Digestive symptoms such as gas, stomach aches, and irregular bowel movements have so many common and varied causes that it can be difficult to tell when to ride them out and when you shouldn’t. But if you’re able to recognize the signs your upset stomach isn’t normal, it will be much easier to make this distinction—and to take any necessary steps to prevent your GI woes from progressing to something more serious.
“If [symptoms] last for a day or two, it’s usually nothing to worry about,” said Eric Esrailian, M.D., M.P.H., the chair of clinical gastroenterology and the director of the Melvin and Bren Simon Digestive Diseases Center at UCLA. This is especially true if you can point to an extenuating circumstance, such as increased stress, recent travel, or new medications, that may be contributing to your issues. “It doesn’t mean you should ignore your stomach, but it’s probably not too concerning,” Dr. Esrailian said.
Meet the experts: Eric Esrailian, M.D., M.P.H., the chair of clinical gastroenterology and the director of the Melvin and Bren Simon Digestive Diseases Center at UCLA; Sarah Mirkin, R.D.N., the author of The Beginner’s Guide to Low-FODMAP.
At the same time, there are plenty of instances when an upset stomach warrants a visit to your doctor, or even a trip to the ER, he added. Here, experts explain how to tell if you’re experiencing a run-of-the-mill digestive problem or if you should be concerned that something else is going on.
Signs your upset stomach isn’t normal
Persistent changes to your habits
The most important thing to take note of is a persistent change in your stomach status, Dr. Esrailian explained, such as gas, stomach aches, or odd bowel movements that are unusual for you. “If you haven’t had issues before, and you have discomfort for more than a few days, it’s time to see your primary care physician,” Dr. Esrailian said. New and persistent changes could be signs of a new food sensitivity or other issue that requires dietary adjustments, said Sarah Mirkin, R.D.N., the author of The Beginner’s Guide to Low-FODMAP.
Stomach aches with side effects
While a brief period of discomfort isn’t too concerning, you’ll want to see a doctor if that discomfort is accompanied by what Dr. Esrailian called “alarm features.” These may include side effects or additional symptoms such as unexplained weight loss, difficulty swallowing, blood in the stool, or changes in your mood, he said. The list of potential gut conditions associated with these symptoms is long and includes everything from hemorrhoids to cancer.
Bloody movements
While blood in your toilet bowl may seem super scary, it’s often a sign of something benign. “If it’s a younger patient with a small amount of red blood on toilet paper after straining during a bowel movement, that could be a small tear in the tissue of the anal canal,” Dr. Esrailian said. “But if somebody’s older and has never had any blood, we start wondering if something more serious could be going on.” According to the Cleveland Clinic, bloody stool could be caused by hemorrhoids, anal fissures, inflammatory bowel disease (IBD), diverticulitis, peptic ulcers, certain infections, colon polyps, and colorectal cancer.
Worsening pain in one spot
If, every once in a while, you feel a stab of gut pain, that’s probably not something to freak out about. But if you have a pain that keeps popping up in the same place every day or every few days—and especially if that pain seems to be getting worse—that’s worth a call to your doctor. “Obviously if the pain is severe or debilitating, you want to go to the ER,” Dr. Esrailian said. He mentioned appendicitis (if the pain is in the lower-right quadrant of your abdomen) and gallbladder trouble (if the pain is in the upper-right quadrant) as two possible emergency issues.
GI woes that disrupt your sleep
If you start to experience stomach issues as soon as you climb into bed at night, this may be a sign of acid reflux, Dr. Esrailian said. “What we call functional disorders, things like irritable bowel syndrome, can also flare up at night and prevent sleep or disturb sleep,” he added. Whatever the case, you’ll want to let your doctor know about it. According to the Cleveland Clinic, poor sleep can also negatively impact the function of your digestive system, so addressing any issues may help improve your sleep and thus your digestive health overall.
The bottom line
If you experience any of the above symptoms, or anything GI-related that is new and unusual for you that lasts for more than a couple of days, give your doctor a call. This is especially important if you are at an increased risk for gut-related diseases. Dr. Esrailian said that if you are a smoker or have a family history of colon cancer or other GI diseases, don’t hesitate to visit your doctor if things seem out of the ordinary. Doing so can help you get any treatment you may need as quickly as possible.
This article was originally published in 2017 and has since been updated.
Additional reporting by the Editors of Prevention
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