When to go to the doctor with stomach pain

Stomach complaints are common and can be divided into different groups. This often concerns non-specific stomach complaints, reflux complaints, ulcer complaints or special stomach problems such as stomach bleeding or stomach perforation. Based on the patient’s story, the GP makes a distinction in which group his stomach complaints belong.

Complaints of stomach problems

Stomach problems can cause various complaints and are often accompanied by:

  • pain in the upper abdomen or pain behind the breastbone
  • heartburn
  • nausea and vomiting
  • bloated feeling
  • many farmers

Complaints that may indicate (acute) serious stomach disorders are:

  • vomiting blood
  • feeling that food is stuck in the esophagus
  • black stools
  • acute and very severe pain in the abdomen.


Non-specific stomach complaints

These stomach complaints do not last longer than two weeks. Complaints are mainly pain in the upper abdomen, heartburn, nausea, bloating or rapid satiety. Often there is no acute onset and no specific diagnosis is made after exclusion of alarm symptoms. These complaints then fall into the residual group in which no serious condition is suspected.

Gastroenteritis (stomach flu)

It is often a viral infection of the gastrointestinal tract. It often starts with nausea and vomiting, but later watery diarrhea can also occur. Sometimes there is also a fever. It often starts quite acutely and often lasts only one or two days, with almost nothing being kept down.
The complaint usually disappears after three days. No treatment is necessary.

HELLP syndrome

This is a rare and serious condition during pregnancy and dangerous for mother and child. It often starts with high blood pressure, the woman does not notice this. Upper abdominal pain often also occurs. Later, liver function is disrupted and blood cells are broken down by the body.

Melaena (black stool)

Melaena is pitch black and tarry stools. This occurs when blood remains in the intestines for longer than fourteen hours. The cause is often stomach bleeding or bleeding high in the intestines.

Reflux esophagitis

With these complaints, the valve between the esophagus and the stomach no longer works properly, causing the acidic contents of the stomach to flow back into the esophagus. The mucous membrane of the esophagus does not provide protection from the acid from the stomach, resulting in etching of the esophageal mucosa.
This results in heartburn, pain behind the breastbone and belching. The complaints often occur when bending over, a full stomach, lying down, pregnancy, tight clothing and excess weight. In the short term, remedies can be used that neutralize stomach acid so that it bothers you less. But if the complaints persist, it should be examined by a doctor at some point.
Ulcer (stomach ulcer)
An ulcer is usually in the stomach or just outside it in the duodenum. It causes a nagging pain in the stomach, often accompanied by heartburn. An empty stomach can worsen the pain. Helicobacter bacteria often play a role in an ulcer in the duodenum. A course of antibiotics is usually prescribed for this.
When should the GP immediately assess stomach pain:

  • When severe acute pain began in the stomach
  • vomiting blood
  • watery stool (malaena)
  • pregnant and pain in the upper abdomen

when to make a normal appointment with the GP

  • children under the age of twelve with stomach complaints for the first time
  • adults over 45 years of age with stomach complaints for the first time
  • if the self-care products do not work well enough
  • with daily complaints for weeks
  • if the pain gets worse or causes a burning sensation
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