Abdominal Pain: When to Worry — ER vs Urgent Care vs Home Care
Learn when stomach and abdominal pain requires emergency care, urgent care, or home treatment. Red flag symptoms, cost estimates, and pain management strategies.
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Updated February 2026
Call 911 Immediately If You Have:
- Sudden, severe abdominal pain with rigid or board-like abdomen
- Vomiting blood or passing bloody/black stools
- Abdominal pain with high fever, chills, and rapid heartbeat
- Severe abdominal pain during pregnancy
These may indicate serious conditions like appendicitis, bowel obstruction, internal bleeding, or ectopic pregnancy.
On this page
Emergency Red Flags — Go to ER Now
Surgical Emergencies
- • Sharp RLQ pain (appendicitis)
- • Rigid abdomen (peritonitis)
- • Sudden severe onset that doesn't let up
- • Abdominal pain with inability to pass gas or stool (obstruction)
Bleeding Signs
- • Vomiting blood or coffee-ground material
- • Black tarry stools (melena)
- • Bright red blood in stool with pain
- • Abdominal pain after blood thinner use
Organ-Specific
- • RUQ pain radiating to shoulder (gallbladder)
- • Severe flank pain radiating to groin (kidney stone)
- • Upper abdominal pain radiating to back (pancreatitis)
- • Pelvic pain with dizziness (ectopic pregnancy)
Systemic Danger
- • Fever above 101.5°F with abdominal pain
- • Rapid heart rate with abdominal distension
- • Signs of dehydration (dry mouth, dark urine, no tears)
- • Jaundice (yellow skin/eyes) with pain
Time is critical: These symptoms may indicate appendicitis, bowel obstruction, internal bleeding, pancreatitis, or ectopic pregnancy requiring immediate treatment.
When to See a Doctor (Same Day or Soon)
Persistent Pain
- • Pain lasting more than 24-48 hours
- • Recurring episodes in same location
- • Pain gradually worsening over days
- • Pain that wakes you from sleep
Digestive Changes
- • Unexplained change in bowel habits
- • Persistent nausea or loss of appetite
- • Unintentional weight loss
- • Difficulty swallowing with pain
Associated Symptoms
- • Low-grade fever with abdominal discomfort
- • Painful or frequent urination
- • Pain with bloating that doesn't resolve
- • Heartburn not responding to antacids
Timing Concerns
- • Pain after eating specific foods (gallbladder)
- • Pain that comes in waves (kidney stone, obstruction)
- • Pain worse during menstrual cycle
- • Pain that started after new medication
What to Expect at Doctor Visit
Assessment
- • Abdominal examination (palpation)
- • Vital signs and hydration assessment
- • Review of pain location and timeline
- • Dietary and medication history
Possible Tests
- • Blood tests (CBC, liver, pancreas enzymes)
- • Urinalysis
- • Abdominal ultrasound or CT scan
- • Stool tests if indicated
Best Place to Go — Quick Comparison
| Care Setting | When to Choose | Tests You'll Get | Typical Cost |
|---|---|---|---|
Emergency Room | Sudden severe pain, rigid abdomen, vomiting blood, high fever + pain, pregnancy + pain. | CT scan, ultrasound, blood work, urine tests, possible surgery consult. | $1,500–$5,000+ Advanced imaging + surgical access |
Urgent Care | Moderate persistent pain, mild dehydration, UTI symptoms with pain. | Physical exam, basic blood/urine tests, pain management. | $200–$500 Same-day evaluation |
Doctor (Primary Care) | Recurring episodes, chronic pain, digestive changes, medication-related. | Detailed history, blood work, imaging referral, specialist referral. | $100–$250 Ongoing management |
Home Care | Mild cramping, gas/bloating, known IBS flare, mild food poisoning. | Symptom monitoring, dietary adjustments, OTC remedies. | $5–$25 OTC medications |
Cost Disclaimer: Estimates are before insurance and vary by location, tests needed, and specific treatments.
Sources: Cost estimates based on CMS Provider Data, KFF Healthcare Cost Analysis, and national healthcare pricing databases.
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When Home Care Is Appropriate
Mild Digestive Issues
Characteristics:
- • Gas, bloating, or mild cramping
- • Related to recent meal or known food sensitivity
- • No fever, vomiting, or blood
- • Pain is intermittent and tolerable
Known IBS or Chronic Conditions
Can manage at home if:
- • Familiar pattern of symptoms
- • No new red flag symptoms
- • Responds to usual treatment
- • No fever or significant worsening
Effective Home Treatments
Immediate Relief
- • Apply warm compress to abdomen
- • Sip clear fluids (water, broth, ginger tea)
- • Rest in comfortable position
- • Avoid solid food until nausea passes
Medications
- • Antacids for heartburn/indigestion
- • Simethicone for gas and bloating
- • Bismuth subsalicylate for mild nausea
- • Follow package instructions carefully
Prevention
- • Eat smaller more frequent meals
- • Avoid known trigger foods
- • Stay hydrated throughout the day
- • Manage stress (gut-brain connection)
When to Follow Up or Seek Care
Return to Doctor If:
- • Pain not improving after 48 hours
- • Recurring pain in same location
- • New nausea vomiting or fever developing
- • Blood in stool or dark tarry stools
- • Unintentional weight loss
- • Pain interfering with eating or sleeping
- • Increasing abdominal bloating
- • Pain with changes in bowel habits
Frequently Asked Questions
How do I know if abdominal pain is appendicitis?
Classic appendicitis starts with dull pain around the belly button that moves to the lower right abdomen within 12-24 hours. The pain worsens with movement, coughing, or pressing on the area. Other signs include loss of appetite, nausea, low-grade fever, and inability to pass gas. Seek emergency care immediately if you suspect appendicitis.
When should I go to the ER for stomach pain?
Go to the ER for severe sudden-onset abdominal pain, rigid or board-like abdomen, vomiting blood or bloody/black stool, abdominal pain with high fever, pain with inability to keep fluids down for 12+ hours, or abdominal pain during pregnancy. These may indicate appendicitis, bowel obstruction, internal bleeding, or other surgical emergencies.
How much does an ER visit for abdominal pain cost?
ER visits for abdominal pain typically cost $1,500-$5,000+ depending on tests (CT scan, ultrasound, blood work). Urgent care costs $200-$500 for milder cases. Costs vary by location, imaging needed, and insurance coverage.
Is it food poisoning or something more serious?
Food poisoning typically causes cramping, nausea, vomiting, and diarrhea within 6-24 hours of eating contaminated food and resolves within 1-3 days. Seek emergency care if you have bloody vomit or stool, fever over 101.5°F, severe dehydration (no urination, extreme thirst, dizziness), or pain that localizes to one specific area rather than general cramping.
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