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Medically reviewed guide · Last updated: 23 July 2026 · Reading time: approx. 9 min.
Stomach pain: spotting the causes, acting correctly
At a glance
What is it?Pain or pressure in the upper abdomen, often burning, pressing or cramping — usually around the stomach below the breastbone
Usually harmless?Yes — most stomach pain is temporary and harmless, for example with an irritable stomach, stress or after a heavy meal
Common triggersStress, heavy or fatty meals, alcohol, painkillers (especially NSAIDs such as Ibuprofen), gastritis, gastrointestinal infection
Warning signsVomiting blood, black stools, sudden severe abdominal pain with a hard abdomen, radiation into the chest or arm — get checked immediately
Key distinctionTiming matters: pain on an empty stomach or at night points more to an ulcer or gastritis, shortly after eating more to an irritable stomach
What to do?Light diet, review triggering medication, acid blockers if needed — and note your symptoms together with their timing
Understand and document stomach pain
Record when the pain occurs, what you have eaten and which medication you take — a clear overview that is worth its weight in gold at your doctor's appointment. Free of charge.
Stomach pain is discomfort in the upper abdomen, usually in the middle below the breastbone. It can feel very different: burning, pressing, cramping or a dull pulling sensation. Often it is accompanied by a feeling of fullness, nausea, belching or loss of appetite. Medically, this upper abdominal discomfort is often grouped under the term "dyspepsia".
In the vast majority of cases, stomach pain is not caused by a serious illness but by an irritated stomach — for example after a heavy meal, during stressful periods or due to irritant substances such as alcohol or certain painkillers. The symptoms often disappear on their own once the trigger is removed.
The most important thing first
Most stomach pain is harmless and temporary. What matters for the assessment is when the pain occurs (on an empty stomach, at night or after eating), whether warning signs such as vomiting blood or black stools are present, and whether you take medication such as Ibuprofen.
2. Harmless or dangerous?
The key question is not just "does my stomach hurt?", but "how does it hurt and what else is going on?". Two situations should be kept apart:
Temporary, mild stomach pain: usually harmless. Typical are symptoms after eating, during stressful phases or with a gastrointestinal infection, which subside on their own after hours to a few days.
Recurring, severe or nocturnal pain: may indicate gastritis (inflammation of the stomach lining) or a stomach ulcer and should be assessed by a doctor — especially if it occurs on an empty stomach or at night.
Stomach pain often goes hand in hand with heartburn when stomach acid plays a role. It becomes dangerous above all when vomiting blood, black stools, a sudden severe abdominal pain with a hard abdomen or radiation into the chest or arm occur (see the chapter "When to see a doctor").
3. Causes & triggers
Stomach pain often has no dangerous cause but arises from irritation of the stomach or disturbed digestion. Frequently a connection with diet, stress or medication can be identified.
Diet: heavy, fatty or spicy meals, eating in a rush, coffee and alcohol irritate the stomach.
Stress and tension: psychological strain is one of the most common causes of an "irritable stomach" (functional dyspepsia) without any disease-related findings.
Painkillers (NSAIDs):Ibuprofen, Diclofenac and similar anti-inflammatory painkillers attack the protective stomach lining — a common, often overlooked cause.
Gastritis: an inflammation of the stomach lining, triggered for example by the bacterium Helicobacter pylori, alcohol or, indeed, painkillers.
Gastrointestinal infection: viruses or bacteria often cause pain together with nausea, vomiting and diarrhoea.
Stomach ulcer: a deeper defect in the lining that typically hurts on an empty stomach and needs medical treatment.
Other causes: less commonly, gallbladder, pancreas or heart problems are behind it, which can present as upper abdominal pain.
Often overlooked: painkillers
Anti-inflammatory painkillers such as Ibuprofen or Diclofenac (NSAIDs) are one of the most common causes of stomach complaints and ulcers — especially with regular use. If you take such medication frequently and develop stomach pain, discuss it with your practice. More on this in the guide Stomach problems caused by medication.
The connection with food, stress or painkillers in particular is easy to observe yourself. A simple log helps to spot patterns.
4. Timing as the key
A simple but very informative self-check for stomach pain is the question: When exactly does it hurt? The timing in relation to eating often gives the decisive clue to the cause — and is especially valuable for the conversation with your doctor.
Timing of the pain
What is more likely behind it
On an empty stomach or at night, improved by eating
More likely a stomach ulcer or duodenal ulcer
Shortly after eating, feeling of fullness
More likely an irritable stomach (functional dyspepsia) or gastritis
Burning behind the breastbone, worse when lying down
More likely heartburn / reflux of stomach acid
With nausea, vomiting, diarrhoea
More likely a gastrointestinal infection
Table scrollable to the right
This categorisation is a pointer, not a diagnosis. It is best to note over several days when the pain comes, how long it lasts, what you have eaten and whether you have taken medication. It is precisely this pattern that helps the practice find the right cause more quickly.
Your stomach log always with you
With brite you record the timing, triggers, diet and medication — the best basis for the practice to quickly get to the bottom of your stomach pain.
Stomach pain is usually harmless, but there are clear situations in which you should have it checked or act immediately.
You should seek prompt medical assessment if the pain recurs frequently, is severe, lasts longer than one to two weeks, occurs on an empty stomach or at night, or if you regularly take painkillers (NSAIDs). Unintended weight loss, persistent vomiting, difficulty swallowing or new-onset stomach pain in people over 50 should also be investigated by a doctor.
Call the emergency number 112 immediately
If stomach pain occurs together with vomiting blood or black, tarry stools, a sudden, severe abdominal pain with a hard, board-like abdomen or radiation into the chest, arm or jaw (possible heart attack!). These signs can indicate bleeding, a perforation or a heart problem and are an emergency.
6. Diagnosis
To find the cause, the practice has simple and informative examinations available. It is important to describe the symptoms as precisely as possible — above all the timing and possible triggers.
Detection of the stomach bacterium via breath test, stool or biopsy
Blood test
Signs of inflammation, anaemia, liver and pancreatic values
Ultrasound of the abdomen
Assesses the gallbladder, liver, pancreas
Gastroscopy (endoscopy of the stomach)
Direct view of the lining, detects gastritis and ulcers
Table scrollable to the right
In younger people without warning signs, a trial treatment is often given first (e.g. with an acid blocker) and further investigation only follows if there is no improvement. A gastroscopy is recommended above all in the case of warning signs, persistent symptoms or from a certain age onwards. A well-kept symptom and medication log makes the assessment even easier.
7. What you can do yourself
Light diet and small meals: several small, easily digestible portions instead of a few heavy meals, eating calmly and chewing well.
Avoid irritants: cut down on alcohol, nicotine, coffee, very fatty and spicy foods for a while and observe whether it improves.
Review painkillers: if you take NSAIDs such as Ibuprofen, talk to your practice about alternatives or accompanying stomach protection — do not keep taking them long-term on your own initiative.
Acid blockers if needed: in the short term, medication such as Pantoprazole or Omeprazole can reduce acid production and relieve the stomach. For longer-term use, have it assessed by a doctor.
Reduce stress: relaxation exercises, exercise and sufficient sleep often help noticeably, especially with an irritable stomach.
Keep a log: when does the pain occur, for how long, with which trigger? This helps you and the practice.
Spot triggers, understand patterns
brite helps you document stomach pain, diet and medication over time — free of charge and ad-free.
Stomach pain is often linked to food, stress or medication — and it is precisely this connection that is hard to keep track of in everyday life. Anyone who records their symptoms, timing and triggers over time gives the practice the decisive clues. brite makes this easy.
Health history — document stomach pain, timing, diet and possible triggers (stress, alcohol, painkillers) over time and bring them along as an overview to your appointment. Track your history
Intake reminder — if an acid blocker such as Pantoprazole is prescribed, brite reliably reminds you to take it correctly (often in the morning before eating). Set up a reminder
Interaction check — checks whether medication you take, such as Ibuprofen, puts a strain on the stomach or combines unfavourably. Check now
Digital medication plan — all your medication clearly in one place for your GP and gastroenterology. To the medication plan
Usually not. Most stomach pain is temporary and harmless, for example with an irritable stomach, stress or after a heavy meal. It becomes dangerous when vomiting blood, black stools, a sudden severe abdominal pain with a hard abdomen or radiation into the chest or arm are added — then it is an emergency.
Pain on an empty stomach or at night that improves with eating points more towards a stomach or duodenal ulcer or gastritis. If the pain instead occurs shortly after eating with a feeling of fullness, an irritable stomach is more often behind it. The timing is an important clue for the practice.
Yes. Anti-inflammatory painkillers (NSAIDs) such as Ibuprofen or Diclofenac attack the protective stomach lining and are a common, often overlooked cause of stomach pain and even ulcers. This is especially true with regular use. In this case, discuss alternatives or stomach protection with your practice.
Rest, warmth (e.g. a hot water bottle), a light, gentle diet and small meals often help. You should avoid irritants such as alcohol, coffee and fatty foods. For acid-related symptoms, acid blockers can help in the short term. If the pain persists or recurs frequently, have the cause assessed by a doctor.
Stomach pain usually sits in the upper abdomen and feels pressing, burning or cramping. Heartburn is a burning sensation behind the breastbone caused by stomach acid flowing back, and it often gets worse when lying down. Both can occur together when stomach acid plays a role.
Yes. Stress and psychological strain are one of the most common causes of an irritable stomach (functional dyspepsia), in which there are symptoms but no disease-related findings. Relaxation exercises, exercise, regular meals and sufficient sleep can often relieve the symptoms considerably.
Have it checked if the pain recurs frequently, is severe, lasts longer than one to two weeks, occurs on an empty stomach or at night, or if you regularly take painkillers. Unintended weight loss, difficulty swallowing or persistent vomiting should also be investigated. Call the emergency number 112 immediately if you have vomiting blood, black stools or sudden severe abdominal pain.
Gastritis is an inflammation of the stomach lining. It can be triggered by the bacterium Helicobacter pylori, by painkillers (NSAIDs), alcohol or stress and causes upper abdominal pain, a feeling of fullness and nausea. Depending on the cause, it is treated with acid blockers or an antibiotic therapy against Helicobacter.
Harmless stomach pain, for example after eating or with an infection, usually subsides within hours to a few days. If it lasts longer than one to two weeks, keeps coming back or becomes stronger, you should have the cause assessed by a doctor — especially with nocturnal pain or warning signs.
gesundheitsinformation.de (IQWiG): Stomach pain, gastritis and stomach ulcers. gesundheitsinformation.de
German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS): Guidelines on dyspepsia and Helicobacter pylori. dgvs.de
Institute for Quality and Efficiency in Health Care (IQWiG): Painkillers and stomach protection. gesundheitsinformation.de
This article is intended for general information and does not replace medical advice, diagnosis or treatment. If you have stomach pain together with vomiting blood, black stools, sudden severe abdominal pain or radiation into the chest or arm, please call the emergency number 112 without delay.
