• Gallstones. Intense pain under the ribs on the right side, lasting hours.

What you can do at home

For a mild stomach ache with no red flags (see the warning section below), these simple steps often help:

• Rest. Lie down comfortably and give your body time. Many stomach aches pass within a few hours.
• Stay hydrated. Sip water or clear fluids regularly, especially if you have diarrhoea or vomiting. Oral rehydration sachets (available from pharmacies) can help replace lost salts.
• Eat small, plain meals. When you feel ready to eat, stick to bland foods (toast, rice, bananas, plain crackers). Avoid fatty, spicy or acidic food until the pain has settled.
• Use a hot water bottle or heat pad. Placing gentle warmth on your stomach can help relax the muscles and ease cramping.
• Move gently. A short, slow walk can help with trapped wind and bloating. Avoid strenuous exercise while you are in pain.
• Avoid painkillers that irritate the stomach. Ibuprofen and aspirin can make some types of stomach pain worse (especially gastritis and ulcers). Paracetamol is the safer option for pain relief. If you are unsure, check with your pharmacist.

What your pharmacist can suggest

The NHS recommends speaking to a pharmacist as a first step for many types of stomach ache. They can advise on:

• Antacids and alginates for indigestion and heartburn.
• Laxatives for constipation that has not responded to dietary changes.
• Oral rehydration sachets for diarrhoea and vomiting.
• Anti-diarrhoeal medicine (such as loperamide) for adults, if needed for a short time.
• Peppermint oil capsules for IBS symptoms (these are pharmacy-available and have some clinical evidence behind them).

A pharmacist can also help you work out whether your symptoms need a GP appointment or can be managed at home.

Natural and traditional remedies

Some traditional approaches are widely used for mild stomach discomfort. Here is what people try and how honest the evidence is:

• Peppermint tea. Peppermint has been studied for IBS and has some evidence for helping with bloating and stomach cramps. Peppermint oil capsules (enteric-coated, available from pharmacies) have stronger evidence than the tea, but the tea is a gentle option for mild wind or nausea.
• Ginger tea or ginger root. Ginger has been studied mainly for nausea (including pregnancy-related nausea and post-operative nausea). The evidence for general stomach pain is limited, but it is widely used and unlikely to cause harm in moderate amounts.
• Chamomile tea. Traditionally used as a calming digestive remedy. There is limited clinical evidence, but it is gentle and harmless for most people (avoid if you are allergic to plants in the Asteraceae/daisy family).
• Heat. A warm compress or hot water bottle on the stomach is one of the oldest and most effective non-medicinal approaches for cramping pain.

When to see your GP or get urgent help

The NHS advises calling 999 or going to A&E if:

• A stomach ache came on very suddenly or is severe
• It hurts when you touch your stomach
• You are vomiting blood or your vomit looks like ground coffee
• Your poo is bloody, black and sticky, and extremely smelly
• You cannot pee, poo or pass wind
• You cannot breathe
• You have chest pain
• You have diabetes and are vomiting
• Someone has collapsed

Do not drive yourself to A&E. Ask someone to drive you or call 999 and ask for an ambulance.

Common questions about stomach ache

Natural World Team

Independent guides to natural remedies and supplements, checked against NHS and EFSA references.