SymptomDigestive system
Stomach Cramps: Causes, Relief and Red Flags
Stomach cramps are squeezing, twisting or gripping pains in the belly that often come and go in waves. They are usually caused by the muscles of the bowel or uterus contracting, as with gas, a stomach bug, constipation, irritable bowel syndrome or period pain, and settle within hours to days. Cramps that become constant and severe, or come with a rigid belly, persistent vomiting, blood or fever, need medical care.
Also called: Abdominal cramps, belly cramps, stomach cramping, tummy cramps, gut cramps
At a glance
- What it is
- Wave-like squeezing pain in the abdomen from muscle contractions in the gut or uterus.
- Common causes
- Gas, gastroenteritis, food poisoning, constipation, IBS, lactose intolerance, period pain.
- Usual duration
- Minutes to a few days, depending on the cause.
- Red flags
- Constant severe pain, rigid belly, vomiting everything, blood in stool or vomit, fever, pregnancy.
- Relief
- Heat, fluids, rest, gentle movement, and treating the cause.
When to get help
Call 911 or go to the ER
- Sudden severe pain that becomes constant, or a hard, rigid belly that hurts to touch
- Cramps with vomiting and inability to pass stool or gas, and a swollen belly
- Vomiting blood or passing large amounts of blood or black stools
- Severe cramps in pregnancy, or with a positive pregnancy test and bleeding or dizziness
- Cramps with fainting, confusion or a rapid heartbeat
See a doctor within a day or two
- Pain that moves to the lower right belly and gets worse over hours
- Cramps with a fever of 38.5 °C (101.3 °F) or higher
- Bloody diarrhea, or diarrhea and vomiting lasting more than 2 days in adults or 24 hours in young children
- Signs of dehydration: very dark urine, dizziness, very little urine
Book a routine appointment
- Cramping that keeps coming back over weeks
- Cramps with weight loss, a change in bowel habits or night-time symptoms
- Period cramps that are severe enough to miss work or school, or that have recently worsened
Usually safe to manage at home
- Mild cramps with gas, bloating or a brief stomach upset that ease within a day
- Usual period cramps that respond to heat and over-the-counter pain relief
What stomach cramps feel like
Cramps are usually colicky: they build, peak and ease, then return. You may feel a knot, twisting or gripping sensation, often with bloating, gurgling or an urge to pass stool or gas. The pain may be anywhere in the abdomen, though the location helps narrow the cause. Constant pain that does not come and go, or pain that is sharp and localized, suggests inflammation of an organ and is more concerning.
Common causes
Gas and indigestion
Swallowed air, fizzy drinks, beans, onions, cruciferous vegetables and sugar alcohols produce gas that stretches the bowel. Cramps ease after passing gas or a bowel movement.
Stomach bugs and food poisoning
Gastroenteritis from norovirus or other viruses causes cramps with diarrhea, vomiting and sometimes a low fever, usually for 1 to 3 days. Food poisoning starts within hours of eating contaminated food. Bacterial infections can cause stronger cramps and bloody diarrhea.
Constipation
Hard, infrequent stools cause cramping, bloating and a sense of fullness, often in the lower left belly. See constipation.
Irritable bowel syndrome (IBS)
IBS causes recurring cramps linked to bowel movements, with bloating and diarrhea, constipation or both. Pain often eases after passing stool. It affects about 1 in 10 people and is often triggered by certain foods and stress.
Food intolerances
Lactose intolerance causes cramps, bloating, gas and diarrhea 30 minutes to 2 hours after dairy. Some people react similarly to fructose or large amounts of FODMAP foods.
Period cramps
Dysmenorrhea causes lower belly cramps that start just before or at the start of a period and last 1 to 3 days, sometimes spreading to the back and thighs. Severe or worsening period pain can come from endometriosis or fibroids.
Other causes
- Exercise: side stitches and cramps during running.
- Medicines: antibiotics, metformin, iron, laxatives, NSAIDs.
- Anxiety and stress.
- Ovulation pain: one-sided lower cramps mid-cycle.
Serious causes to know about
| Cause | Clues |
|---|---|
| Appendicitis | Pain starting around the navel, moving to the lower right, worse with movement, loss of appetite, fever |
| Bowel obstruction | Severe waves of cramping, vomiting, swollen belly, no stool or gas |
| Inflammatory bowel disease | Ongoing cramps, diarrhea with blood or mucus, weight loss |
| Diverticulitis | Constant lower left pain, fever, usually over 50 |
| Ectopic pregnancy | Lower belly pain, missed period, spotting, dizziness |
| Gallstones | Steady upper right pain after fatty meals |
| Kidney stones | Severe waves of flank pain spreading to the groin |
Stomach cramps by pattern
| Pattern | Likely causes |
|---|---|
| Cramps and diarrhea | Gastroenteritis, food poisoning, IBS, lactose intolerance, IBD |
| Cramps and constipation | Constipation, IBS, rarely obstruction |
| Cramps after eating | Gas, IBS, food intolerance, gallstones (upper right) |
| Lower stomach cramps in women | Periods, ovulation, endometriosis, pelvic infection, pregnancy |
| Cramps at night | IBS, ulcers, gallstones |
| Cramps with fever | Infection, appendicitis, diverticulitis |
How doctors find the cause
A doctor will ask where the pain is, how it started, what makes it better or worse, and about bowel habits, vomiting, periods, pregnancy, food, travel and medicines. They will examine your abdomen for tenderness, swelling and guarding. Depending on the picture, tests may include urine and pregnancy tests, blood tests, stool tests, ultrasound or CT, and for recurring symptoms, celiac testing, fecal calprotectin or colonoscopy.
Stomach cramps relief
- Apply heat: a hot water bottle or heating pad relaxes cramping muscles.
- Sip fluids: water or oral rehydration solution if you have diarrhea or vomiting.
- Eat lightly: bland foods such as toast, rice, bananas and soup once you can eat. Avoid fatty, spicy food, alcohol and caffeine until better.
- Move gently: a short walk helps gas pass.
- Pain relief: acetaminophen (paracetamol) is gentle on the stomach. Ibuprofen and naproxen work well for period cramps but can irritate the stomach. Follow the label dose.
- Antispasmodics: peppermint oil capsules and over-the-counter antispasmodics may help IBS cramps.
- For gas: simethicone may help some people.
Avoid antidiarrheal medicines if you have bloody diarrhea or a high fever.
Preventing recurring cramps
Keep a food and symptom diary, eat regular meals, increase fiber gradually with plenty of water, reduce fizzy drinks and sugar alcohols, limit dairy if lactose is a problem, manage stress, and stay active.
Frequently asked questions
What causes stomach cramps?
Most stomach cramps are caused by gas, a stomach bug, food poisoning, constipation, irritable bowel syndrome, food intolerance or period pain. Less often they signal appendicitis, bowel obstruction, inflammatory bowel disease or gynecological problems, especially if pain is severe, constant or comes with fever or blood.
When should I worry about stomach cramps?
Get urgent help for severe or constant pain, a hard belly, vomiting with no stool or gas, blood in vomit or stool, high fever, fainting, or severe pain in pregnancy. See a doctor for cramps that keep coming back or come with weight loss or a change in bowel habits.
What helps stomach cramps fast?
Heat on the belly, sipping fluids, resting and a short gentle walk often help quickly. Acetaminophen can ease pain, and ibuprofen is effective for period cramps. Peppermint oil may relieve IBS-type cramps. Avoid heavy, fatty or spicy food until the cramps settle.
Why do I get stomach cramps and diarrhea?
Cramps with diarrhea usually mean the bowel is irritated or infected, as in gastroenteritis or food poisoning. IBS, lactose intolerance, medicines such as antibiotics, and inflammatory bowel disease are other causes. See a doctor if it lasts more than a few days or includes blood.
Can stress cause stomach cramps?
Yes. Stress and anxiety affect gut movement and sensitivity, causing cramps, urgency and diarrhea or constipation. This is common in IBS. Stress-related cramps should not cause fever, bleeding or weight loss, which need a doctor's assessment.
Sources
This guide was written from current patient and clinical guidance, including:
- National Institute of Diabetes and Digestive and Kidney Diseases: Symptoms and Causes of Irritable Bowel Syndrome
- MedlinePlus: Abdominal pain
- NHS: Stomach ache
- American College of Obstetricians and Gynecologists: Dysmenorrhea, Painful Periods
- CDC: Norovirus symptoms