Stomach issues are the worst—and they can sometimes be embarrassing (we’ve all had unexpected diarrhea before, right?). But there are different kinds of pain, and each one can offer insight into what’s really going on in your gut. Here are some of the most common stomach symptoms and what they might be telling you about your health:
1. Burning in your chest
What it could be: Acid reflux
When you have acid reflux, stomach acid is literally washing back up into your chest, says Niket Sonpal, M.D., assistant clinical professor at Touro College of Medicine in New York City. Most people will experience the burning sensation right below their breastbone.
What to do: There’s no one-size-fits-all solution, says Sonpal. “Your heartburn trigger foods are as individual as you are,” he says. The good news is, once you figure out what bothers you, cutting it out of your diet should help a lot. You can also sleep slightly propped up (at about a 15 degree angle) to help keep the acid down in your stomach where it belongs.
2. Pain around your belly button
What it could be: Appendicitis
If you’re experiencing an appendix issue, it’ll usually start with a dull pain right around your belly button. As it worsens, the intense discomfort will move towards your right hip bone.
What to do: Get yourself and your swollen appendix to the hospital, ASAP. Appendicitis means you’ll need surgery to remove that sucker. If you don’t have it taken care of right away, you run the risk of the appendix rupturing, which is insanely dangerous. Don’t wait in the hopes that the pain will subside.
3. Sharp pain under your ribs
What it could be: Gallstones
Gallstones are little lumps of cholesterol and bile that can be as small as a pea or as big as a golf ball. No matter the size, an obstruction in your gallbladder causes a sharp pain that might worsen after eating.
What to do: Unfortunately, estrogen, contraceptive use, and general fertility all impact your risk for getting them. “Basically, being female predisposes you for gallstones,” says Sonpal. If they’re an issue for you and you’re on the Pill, talk to your GP about alternative methods of birth control. Gallstones usually aren’t cause for major concern, but if they continue to cause problems, surgery might be an option.
4. Burning in your stomach
What it could be: Peptic ulcer
“If you have chronic pain every day and it’s typically worse after eating, that’s a classic symptom of an ulcer,” says Sonpal. Unlike heartburn, which occurs in the chest, you’ll feel this burn right in your gut.
What to do: Stop taking OTC pain meds like ibuprofen, since they make the problem way worse. Visit your doc: Depending on the severity of the ulcer, you might need meds or even surgery.
5. Whole belly discomfort and the urge to run to the bathroom
What it could be: Lactose intolerance
“If a person cannot eat lactose, it’s not going to centralise to a specific area,” says Sonpal. “Your whole belly is going to feel discomfort, because it’s really a small intestine problem.” And unfortunately, that’s not the worst of it. That discomfort is caused by a mix of gas and diarrhea, which means—you guessed it—an explosive trip to the bathroom.
What to do: First, you have to figure out your level of lactose intolerance. You could be totally good with a few slices of pizza, or a single bite of ice cream might put you over the edge. “To test it, I tell my patients to ‘Netflix and lactose,'” says Sonpal. “Have a couple of glasses of milk, put on a show, and see what happens. Then we’ll go from there.”
6. Intestinal cramps and chronic diarrhea
What it could be: Gluten sensitivity
If you’re allergic to gluten or have celiac disease, you’ll notice bloating, gas, and cramps in your gut after eating foods containing gluten.
What to do: Similar to the “Netflix and lactose” method, test how you react to certain foods, and talk to your doc about the best way to eliminate them. If the allergy is severe, you might want to involve a nutritionist to make sure you’re still getting enough of the nutrients you need.
7. Bloody diarrhea, pain, and fever
What it could be: Colitis or Crohn’s disease
Along with gas, cramps, and bloating, you also might see blood in your poop, accompanied by nausea and fever. Not fun.