When Should I Trust My Gut and Go to the ER?

Stomach pain is now one of the top reasons both adults and children go to the ER. A National Center for Health Statistics report of the decade 1999-2008 shows a nearly 32 percent increase in non-injury emergency department visits in which abdominal pain was the primary reason for the visit.

Which is interesting but not very useful when it’s you who’s trying to decide if a trip to the ER is necessary. So here’s a little help.

You should seek immediate treatment for stomach pain that is:

  • Accompanied by a high fever
  • Accompanied by repeated vomiting
  • Accompanied by other serious or unusual symptoms, such as difficulty breathing or change in behavior
  • Severe or prolonged (lasting 24 or more hours)
  • Localized to one particular area
    • Right lower quadrant could indicate appendicitis
    • Right upper quadrant could indicate cholecystitis, or a gallbladder infection
    • Left lower quadrant could indicate diverticulitis, or a colon infection
Stomach pain

5 questions to ask someone with abdominal pain.

The questions below were developed by an ER doctor for her friends and family and can be used to help decide if you should go to the ER.

  • Severity: Does it hurt so badly that it’s hard or impossible to concentrate or perform normal activities?
  • Vomiting: Are you vomiting? While vomiting doesn’t automatically signal a trip to the ER, if you’re unable to keep down fluids or are vomiting up blood, it’s time to go.
  • Output: Are your stools a different color than normal, such as bloody or dark black (also potentially a sign of bleeding) or are you having diarrhea? Like vomiting, diarrhea isn’t necessarily serious unless it causes dehydration. If you’re unable to keep down liquids and you’re having excessive diarrhea, you may need to have fluids administered. What about changes to your urine? Are you going more or less than normal? Is it bloody or another unusual color?
  • Other symptoms: Are you having difficulty breathing? Chest pain? Does your abdominal pain spread directly to your back?
  • Health history: Have you recently suffered an abdominal injury or had abdominal surgery? Are you pregnant or have you recently given birth? Are you on chemotherapy or do you have any other conditions that could compromise your immune system?

If you are having a medical emergency, call 911.