When To See A Doctor For A Stomachache

I recently saw a middle-aged man who told me he had abdominal pain for four days, plus fever every day of 101-102 degrees. During the four days, the pain got steadily worse, while he lost his appetite and stopped having bowel movements.

While connecting with him, although he did not look terribly sick, he did not look really well, either. Instead, he looked tired and worn out, even though he had been home in bed during his illness. His wife checked his temperature again, with a thermometer under his tongue, and it was 102.

I then directed this young man go straight to the emergency room for further evaluation. They evaluated him, admitted him to the hospital, operated on him that evening, and removed his gall bladder. They told his wife it was “full of pus”, and badly infected.

Here are some warning signs that your “belly ache” may be more severe:

• Lasts too long: a belly ache lasting longer than one or two days
• Gets worse: the pain keeps getting worse, not better
• Accompanied by fever: 101 or higher, measured in the ear or under the tongue (forehead or underarm temperature measurements are less reliable)
• No appetite: the body is too ill to want food and the stomach is too ill to make hunger grumbles
• Unable to make a bowel movement: the bowels shut down when there is serious illness somewhere in the belly
• Tender to the touch: when the stomach is pushed and pressed upon pain in the stomach in sharp and intense with increasing pain.

These warning signs can signal a serious infection in one of the abdominal organs, or in the lining of the abdomen (called PERITONITIS), or both. They call for prompt evaluation and often require surgery, as in this case. Otherwise, they can be life-threatening.

It’s also a good idea to include a family member in the consultation, to verify the story, help with the exam and get the patient to an urgent care or emergency facility for further evaluation and advanced care, as needed.