From the Guidelines
For stomach pain, the most effective initial approach is to rest, avoid food that may worsen symptoms, and consider over-the-counter medications like acetaminophen or antacids as needed, as recommended by the British Society of Gastroenterology guidelines on the management of functional dyspepsia 1.
Initial Management
- Rest and avoid foods that may exacerbate symptoms
- Take over-the-counter medications like acetaminophen (Tylenol) at 500-1000mg every 6 hours as needed for pain, or antacids such as Tums or Pepto-Bismol following package directions
- Stay hydrated with small sips of water or clear fluids
- Apply a heating pad to the abdomen for 15-20 minutes to relax muscles
When to Seek Medical Attention
- If pain is accompanied by fever over 101°F, severe vomiting, blood in stool, inability to keep fluids down for 24 hours, or pain lasting more than 2-3 days, seek medical attention immediately
- These symptoms could indicate more serious conditions like appendicitis, gallstones, or ulcers requiring professional treatment
Additional Considerations
- Regular exercise and lifestyle changes, like avoiding certain foods that may trigger symptoms, can be helpful for some patients, as suggested by the British Society of Gastroenterology guidelines on the management of irritable bowel syndrome 1
- A diet low in fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) may be beneficial for some patients, but its implementation should be supervised by a trained dietitian 1
- Psychological or behavioral therapies, such as cognitive behavioral therapy or gut-directed hypnotherapy, may be beneficial for treating symptoms in functional dyspepsia, as discussed in the guidelines on irritable bowel syndrome and mental health comorbidity 1
From the FDA Drug Label
Concomitant antacids should be given as needed for pain relief to patients with active duodenal ulcer; active, benign gastric ulcer; hypersecretory states; GERD; and erosive esophagitis. For stomach pain, antacids can be given as needed for pain relief 2.
From the Research
Stomach Pain Treatment Options
- For stomach pain caused by Helicobacter pylori (H. pylori) infection, treatment with proton pump inhibitors (PPIs) and antibiotics is recommended 3, 4, 5, 6.
- The choice of PPI dosage and treatment duration can affect the effectiveness of H. pylori eradication therapy 3.
- H2-receptor antagonists may be used for mild to moderate gastroesophageal reflux disease, but proton pump inhibitors are generally more effective for erosive and ulcerative reflux esophagitis 4, 7.
- A meta-analysis comparing PPIs and ranitidine bismuth citrate (RBC) plus two antibiotics for 1 week found similar efficacy for H. pylori eradication when using clarithromycin and amoxicillin, but RBC seemed to have a higher efficacy than PPI when clarithromycin and a nitroimidazole were used 5, 6.
Treatment Considerations
- The use of high-dose PPIs in 14-day triple therapy and in 10- or 14-day quadruple concomitant therapy is recommended for first-line treatment of H. pylori infection 3.
- Standard-dose PPIs may be sufficient in 10-day bismuth quadruple therapies 3.
- Proton pump inhibitors are generally more effective than H2-receptor antagonists for healing erosive esophagitis, especially in severe cases 7.