5 Abdominal Pain Warning Signs That Mean You Should Go to the ER

• Pain can hide emergencies
• Black stools are a warning sign
• Dizziness requires immediate attention

Abdominal pain can be caused by multiple factors, but there are signs that, when they appear along with this discomfort, can indicate that waiting at home is not the best option.

Gastroenterologist Trisha Pasricha, a physician and columnist for The Washington Post, identified five warning signs that may require an immediate visit to the emergency room.

Some of these signs may be little known: from feeling that the pain worsens when driving over a pothole to stopping the passage of gas or discovering that stools have turned black.

The key, according to Pasricha’s approach, is to observe not only how much the abdomen hurts, but also what other symptoms appear at the same time.

5 Signs of Abdominal Pain That Warn of Danger

1. Pain That Worsens When Coughing, Jumping, or Driving Over a Pothole Can Be a Warning Sign

One of the signs described by Pasricha is abdominal pain that increases when a person coughs, jumps, or even when the car drives over a pothole.

This worsening with movement can be a sign of peritonitis, i.e., inflammation of the lining of the abdominal cavity.

Behind this condition, there may be a perforation or rupture related to structures such as the intestine or appendix, among other possible causes.

In the event of suspected perforation, medical evaluation may include imaging studies, and depending on the findings, emergency surgery may be necessary.

• The sign to watch out for: that relatively small movements cause a clear increase in abdominal pain.

2. Stopping the Passage of Gas Along With Pain Can Indicate an Intestinal Obstruction

Being unable to pass gas may seem like a minor detail, but it takes on another importance when it occurs at the same time as abdominal pain.

Pasricha explains that the combination of abdominal pain and stopping the passage of gas can point to an intestinal obstruction.

Other symptoms that may accompany this problem include:

• Severe vomiting.
• Inability to keep fluids down.
• Difficulty tolerating food.
• Vomiting that can take on a dark green tone due to bile in certain obstructions.

An intestinal obstruction can become an emergency, so the simultaneous appearance of these signs requires medical evaluation and should not be treated simply as constipation.

3. Fever and Yellow Eyes Along With Abdominal Pain Can Hide a Severe Infection

Fever accompanied by abdominal pain can also warn of different problems, especially when other physical changes appear.

Pasricha pays special attention to jaundice, which can be recognized by a yellowish coloration of the skin or the white part of the eyes.

The combination of fever, abdominal pain, and jaundice can be related to an infection of the bile ducts, a situation that can rapidly evolve into sepsis.

In these cases, the patient may need intravenous antibiotics and a procedure to drain or unblock the bile ducts.

Therefore, yellow eyes or skin along with fever and abdominal pain represent a combination that should not be ignored.

4. Black Stools Can Reveal Bleeding That Does Not Always Appear Red

Gastrointestinal bleeding does not necessarily produce visible red blood, and that is why another sign can be easily overlooked.

When blood comes into contact with the acids in the stomach, stools can take on a black, sticky, and tar-like appearance.

There is also another sign that can accompany digestive bleeding: vomiting with an appearance similar to coffee grounds.

These symptoms can lead doctors to perform an urgent endoscopy to locate the source of the bleeding and stop it.

But Pasricha also makes an important distinction: iron supplements, medications containing bismuth, and certain foods can darken stools, so dark stools do not automatically mean there is bleeding.

5. Abdominal Pain and Dizziness Can Warn of Internal Bleeding

The last sign brings together two symptoms that, when they appear together, take on special importance: abdominal pain and dizziness or a feeling of fainting.

This combination can indicate internal bleeding and a drop in blood pressure, so it requires emergency attention.

Among the possible causes mentioned are:

• Peptic ulcers.
• Diverticular bleeding.
• Rupture of an abdominal aortic aneurysm.

This last emergency is especially dangerous because an aneurysm can develop over years without causing symptoms until it finally ruptures.

The rupture can cause sudden pain in the abdomen or back and rapidly trigger a potentially fatal hemorrhage.

The Aneurysm Can Remain Hidden for Years Before Becoming an Emergency

Pasricha also highlights the importance of prevention in the face of an abdominal aortic aneurysm, precisely because it can remain silent for a long time.

The gastroenterologist recalls the recommendation to perform a screening ultrasound on men between 65 and 75 years old who have ever smoked.

However, according to the data presented by Pasricha, only around 4% of eligible American men undergo this test.

The message that these five signs convey is clear: the severity of an abdominal problem does not always depend on the pain being unbearable.

An apparently strange change —not passing gas, feeling more pain when driving over a pothole, presenting jaundice, observing black stools, or experiencing dizziness— can provide crucial information about an emergency.

In the face of any of these combinations, especially when symptoms appear suddenly or worsen, the recommendation in the article is to seek urgent medical evaluation instead of waiting for them to disappear on their own.

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SOURCE: The Washington Post, article by gastroenterologist Trisha Pasricha