Persistent stomach pain means discomfort in your belly region that sticks around for weeks, months, or even longer. Unlike an occasional cramp or a brief stomachache, this pain doesn’t fully go away and often comes and goes in a pattern, or it might gradually get worse. The abdomen holds a ton of important organs, your stomach, intestines, liver, pancreas, kidneys, reproductive organs, and more, so pinpointing what’s wrong can be tricky.

Common and uncommon reasons why your stomach won't quit hurting
According to Mayo Clinic, a major trusted US healthcare resource, abdominal pain causes stretch from the simple and harmless (like indigestion or muscle strain) to the complex and serious (such as cancer or organ disease). Studies in primary care settings show that about one in ten patients with abdominal pain actually have acute or urgent medical issues that need immediate attention.

Here’s an easy-to-scan breakdown of notable conditions that often underlie persistent abdominal pain:

Digestive issues
Irritable Bowel Syndrome (IBS)
IBS is like that annoying roommate who never leaves. It messes with your gut, especially the large intestine, causing cramping, bloating, gas, and unpredictable bathroom runs. There’s no obvious damage in your intestines, but the pain and discomfort feel very real and very frequent.

Gastroesophageal Reflux Disease (GERD)
If you constantly feel like your lunch is trying to climb back up, GERD might be the culprit. It’s when stomach acid flows the wrong way into your esophagus, leaving a burning feeling in your chest or throat. It’s not just heartburn it can become a daily struggle if left untreated.

Gastritis and peptic ulcers
Your stomach lining isn’t invincible. Inflammation (gastritis) or open sores (ulcers) can cause sharp or burning pain in your upper belly. Often caused by an H. pylori infection or too many painkillers like ibuprofen, these conditions also bring nausea, bloating, and that gnawing empty-stomach feeling.

Celiac disease
This autoimmune condition means your body goes to war with gluten, a protein found in wheat, rye, and barley. Eat it, and you could end up with stomach pain, diarrhea, fatigue, and nutrient deficiencies. It’s more than a trendy gluten-free diet; it’s a serious medical issue.

Inflammatory & infectious causes
Diverticulitis
Little pouches can form in your colon (called diverticula), and sometimes they get infected. When that happens, welcome to diverticulitis. It usually causes pain in the lower left side of your belly and might come with fever, nausea, and even constipation.

Crohn’s disease & ulcerative colitis
Both are forms of inflammatory bowel disease (IBD), and they love to stir up trouble. Think chronic pain, diarrhea, fatigue, and sometimes weight loss. Crohn’s can affect any part of the digestive tract, while ulcerative colitis sticks to the colon and rectum. Either way, it’s a painful and ongoing battle.

Pelvic Inflammatory Disease (PID)
For women, lower abdominal pain could be caused by PID, a serious infection of the reproductive organs. It often stems from untreated STIs and can bring fever, unusual discharge, and pain during sex. If not treated early, it can lead to long-term issues like infertility.

Structural & functional problems
Gallstones
These tiny troublemakers form in your gallbladder and can block the flow of bile. When that happens, you might get hit with sudden, intense pain in your upper right abdomen—pain that often shows up after a fatty meal and sticks around for hours.

Kidney stones
If you've ever felt like your body is trying to pass a jagged rock, that’s a kidney stone. The pain usually starts in your back or side and radiates down to your lower belly or groin. It comes in waves and is often brutal.

Hernias
When an organ or tissue pushes through a weak spot in your abdominal wall, it’s called a hernia. You might notice a bulge and feel pain when you cough, lift, or even laugh too hard. It’s not just annoying—it can become serious if not treated.

Serious conditions to watch for
Cancer
Ongoing belly pain that doesn’t go away could point to something serious like cancer. Tumors in the pancreas, liver, or intestines often don’t show symptoms early on, but when pain shows up, especially if it gets worse over time, it’s time to see a doctor.

Vascular problems
Chronic mesenteric ischemia is a rare but serious condition where blood flow to your intestines gets restricted. You’ll often feel cramping pain after eating because your digestive system isn’t getting enough oxygen. It’s sneaky but dangerous if missed.

Appendicitis
Starts as a dull ache around your belly button and then suddenly shifts to the lower right side—that’s the classic sign of appendicitis. It can come with nausea, fever, and a sense that something's not right. It’s a medical emergency, so don’t wait it out.

A 2014 systematic review published in Family Practice highlighted that about a third of abdominal pain cases have no definitive diagnosis after initial evaluation, underscoring the complexity and diagnostic challenge clinicians face. Still, the most common diagnoses among U.S. primary care patients presenting with abdominal pain were gastroenteritis (7-19%), irritable bowel syndrome (3-13%), urological causes like kidney infections or stones (5%), and gastritis (5%).

More recent gastroenterology research emphasizes the need to consider less obvious causes like vascular diseases—for example, median arcuate ligament syndrome (a rare compression of an artery) and chronic mesenteric ischemia, both of which can cause persistent or recurrent abdominal pain. These are less common but can be overlooked, especially if a patient has risk factors like smoking, diabetes, or heart disease common in US populations.

Why is it important to know this?
In the US, where lifestyle factors such as high-fat diets, obesity, and sedentary living are prevalent, risks for digestive and vascular causes of abdominal pain may be higher. For instance, nonalcoholic fatty liver disease, which can cause liver pain, is on the rise and can lead to more serious liver damage if left unchecked. Similarly, obesity and diabetes increase risk for gallstones and vascular issues that cause chronic abdominal symptoms.

If your abdominal pain is persistent, worsening, associated with symptoms like unintentional weight loss, vomiting, blood in stool or urine, jaundice (yellowing of eyes/skin), fever, or changes in bowel habits lasting more than a few weeks, seek medical help. These could be signs of serious underlying diseases needing prompt diagnosis and treatment.

Primary care physicians often use a combination of detailed history, physical exams, lab tests, imaging (ultrasound, CT scans), and sometimes endoscopies to find the cause. They may refer you to gastroenterologists, surgeons, or other specialists for more advanced care.

Lifestyle and prevention tips
Though causes can be varied, there are some general tips for better gut and abdominal health:

• Eat a balanced diet rich in fiber, fruits, and vegetables.
• Stay hydrated and exercise regularly.
• Limit excessive use of NSAIDs, alcohol, and smoking.
• Manage chronic conditions like diabetes and high blood pressure.
• Report new or persistent pain to a healthcare provider.

Disclaimer: This information is for educational purposes only and does not replace professional medical advice. If you experience persistent or severe abdominal pain, consult a healthcare provider promptly for diagnosis and treatment. Individual conditions vary, and only a qualified professional can provide guidance tailored to your specific health needs. Always seek urgent care for sudden or worsening symptoms.