How to Describe Stomach Pain to a Doctor

"Where does it hurt?" sounds like the easiest question in medicine. With stomach pain it often is not. The pain seems to be everywhere, it changes from hour to hour, the word "cramping" feels far too small for what happened on the bathroom floor last Tuesday, and by the time you are sitting in the consulting room it has faded to a dull ache that makes you sound as though you are making a fuss.

The short answer is to describe six things, in roughly this order: where the pain sits and whether it moves, what it feels like, how it behaves over time, what changes it, what comes with it, and what it stops you doing. Then give a usual and a worst rating, each tied to something you could or could not do, rather than one number out of ten. If anything about the pain is new or different from your usual pattern, say that before anything else.

That is not a script invented for patients. It is close to how doctors are trained to take a pain history, and it maps onto what the evidence says actually carries information in gut pain. NICE's IBS guideline, for example, tells clinicians to establish "the quantity and quality of the pain or discomfort", to identify its site "(which can be anywhere in the abdomen) and whether this varies", and to ask open questions about how symptoms affect daily life, such as leaving the house (NICE CG61). If you arrive having already thought about those things, the conversation starts in the right place.

This post is only about pain: the vocabulary, the location problem, the timing, the out-of-ten question, and how pain gets written down. Our guide on how to explain IBS to your doctor covers the whole consultation opener, stools and red flags for IBS; how to prepare for a GI appointment covers the run-up and the one-page summary; and what a symptom tracker for your doctor should contain covers the handover document. We link to them rather than repeating them. Where we say we "could not find" something, that reflects our searching of PubMed and Europe PMC for this article, not proof that nothing exists.

The short answer: six things, in this order

Here is the order that works, with the question each part answers for the person listening.

1. Anything new. Is this the pain you always have, or is something different? For someone with a long-standing gut condition this decides whether the conversation is about management or about a new problem.
2. Where. Where it sits, whether you can pinpoint it, and whether it moves or spreads.
3. What it feels like. Cramping, aching, burning, sharp, pressure, and how it makes you feel.
4. How it behaves. Sudden or gradual onset, how long an episode lasts, how often, whether it ever fully goes away.
5. What changes it. Eating, opening your bowels, passing wind, moving, lying still, your period, time of day.
6. What comes with it and what it costs you. Diarrhoea, constipation, bloating, nausea, sweating, fever, blood. And what the pain stops you doing.

Most people naturally start with number 3 and stop there. "I get really bad cramps" is true, but it is the least informative sentence available, because nearly every cause of abdominal pain can be described as cramping. The rest of this article takes each part in turn and explains what makes it useful.

Why stomach pain is so hard to put into words

Stomach pain is hard to describe because the gut reports pain differently from skin or muscle, not because you are bad at describing it. Visceral pain, meaning pain from internal organs, is the most common form of pain produced by disease and one of the most frequent reasons people seek medical attention, yet it has been studied far less than pain from skin, muscles and joints, and its management is frequently unsatisfactory (Cervero 1999).

The anatomy explains a lot. The nerve supply to the internal organs is sparse compared with other tissues, and as a result visceral sensations tend to be diffuse, are typically felt in other body structures rather than in the organ itself (referred pain), and are difficult to localise (Gebhart 2016). Skin tells you exactly where you were touched. The bowel tells you, roughly, that something somewhere in the middle of you is wrong.

A small study from 1973 shows this vividly. Researchers inflated a balloon in the lower colon, at the same spot every time, in 67 people with what was then called irritable colon syndrome and 16 comparison volunteers. The stimulus was in one place. Where people felt it was not: 40% felt the pain low in the middle of the abdomen, 31% in one or both sides of the lower abdomen, 21% in the rectum, and 8% in the back or elsewhere (Ritchie 1973). Same balloon, same position, four different answers to "where does it hurt?"

The same study found something else that matters for this article. At a balloon volume of 60 ml, 55% of the people with IBS reported pain compared with 6% of the comparison group, even though the measured tension in the bowel wall was normal in the IBS group (Ritchie 1973). It is an old, small study, and its comparison group mixed healthy and constipated volunteers, but it was one of the first pieces of evidence for what is now called visceral hypersensitivity: an ordinary stretch of the bowel being felt as pain.

So two things are true at once. Your pain can be real and severe, and it can still be genuinely hard to pin down. Neither makes you an unreliable witness. The practical consequence is that you should describe the pain the way your body presents it, including the vagueness, rather than trying to force it into a tidy anatomical answer.

"Where is it?" when it seems to be everywhere

Point with your hand instead of naming an organ. "It's my stomach" or "it's my colon" is a guess about the cause. "Here, spreading across to here" is data.

Clinicians often think about the abdomen in regions: upper right, upper left, lower right, lower left, and the midline (upper middle, around the belly button, low in the middle). You do not need the terminology. Put your hand where the pain is and say three things:

• Where it usually starts. Even if it spreads, most pain has a home.
• Where it spreads to. Across the belly, round to the back, down into the rectum, up under the ribs, or into the shoulder.
• One finger or a whole hand. Can you cover it with a fingertip, or does it take your palm or more?

That last question is worth taking seriously, because the answer points in different directions. Pain from the gut itself tends to be diffuse, for the reasons above. Pain that is sharply localised, with tenderness in the skin and muscle over one small spot, can come from the abdominal wall rather than from anything inside. Chronic abdominal wall pain is frequently misdiagnosed as coming from the gut, and in gastroenterology practices it may account for about 10% of people with chronic unexplained abdominal pain (Srinivasan 2002). A doctor can check for it with a simple test at the bedside, pressing on the tender spot while you tense your stomach muscles: pain from the wall tends to get worse, pain from inside tends not to. That review estimated the chance of missing a disease inside the abdomen at probably less than 7% when strict criteria are applied, which is why it should be a doctor's call and not a self-diagnosis. But you can only get that conversation if you say "I can put one finger on it and it's tender to touch".

"It moves around" is a finding. NICE notes that IBS pain can be anywhere in the abdomen and can vary, and that this distinguishes it from cancer-related pain, which typically has a fixed site (NICE CG61). In a study of 568 people who completed a detailed symptom questionnaire and then had a full diagnostic work-up, pain that radiated outside the abdomen was associated with a final diagnosis of IBS rather than organic lower gut disease (odds ratio 2.9) (Hammer 2004). In the same study, people whose final diagnosis was functional dyspepsia were significantly more likely to report pain in the upper abdomen. So "upper middle, after meals" and "lower down, moves about, sometimes into my back" send a doctor down different paths, even though both might be described by the patient as "my stomach".

A pain that moves once and then stays put is different. The one kind of movement to flag urgently is pain that starts in one place and then migrates and settles somewhere else, classically from around the belly button to the lower right. In a meta-analysis of the diagnosis of appendicitis, a history of migrating pain was one of the strongest discriminating features, alongside signs of peritoneal irritation and blood markers of inflammation, although every single feature was a weak guide on its own (Andersson 2004). If your pain has done that, it is not a "describe it at the next appointment" situation. See a doctor the same day.

One community thread asking people with IBS where they feel their pain drew answers ranging from around the belly button, to the left side, to "everywhere like someone is squeezing me" (r/ibs thread). That spread is normal for gut pain. What makes your answer useful is not that it matches anyone else's, but that it is consistent: the same home, the same spread, described the same way each time.

What it feels like: words that carry information

Use the plainest word that fits, then attach the pattern. The single word matters less than people think; the pattern it comes in matters more.

It also helps to know that pain has more than one dimension, and all of them are legitimate to describe. The McGill Pain Questionnaire, one of the oldest structured pain tools, sorts pain words into three classes: sensory words (what it physically feels like: cramping, burning, stabbing), affective words (what it does to you: exhausting, sickening, frightening) and evaluative words (how bad overall: annoying, miserable, unbearable) (Melzack 1975). People often hold back the second and third kinds for fear of sounding dramatic. They should not. "Frightening" is information: it tells a clinician something about the intensity and about what the pain is doing to your life.

Here is a working vocabulary, with what each word tends to prompt a clinician to ask next. This is about making your description useful, not a key for diagnosing yourself: plenty of different conditions share every one of these words.

The table makes a point that runs through the whole article: almost every word on the left needs something from the middle column before it carries much weight. "Cramping" is the most common word people with gut conditions use, and it covers everything from mild wind pain to an obstruction. "Cramping that comes in waves of about a minute, builds, and eases briefly after I pass stool" is a description a clinician can reason with.

Patient communities are full of vivid language for this, and vivid is fine. One long-running r/ibs thread about hard-to-describe, near-constant abdominal pain landed on phrases like "insides are raw" and "gnawing", which several people said they had been looking for for years (r/ibs thread). If a metaphor captures it, use it, then add the plain facts: where, how long, what changes it.

How it behaves over time: the pattern is the point

The timing of pain often tells a clinician more than its character. There is direct evidence that this is also true of how much pain affects people.

In a study of people with IBS that asked them to rate many separate dimensions of their pain, including intensity, frequency, constancy, predictability, duration of episodes, speed of onset and relationship to bowel movements, four dimensions were strongly and independently linked to how severe their illness was overall: intensity, frequency, constancy and predictability (Spiegel 2010). The authors, whose work was NIH-funded, concluded that measuring pain as a single number misses much of what drives the illness. In other words, "how often, how constant, and how unpredictable" belong in your description alongside "how bad".

Walk through these:

Onset. Did this episode start suddenly, over seconds or minutes, or build over hours? Can you name when it started? Sudden severe pain is handled very differently from pain that crept up over a day.

Episode length. How long does one episode last? Minutes, hours, all day? If it comes in waves, how long is each wave and how long is the gap?

Frequency. How many days in the last two weeks did you have it? This is one of the most useful numbers you can bring, and one of the easiest to get from a diary.

Constancy. Does it ever fully go away? This one needs care, because "constant" means different things to different people. Some mean "every day"; some mean "every waking minute". It now affects the label: the Rome V criteria for bowel disorders were published in 2026 (Corsetti 2026), and a UK survey comparing them with earlier versions described the Rome V definition of IBS as excluding people who reported continuous abdominal pain on every day of the week. In that survey of 1,275 people who said they had IBS, 78.0% met the older Rome III criteria, 59.0% met Rome IV and 70.0% met Rome V, and the authors put the difference mainly down to the exclusion of people with continuous pain (Staller 2026). That study was funded by a grant from Tillotts Pharma. The practical point is simple: say exactly what you mean. "There's a background ache most of the day, and a few times a week it becomes sharp cramping" is far more useful than "constant pain".

Predictability. Can you tell when it is coming? Is it after certain meals, at certain times of day, at a certain point in your cycle? "I never know when it will hit" is itself worth saying, because unpredictability was one of the dimensions tied to severity.

Time of day and night. Pain that wakes you from sleep is a different signal from pain that only happens when you are awake and eating. Our post on IBS waking you up at night explains why clinicians ask about this so specifically.

What makes it better or worse

The most useful single thing you can report about gut pain is what happens to it when you open your bowels. NICE's definition of when to consider IBS rests on abdominal pain or discomfort that is either relieved by defecation or associated with altered bowel frequency or stool form (NICE CG61). Better, worse, or no change are all informative answers. "I've never noticed" is an honest answer too, and a week of paying attention usually settles it.

The r/ibs thread behind this article's keyword gives a good example of a precise description written by someone who had never been taught how. They described an urge, then cramping, then passing stool, then a short pain-free interval, then a new wave of cramping that built steadily until more stool came, each round looser than the last (r/ibs thread). That is exactly the level of detail a clinician can work with: waves, their relationship to stool, the progression. Dozens of replies recognised it, and several noted it lined up with ovulation or their period, which is a pattern worth mentioning in its own right; our post on why IBS gets worse on your period covers that overlap.

Other things worth checking and reporting:

• Eating. Does pain start during a meal, within an hour, or several hours later? Does eating ever relieve it? Our post on how long after eating an IBS flare can start goes into the timing question in detail.
• Passing wind. Relief after wind points somewhere different from relief after stool.
• Movement. Is it worse when you walk, cough, go over a bump in a car, or press on it? Or do you find yourself unable to keep still and pacing around? Those are opposite patterns and both are informative.
• Position. Does lying still, curling up, sitting forward or lying flat change it?
• Heat, and anything you have taken. Say what you have tried and whether it helped, including heat pads. Be accurate about over-the-counter medicines, because the doctor needs to know.

What comes with it

Pain rarely arrives alone, and what comes with it often decides what happens next. Mention bowel changes (diarrhoea, constipation, urgency), bloating or visible swelling, nausea or vomiting, fever or chills, blood in the stool or black stool, weight loss you did not intend, and any sweating, shaking or feeling faint. If the sweating or faintness comes around a bowel movement, see cold sweats before a bowel movement.

That last group deserves its own paragraph, because it is common, frightening, and often left out of the conversation out of embarrassment. The same r/ibs thread described cold sweats, wanting to strip off, near-fainting and needing to lie down after a bout (r/ibs thread), and one reply said the only thing that had stopped them calling an ambulance when nearly passing out was embarrassment. Another thread titled "the worst pain I've ever felt" described hours of bloating and pain, then sudden dizziness, drenching sweat, shaking and nausea on the toilet (r/ibs thread). Later in that thread the poster reported that their diarrhoea had become bloody, and the replies, rightly, told them to go to the emergency department.

Fainting linked to opening the bowels, called defecation syncope, is a recognised situation in the medical literature. In one hospital series of 20 people with it, gut symptoms came before the faint in 55%, far more often than in people who fainted while passing urine (Komatsu 2010). It is a small series from a cardiology journal and does not tell you why any particular person faints. That is the point: a faint needs its own assessment. Tell your doctor exactly what happens, and whether you have actually lost consciousness, fallen or hurt yourself. "I nearly pass out on the toilet about once a month during bad cramps, and once I did" is not an embarrassing detail. It is one of the most important things you can say.

"Out of ten": how to answer when it varies wildly

Give three numbers instead of one, and tie each to what you could still do. That answer is more honest and more useful than any single score.

The 0 to 10 scale is the most widely used tool for a reason. A systematic review of studies comparing numerical, verbal and visual pain scales found the numerical version had better completion rates in 15 of the 19 studies that reported it, and recommended it in most settings (Hjermstad 2011). In IBS specifically, a 0 to 10 abdominal pain scale tracked overall IBS severity well in a study of 277 people with IBS, correlating with the IBS Severity Scoring System (r = 0.60), and it did not correlate with stool frequency or form (Spiegel 2009). Pain is its own measurement. You cannot infer it from how your bowels are behaving, which is exactly why you need to report it.

But the same review exposes the weakness. Across the studies it included, 24 different descriptions were used to anchor the ends of these scales, and many studies found a wide spread of numerical scores among people who had picked the same verbal category (Hjermstad 2011). One person's "moderate" is a 4; another's is a 7. The number only means something if the listener knows what you meant by it.

Patient communities describe the anchoring problem precisely. One r/ibs poster, told by their gastroenterologist that IBS cramping "isn't as bad as a kidney stone", asked whether their 9 out of 10 was abnormal, since they had never had a kidney stone or given birth and had nothing to compare with (r/ibs thread). In a Crohn's thread about pain scales, people described the opposite habit: saving 9 and 10 for something worse that might come, so habitually under-rating, and some said they now add a point or two at the doctor's to compensate (r/CrohnsDisease thread). Neither guessing nor inflating solves the problem. Anchoring does.

Three numbers, each with an anchor

Try this format:

• A usual day: "Usually a 3. I notice it but I work through it."
• A bad day: "On bad days a 7. I have to stop what I'm doing and lie down."
• How often: "Bad days about four times in the last two weeks."

That takes ten seconds and replaces a single number that the listener had to interpret. It also captures three of the four dimensions linked to IBS severity in the research above: intensity, frequency and, implicitly, how constant it is (Spiegel 2010).

Tying numbers to function is not a patient invention. The US military's Defense and Veterans Pain Rating Scale was developed because military clinicians worried the standard 0 to 10 scale was inconsistently used and of questionable clinical value. It pairs each number with word descriptions and adds questions about activity, sleep, mood and stress; in a validation study with 350 service members, ratings with and without the word descriptors agreed closely (Buckenmaier 2013). That is a military population, not a gut clinic, but the principle transfers. A Crohn's community post sharing that scale drew replies from people saying they had not realised their everyday pain counted as a 4 or 5 once they read the descriptions (r/CrohnsDisease thread).

How big a change actually matters

If you track pain over time, know what size of change means anything. Across 10 clinical trials of a pain medicine covering 2,724 people with nerve pain, back pain, fibromyalgia and osteoarthritis, a drop of about 2 points, or about 30%, on the 0 to 10 scale was what corresponded to patients rating themselves "much improved" (Farrar 2001). That study pooled data from trials of one company's drug, and we did not read a funding statement for it. The IBS-specific estimate is strikingly similar: in the study of 277 people with IBS, the smallest change patients felt was meaningful was 2.2 points, corresponding to a 29.5% reduction (Spiegel 2009).

Two practical consequences. A pain score that moves from 6 to 5 between appointments is probably within the noise. And a treatment that takes you from a usual 6 to a usual 4 is, by the research standard, a real improvement worth reporting as one, even if it does not feel like victory.

Your memory is not a recording

The number you give at an appointment is usually a memory, and memories of pain are built in a predictable way. In a study of people having colonoscopy or kidney stone lithotripsy who rated their pain in real time, their later judgement of the whole experience was strongly tied to the worst moment and to the last few minutes, and the length of the procedure barely registered (Redelmeier 1996). A Crohn's thread said the same thing in plain words: after a few pain-free days you start underestimating how bad it was, then it returns and you remember (r/CrohnsDisease thread).

For you, that means two opposite biases are possible. If you had a terrible episode yesterday, your "average" will be pulled up. If the last week was quiet, the terrible fortnight before it will fade. Numbers written down at the time are the only reliable correction. They need not be elaborate: one line per day is enough. Our post on what to track in an IBD symptom diary covers how to set the recall window for each field.

How to sound credible without performing

The fear behind "how do I describe pain without sounding like I'm exaggerating?" is reasonable, and the evidence says the risk usually runs the other way. A review of 80 studies covering 20,496 patients, comparing pain ratings by patients and by health professionals within the same day, found professionals underestimated pain in 62 of the 80 studies (78%), overestimated it in one, and the underestimation tended to be larger when pain was more severe (Seers 2018). Those were institutional settings across many conditions, not gut clinics specifically, but the direction was consistent: in 10 of the 11 highest-quality studies, professionals rated pain lower than patients did.

And the gap is not the same for everyone. In one US emergency department, among 981 adults with acute abdominal pain, men and women reported similar pain scores, yet women were less likely to receive any pain relief (60% vs 67%), less likely to receive opioids (45% vs 56%), and waited longer for it (median 65 vs 49 minutes) (Chen 2008). That is one hospital's data from 2004 and 2005. In a US study using mock cases, half of a sample of white medical students and residents endorsed false beliefs about biological differences between Black and white people, such as thicker skin, and those who held them rated a Black patient's pain lower (Hoffman 2016). None of that is your fault, and none of it disappears because you say things differently. But it does mean that vague descriptions are easier to discount, and specific ones are harder to.

What helps:

• Behaviour over adjectives. "I vomited from the pain", "I could not stand up straight", "I was on the bathroom floor for forty minutes", "my partner wanted to call an ambulance". Other people's reactions are useful evidence precisely because they are not your self-report. One reply in the 9-out-of-10 thread suggested exactly this kind of language, describing how pain affects work and how others react to seeing it (r/ibs thread).
• Function over feeling. Days off, plans cancelled, meals skipped, sleep lost. NICE explicitly tells clinicians to ask how symptoms affect daily life, such as leaving the house (NICE CG61).
• The usual and the worst, not only the worst. Giving a range signals that you are reporting, not pleading.
• Skip comparisons you cannot stand behind. "Worse than childbirth" from someone who has not given birth invites an argument. "The worst pain I have ever had" is true, checkable against your own life, and a phrase clinicians are trained to take seriously.
• Say how you look is not how it feels. People who live with pain for years often learn not to show it. If you are sitting calmly at a 6, say so: "I've had this for years, so I don't look like I'm in pain, but this is a 6 for me."

If you have done all of that and are still not being heard, that is a different problem with a different set of routes: second opinions, changing clinician, formal routes. Our guide on how to get your doctor to take IBS seriously covers the escalation ladder.

If you have Crohn's or colitis: describe the change, not just the pain

For someone with inflammatory bowel disease, the most important thing to communicate is usually how this pain differs from your usual pain, because pain in IBD has more than one source.

Pain is common and long-lasting in IBD. In the Swiss IBD Cohort Study, a pain questionnaire was sent to 2,152 people and 1,263 completed it; 71% reported pain during their disease course, abdominal pain (59.5%) and back pain (38.3%) were the main locations, and the authors concluded that pain was undertreated (Zeitz 2016). The authors themselves note that people with pain may have been more likely to return the questionnaire, which could overstate how common it is. The abstract also reports that 67% took pain medication and 24% received no pain treatment without making clear which group each percentage refers to, so we have not tried to combine them.

Some of that pain is inflammation. Some is not. A meta-analysis of 13 studies found that 39% of people with IBD had symptoms meeting criteria for IBS, and even among those thought to be in remission the figure was 35% (Halpin 2012). So "I'm in pain" does not by itself tell your IBD team whether your disease is active. The details that help them decide:

• Is this the same kind of pain you get between flares, or new?
• Has it come with more frequent or looser stools, blood, urgency, fever or weight loss?
• Is it cramping after meals with bloating and vomiting? For people with Crohn's disease, especially with known narrowing, that pattern needs prompt attention; our post on how to tell if you're in a Crohn's flare covers obstructive presentations.
• Is it somewhere new, or in your joints or back? Our post on joint pain with Crohn's disease explains which pains outside the gut are recognised parts of IBD.

A long-standing IBD diagnosis can also mask something unrelated. A Crohn's thread about pain scales included several people describing how appendicitis or a ruptured appendix went unrecognised because they were used to severe abdominal pain, and one who was told that it could not be appendicitis because they had walked to the clinic (r/CrohnsDisease thread). Those are individual stories, not evidence of how often this happens. The lesson they carry is still sound: "this is different from my usual pain" is the sentence that stops everyone, including you, filing a new problem under an old label.

Pain outside the gut can also fall between specialists. One widely upvoted r/CrohnsDisease post described joint pain on a biologic, with the gastroenterologist and rheumatologist each deferring to the other, and repeated advice to "take Tylenol" (r/CrohnsDisease thread). A useful reply suggested saying explicitly that the pain management was falling through the cracks and asking one of them to own it. That is a description strategy too: name the gap, not just the symptom.

A translation table for the appointment

The left column is what most of us say. The right column is the same information, made usable.

A worked example: the same afternoon, described twice

A 34-year-old with IBS had an episode on Saturday: an hour of building cramps after lunch, then urgent loose stools, near-fainting on the toilet, drenching sweat, and a wiped-out evening. By Tuesday's appointment it has faded.

Version one. "I had a really bad flare at the weekend. The pain was awful, like a 10. It's just been really bad lately."

The clinician hears: flare, severe, recent, vague. The obvious response is to ask a string of questions, and if time is short, to adjust something and move on. Nothing in that description distinguishes this from any other bad IBS day.

Version two. "On Saturday I had pain that was different in one way from my usual. It started about an hour after lunch, lower middle, spreading to both sides. It came in waves of about a minute that built for an hour. Then I had urgent loose stools, three times, and on the second one I nearly fainted, cold sweat, had to put my head down. No blood, no fever. Afterwards I was exhausted but the pain went within the hour. My usual pain is a 3 on most days; this was the worst in months, and it stopped me doing anything that evening. I've had two of these near-faints in the last three months, and that's the part that worries me."

That takes about forty seconds. It gives onset, site, spread, character, pattern, the relationship to bowel movements, associated symptoms including a near-faint, two red flags explicitly absent, a usual and a worst score tied to function, frequency over three months, and a stated concern. The conversation that follows is about the near-fainting and whether it needs assessing, not about whether the patient is exaggerating.

Bringing your tracking: what to pull out of it

Extract five facts from whatever you have recorded, not the whole record. A clinician in a short appointment can use a handful of numbers; they cannot use pages. The rationale for keeping it short, and the chart formats that survive a ten-minute slot, are covered in our post on what a symptom tracker for your doctor should contain.

For pain specifically, the five facts are:

1. Pain days in the last 14 or 28 days.
2. Your usual and worst scores over that period, with your anchors ("3 = work through it, 7 = lie down").
3. Typical episode length and whether it ever fully goes.
4. The relationship to eating and to bowel movements, in one sentence.
5. Anything new: a new location, a new character, a faint, pain at night, pain with blood or fever.

Photos can help with stool; for pain, the equivalent is a short note written during or straight after a bad episode, while the details are fresh. The peak-and-end effect described above means that note will be more accurate than anything you reconstruct on Tuesday. If you use an app, Clairop lets you log symptoms in seconds as they happen and produces a one-page summary for your appointment, but a notebook with one line a day does the same job for pain.

Check what got written down

What you say becomes a sentence or two in your notes, and that sentence is what the next clinician reads. It is worth checking.

In a survey of 22,889 US patients who read their outpatient visit notes online, 21.1% reported finding what they believed was a mistake, and 42.3% of those judged it serious. Among the most serious, the commonest categories were errors in diagnoses and inaccurate medical history (Bell 2020). These were patient-perceived mistakes, not verified ones, but pain history is exactly the kind of detail that gets compressed: "abdominal pain, chronic, stable" can be written about pain that has just changed.

If your health system lets you read your notes, read them after the visit. If the pain description is wrong, ask politely for it to be corrected or for your account to be added. A short message works: "The note says my pain is unchanged; I reported that it had moved to the right side and was steady rather than cramping. Could that be added?" Pain that is recorded accurately is pain that the next person to read your notes will take seriously.

What a doctor will do with your description

Once they have your description, a doctor usually examines your abdomen, pressing different areas, checking for tenderness and swelling, and sometimes asking you to tense your stomach muscles to check whether the pain is coming from the abdominal wall (Srinivasan 2002). What happens next depends heavily on what you said.

For new pain lasting less than a week, a review for family physicians lists the most common causes as gastroenteritis and non-specific abdominal pain, followed by gallstones, kidney stones, diverticulitis and appendicitis. It notes that tests might include blood counts, inflammation markers, liver and kidney tests, a urine test and a pregnancy test, and that several causes, such as appendicitis and gallbladder inflammation, cannot be confirmed without imaging, with the type of scan chosen according to where the pain is (Yew 2023). That is why "where exactly" matters: it can decide whether you get an ultrasound or a CT scan.

For chronic or recurring pain, your description does even more of the work, because it is what distinguishes a pattern that fits IBS from one that needs more investigation. The consultation side of that, including the tests worth asking about, is in our guide on how to explain IBS to your doctor.

Age changes the stakes. In a study of 360 people aged 60 and over who came to emergency departments with abdominal pain, 58% were admitted to hospital, 18% needed surgery or another invasive procedure, and 5% had died within two weeks; bowel obstruction was among the most common causes (Lewis 2005). If you are older, or describing pain for an older relative, do not let a calm manner or a long history of "stomach trouble" make a new pain seem routine.

Myths about describing stomach pain

"If I can't say exactly where it is, I'm being vague." Gut pain is diffuse and often felt away from its source because of how the gut is wired (Gebhart 2016). Describe it as it is.

"A higher number gets taken more seriously." A number without an anchor is easy to discount, and clinicians already tend to rate pain lower than patients do (Seers 2018). A range tied to function travels better than an inflated single score.

"If my bowels are fine, the pain can't be that bad." In IBS, pain scores did not correlate with stool frequency or form (Spiegel 2009). They are separate measurements.

"Sweating and nearly fainting are just part of a bad cramp." They are common, but a faint needs to be described and assessed on its own (Komatsu 2010).

"I already have a diagnosis, so there's no point describing it again." In IBD, IBS-type pain is common even in remission (Halpin 2012), and a long history of pain can hide a new cause. The description is how anyone tells old from new.

"Talking about how the pain makes me feel sounds dramatic." Emotional and evaluative words are a recognised dimension of pain and have been part of structured pain assessment for fifty years (Melzack 1975).

"If I walked in, it can't be serious." Being able to walk does not rule out an emergency. Migrating pain, a rigid belly, vomiting with no stool or wind, fever or fainting matter more than how you got there.

When to see a doctor promptly

See a doctor promptly, rather than waiting for a routine appointment, if your abdominal pain comes with any of:

• Blood in your stool, or black, tarry stool
• Weight loss you did not intend
• Pain or diarrhoea that wakes you from sleep
• Fever, or feeling generally unwell
• A change in bowel habit starting after about age 50
• A family history of bowel cancer, coeliac disease or IBD
• Pain that is new, steadily getting worse, or has become steady rather than coming and going
• Fainting, or nearly fainting, during pain or bowel movements
• Pain that is different from your usual pattern if you have Crohn's disease or ulcerative colitis

Get urgent help the same day for sudden severe pain, pain that started centrally and moved to the lower right, a rigid or very tender belly, persistent vomiting, being unable to pass stool or wind, passing a large amount of blood, a high fever, collapse, or severe pain in pregnancy.

The honest bottom line

You do not need medical vocabulary to describe stomach pain well. You need the pattern: where it lives and where it goes, what it feels like, how it comes and goes, what changes it, what comes with it, and what it costs you, with a usual and a worst number that someone else can interpret. If something is new, lead with that.

None of this guarantees you will be believed. The research on underestimated pain says the problem is real and not yours to solve alone. But a precise description is harder to set aside than a vague one, it gets written down more accurately, and on a bad day it is the fastest way to the right test. If you are building that description ahead of your next visit, our guide on preparing for a GI appointment covers the fortnight before it.