Stomach pain: causes, warning signs, and what helps in everyday life

What to expect in this article

1. What is stomach pain—and where exactly is it located?
2. What are the most common underlying causes?
3. How can you assess your symptoms yourself?
4. Which common assumptions about stomach pain are incorrect?
5. Gastritis, ulcer, or functional dyspepsia—how can you tell the difference?
6. Which warning signs require immediate medical evaluation?
7. What helps with recurring stomach pain in everyday life?
8. When is a gut microbiome analysis useful—and when is it not?
9. Context: What a self-test for stomach pain cannot do
10. Conclusion
Frequently asked questions
Sources

What is stomach pain—and where exactly is it located?

Stomach pain is pain in the upper abdomen, that is, the area between the lower rib cage and the navel. The stomach itself is not located centrally behind the navel, but higher up and more toward the left side of the body.

This location explains why describing the site of the pain is so valuable when speaking with a doctor. According to IQWiG (2025), the symptoms of a stomach ulcer typically occur “in the middle to left upper abdomen”—a description that clearly differs from symptoms in the lower abdomen.

Upper abdomen, navel, breastbone: three regions, three meanings

A burning sensation that rises upward points in a different direction than a dull pressure that stays in one place. According to IQWiG (2024), in reflux disease the burning radiates “upward from the upper abdomen or the area behind the breastbone to the throat.”

Symptoms that are clearly located below the navel and accompanied by changes in bowel movements are more likely to indicate intestinal problems. IQWiG (2023) describes irritable bowel syndrome as “persistent abdominal or lower abdominal pain, cramps, and altered stools.”

Why the quality of pain reveals as much as its location

People describe stomach pain in very different ways: as burning, pressure, cramping, or pulling. For functional dyspepsia, IQWiG (2025) explicitly identifies two different symptom patterns—on the one hand, “early satiety while eating or a feeling of fullness after eating,” and on the other, “pain or a burning sensation in the upper abdomen.”

Being able to describe the quality of your pain gives the doctor a genuine clue—instead of treating every twinge in the abdomen as a stomach problem.

Associated symptoms are part of the picture

Stomach pain rarely occurs on its own. For acute gastritis, IQWiG (2025) lists, verbatim, “stomach pain, a feeling of fullness, bloating, heartburn, nausea, sometimes with vomiting, belching, loss of appetite, and a bloated abdomen.”

According to IQWiG (2024), reflux disease can also cause “severe feelings of fullness, and sometimes nausea and retching.” Which accompanying symptoms you experience should therefore be included when preparing for your doctor’s appointment.

What are the most common causes?

Recurring stomach pain is mainly associated with four conditions: gastritis, stomach or duodenal ulcers, reflux disease, and functional dyspepsia.

Gastritis

The stomach lining is the protective layer between the stomach contents and the stomach wall. IQWiG (2025) describes it as follows: “The stomach lining protects the stomach wall from acid and pathogens. If this protective lining becomes irritated or damaged, it can become inflamed.”

In addition to these two main causes, IQWiG (2025) names another trigger: “Excessive alcohol consumption can also cause acute gastritis.” This identifies three factors that can genuinely be influenced in everyday life or medically evaluated.

Stomach and duodenal ulcers

The causes of stomach and duodenal ulcers are the same. According to IQWiG (2025), “the most common causes are a bacterial infection with the pathogen Helicobacter Pylori or the regular use of anti-inflammatory painkillers.”

According to IQWiG (2025), around 1 to 2 in 100 people aged 18 to 29 develop an ulcer; from age 45 onward, 8 to 10 in 100 women and 9 to 14 in 100 men develop one. The risk therefore increases significantly with age.

Reflux disease and heartburn

Not every burning sensation in the upper abdomen is an illness. IQWiG (2024) distinguishes it as follows: “Reflux disease involves very frequent or severe heartburn.” Occasional heartburn therefore does not automatically indicate reflux disease.

According to IQWiG (2024), up to 25 in 100 people in Western countries repeatedly experience symptoms such as heartburn or belching. Reflux is therefore one of the most common symptom patterns in the upper abdomen.

Functional dyspepsia

Sometimes no organic cause is found despite evaluation. IQWiG (2025) defines it as follows: “With functional dyspepsia, also called an irritable stomach, symptoms occur in the upper abdomen over a period of months and cannot be explained by organic causes.”

According to IQWiG (2025), around 10 to 15% of adults in Germany have functional dyspepsia. Younger people are also affected: According to the same source, between 10 and 20% of children complain “of the typical symptoms that persist or recur over a longer period.”

The sequence is important: According to IQWiG (2025), functional dyspepsia is only considered once “other causes of the symptoms have been investigated and ruled out.” The diagnosis therefore comes at the end of the evaluation, not at the beginning.

How would you describe your symptoms?

Four observations will help you: location, timing, accompanying symptoms, and duration. They do not replace a diagnosis—they turn a vague feeling into a describable observation.

The second question is particularly revealing because it distinguishes between duodenal and gastric ulcers. According to IQWiG (2025), symptoms of a duodenal ulcer “tend to occur when the stomach is empty and decrease after eating,” whereas symptoms of a gastric ulcer “may occur immediately after eating, but also independently of meals.”

This is precisely where this article deliberately differs from its companion articles: Here, the focus is on stomach pain regardless of eating—its location, timing, duration, and warning signs. If your symptoms regularly begin immediately after a meal, Stomach pain after eating is the more appropriate article; if nausea is your main symptom, you can find the relevant information in Nausea after eating.

Which common assumptions about stomach pain are incorrect?

Two assumptions are particularly persistent—and both lead people to wait too long. The first concerns the cause of ulcers; the second concerns the apparent harmlessness of over-the-counter painkillers.

The distinction is practically important: A Helicobacter pylori infection can be diagnosed and treated by a doctor. Anyone who attributes the symptoms solely to stress is delaying precisely this evaluation—often by months.

The key word here is “regularly.” This is not about the occasional tablet for a headache, but about taking them continuously or frequently, as is common with chronic pain. Anyone who takes these medications long term and develops stomach pain should discuss it with a doctor rather than continuing to adjust the dosage independently.

Gastritis, an ulcer, or an irritable stomach—which is how can you tell the difference?

The three conditions can only be distinguished with certainty by a doctor. However, there are patterns that can be described—and that can help you organize your observations. The following overview compares the three most common conditions using the same five criteria.

Why the timing pattern is the strongest clue

The line “When does it occur?” distinguishes the three conditions most clearly. According to IQWiG (2025), pain that occurs on an empty stomach and eases after eating is more consistent with a duodenal ulcer than with a gastric ulcer.

With functional dyspepsia, premature fullness is often the main symptom: The stomach already feels full after small portions. This observation can also be made without any equipment.

Prevalence helps put things into perspective, but it does not replace a diagnosis

Functional dyspepsia is the most common of the three conditions: According to IQWiG (2025), 10 to 15% of adults in Germany are affected. Ulcers are less common but increase significantly with age—from 1 to 2 in 100 people aged 18 to 29 to 8 to 10 in 100 women and 9 to 14 in 100 men aged 45 and older (IQWiG, 2025).

These figures say something about probabilities, not about your individual case: According to IQWiG (2025), functional dyspepsia may only be considered once “other causes of the symptoms have been investigated and ruled out.”

Which warning signs require immediate medical evaluation?

Certain accompanying signs immediately change the urgency. They are not a reason to panic, but they are always a reason to make a doctor’s appointment. In one case, even the emergency number should be called.

The IQWiG (2023) names four signs that argue against a harmless functional cause: “Additional symptoms such as significant weight loss, blood in the stool, fever or pallor are more likely to indicate another intestinal disease.”

Blood in the stool and black-colored stool

Blood in the stool is never something to wait and see about. According to the IQWiG (2023), “blood in the stool should generally be medically examined to clarify the cause.” This applies regardless of how severe the stomach pain itself is.

In the case of gastric and duodenal ulcers, “black-colored stool” is also listed by the IQWiG (2025) as a warning sign of complications. Dark discoloration of the stool therefore belongs in the same category as visible blood: report it immediately.

Vomited blood and signs of anemia

The IQWiG (2025) explicitly names “vomited blood (red or black vomit)” as a warning sign. Here, too, the color matters: not only fresh, red blood is significant, but also dark-colored vomit.

Long-term unnoticed blood loss often appears indirectly. The IQWiG (2025) lists “fatigue, dizziness, pallor or shortness of breath during physical exertion” as “signs of anemia.” Anyone who notices such signs together with stomach pain should seek medical attention promptly.

Sudden, severe abdominal pain: Call 112

There is one situation in which you should not wait: In the event of sudden, severe abdominal pain, the IQWiG (2025) advises that “the emergency number 112 should be called immediately.” This recommendation is deliberately placed at the beginning rather than the end of this article because, in case of doubt, it can determine what happens over the course of hours.

All other warning signs do not indicate an emergency, but they do warrant an appointment. The difference lies in the speed required, not in the seriousness: both should be medically assessed, and neither belongs in a self-test.

What helps in everyday life with recurring stomach pain?

If organic causes have been medically ruled out, the first measures focus on everyday habits. For irritable stomach syndrome, the IQWiG (2025) lists “adjusting the diet, getting more exercise and individually tailored medication” as initial steps.

Adjusting your diet – without a blanket list of prohibited foods

There is no universally applicable diet for stomach pain. The IQWiG (2023) puts it plainly for digestive complaints: “However, how people react to certain foods is highly individual.”

A simple symptom diary kept for two to four weeks is therefore more useful than someone else’s list of prohibited foods: time, meal, type of symptom, and duration. This creates a personal pattern that is more useful in a conversation with your doctor than any general recommendation.

For basic nutritional needs, however, there is a clear benchmark: the German Nutrition Society (DGE) recommends that adults consume at least 30 g of fiber per day (as of 2021). According to DGE (2021), “increased fiber intake has protective effects against cardiovascular disease, type 2 diabetes, obesity, high blood pressure, colon cancer, and breast cancer, as well as on the risk of death.”

Review painkillers and alcohol critically

Two everyday factors associated with stomach complaints are documented and modifiable. According to IQWiG (2025), regular use of anti-inflammatory painkillers is among the most common causes of gastritis and ulcers.

The second factor is alcohol: “Excessive alcohol consumption can also trigger acute gastritis,” IQWiG (2025) writes. These are both points you can raise proactively in a conversation with your doctor—they often significantly affect the assessment.

Exercise and realistic expectations

According to IQWiG (2025), getting more exercise is explicitly one of the first steps for functional dyspepsia—this means regular everyday activity, not peak athletic performance.

At the same time, honesty is important: According to IQWiG (2025), functional dyspepsia is not dangerous, but it can be burdensome and long-lasting. Knowing this means measuring the success of everyday measures not by complete relief from symptoms, but by gradual improvement.

Caution is advised with products that promise a quick solution. For digestive complaints, IQWiG (2023) states: “It has not been established that additional fiber supplements help.” A lack of evidence is not proof of ineffectiveness—but it is not a reason to buy them either.

When a gut flora analysis makes sense—and when it does not

This is where many providers skip a sentence that belongs at the beginning: Stomach pain originates in the stomach, whereas a microbiome analysis examines the gut flora from a stool sample. These are two different locations in the digestive system.

This leads to a clear limitation: A microbiome test cannot detect gastritis, a stomach ulcer, an infection with Helicobacter pylori, or a tumor. Medical evaluation is responsible for precisely these questions—a stool test for gut flora analysis can neither replace nor expedite it.

A gut flora analysis only becomes interesting in a specific situation: when persistent intestinal symptoms are present in addition to stomach complaints and organic causes have already been ruled out by a doctor. In that case, the aim is no longer to search for the cause of the stomach problem, but to obtain a profile of the gut flora as one component alongside medical assessment.

For this situation, mybody® (MYBODY Lab GmbH) offers two variants of gut flora analysis. Both involve collecting a stool sample at home and having it analyzed in an ISO-certified laboratory; the data is transmitted in compliance with the GDPR.

The more comprehensive of the two variants is the Complete Test with FODMAP index and enterotype classification.

Gut Flora MICROBIOME Test Complete

The Complete Test determines over 1,500 bacterial species through DNA sequencing and summarizes the results in a report of around 15 pages—including bacterial diversity, the ratio of protective to problematic microbes, indications of dysbiosis, the FODMAP index, and enterotype classification. What it explicitly does not do: It does not provide a diagnosis and cannot detect gastritis, a stomach ulcer, a Helicobacter pylori infection, or a tumor. It is therefore only a useful component for stomach complaints if intestinal symptoms are also present and organic causes have been ruled out by a doctor.

Price: €189.00 (instead of €219.00)  ·  Sample type: Stool sample  ·  Processing time: approx. 20–25 business days after receipt of the sample  ·  Laboratory: ISO-certified laboratory analysis, ISO 27001, GDPR-compliant

To the Microbiome Test Complete

If you initially only want a basic picture of your gut flora, the Basic version offers a more affordable entry point. It covers fewer report topics but uses the same sample type and the same laboratory methodology.

Gut Flora MICROBIOME Test Basic

The Basic version shows the composition of the gut flora, the ratio of beneficial and potentially harmful bacteria, the intestinal environment based on the pH value, possible fungal colonization, and indications of dysbiosis—also in a report of around 15 pages. The same applies to this version: no diagnosis and no detection of gastritis, an ulcer, or a Helicobacter pylori infection. It is the more affordable entry point if you first want to gain an overview of your gut flora.

Price: €139.00  ·  Sample type: Stool sample  ·  Processing time: approx. 20–25 business days after receipt of the sample  ·  Laboratory: ISO-certified laboratory analysis, ISO 27001

To the Microbiome Test Basic

All price and service information is current as of July 28, 2026. Prices and processing times may change; the relevant product page on mybody® (MYBODY Lab GmbH) always applies.

Context: What a self-test for stomach pain cannot do

A self-test provides measurements, not a diagnosis. This distinction is particularly important for stomach pain because, according to IQWiG (2025), the most common causes can be identified and treated by a doctor.

No detection of infections, ulcers, or tumors

A microbiome analysis from a stool sample reflects the composition of the gut flora. It does not detect an infection with Helicobacter pylori, an ulcer, gastritis, or a tumor—medical examination procedures are intended for these purposes.

It cannot detect chronic inflammatory bowel diseases either. IQWiG (2026) describes Crohn’s disease as a chronic inflammatory bowel disease; in Europe, an estimated 320 out of 100,000 people have Crohn’s disease, and around 3 to 6 out of 100,000 people develop it each year. Such conditions require medical evaluation and treatment.

FODMAP guidance does not replace a supervised dietary change

The Complete test includes a FODMAP index. However, an elimination diet based on it should never be undertaken alone: According to IQWiG (2023), a low-FODMAP diet “carries the risk of malnutrition because it becomes difficult to consume enough vitamins and minerals.”

For context: “It is suspected that consuming FODMAPs causes more water to enter the intestine and promotes diarrhea,” writes IQWiG (2023). Such a dietary change should therefore be professionally supervised—by a nutrition specialist or the treating practice.

What a test result can realistically contribute

Realistically, a microbiome result is a snapshot of the gut flora and a basis for discussion. It can help structure a change in diet, but it cannot replace one or predict treatment success.

The order remains the same: first have the stomach complaints medically evaluated, then—if intestinal symptoms are also present—consider supplementary analysis.

Conclusion

Stomach pain is an upper-abdominal complaint with a manageable range of common causes: gastritis, a gastric or duodenal ulcer, reflux disease, and functional dyspepsia. For the first two, IQWiG (2025) identifies the same main causes—a Helicobacter pylori infection or regular use of anti-inflammatory painkillers.

Concretely, this means: For four weeks, note the location, timing, accompanying signs, and duration of your symptoms, and take these notes with you to your doctor’s office. If warning signs such as blood in the stool, black stool, vomited blood, fever, paleness, or significant weight loss occur, arrange an appointment promptly; in the event of sudden, severe abdominal pain, IQWiG (2025) advises calling emergency services at 112.

A gut flora analysis comes at the end of this process, not the beginning. It is worth considering when persistent intestinal symptoms occur in addition to stomach complaints and organic causes have been medically ruled out—as supplementary information, not a diagnosis.

Frequently asked questions

Sources

1. IQWiG / gesundheitsinformation.de: Gastritis (2025) — gesundheitsinformation.de
2. IQWiG / gesundheitsinformation.de: Gastric and duodenal ulcers (2025) — gesundheitsinformation.de
3. IQWiG / gesundheitsinformation.de: Functional dyspepsia (2025) — gesundheitsinformation.de
4. IQWiG / gesundheitsinformation.de: Heartburn and reflux disease (2024) — gesundheitsinformation.de
5. IQWiG / gesundheitsinformation.de: Irritable bowel syndrome (2023) — gesundheitsinformation.de
6. IQWiG / gesundheitsinformation.de: What helps with irritable bowel syndrome—and what does not? (2023) — gesundheitsinformation.de

The definition, causes, and symptoms of gastritis—including the institute’s verbatim quotation—are based on [1]. Pain patterns, frequency figures, warning signs of complications, and the advice to call emergency services at 112 are taken from [2]. The definition, prevalence, symptom types, exclusion diagnosis, and initial treatment steps for functional dyspepsia are based on [3], while the information on heartburn and reflux disease comes from [4]. The warning signs “significant weight loss, blood in the stool, fever, or paleness” and the description of irritable bowel symptoms are taken from [5], while the statements on FODMAPs, the risk of malnutrition, individual food reactions, and fiber supplements come from [6]. The guideline value of at least 30 g of fiber per day comes from the German Nutrition Society (DGE), Reference Values for Fiber, as of 2021; the information on Crohn’s disease comes from the IQWiG overview “Crohn’s Disease,” as of 2026. Product information comes from the mybody® product pages, accessed on July 28, 2026. All other sources cited in the text are identified directly at the relevant point by institution and year.

mybody® Editorial & Medical Team

Stomach & Upper Abdomen Gut Health Microbiome Nutritional Science

This article was created and medically reviewed by the mybody® Editorial and Medical Team. The team combines expertise in nutrigenetics, microbiome and gut science, blood analysis interpretation, nutritional science, and laboratory diagnostics.

Published on July 28, 2026 · Last updated on July 28, 2026

Medical notice: This article is for general information only and does not replace medical advice, diagnosis, or treatment. Persistent, severe, or recurring stomach pain should be medically evaluated; in the event of sudden, severe abdominal pain, call emergency services at 112. A microbiome test is not a diagnostic procedure and cannot detect gastritis, an ulcer, a Helicobacter pylori infection, or a tumor.