If there were a universal sign for "I don't feel so good," it might very well be a person with their hand on their abdomen. For many of us, the body's first warning signs of trouble are expressed through the belly. But what kind of trouble? There's the rub. When it comes to stomach pain, finding the causes can be harder than solving an advanced Sudoku. Use this symptom decoder to help decipher what's up with your gut.
1. Acid Reflux
What it is: Acid flowing backward from the stomach up into the throat. It affects 20 percent of adults at least once a week.
What it feels like: Pain or burning below your breastbone that's usually worse after you eat or when you lie down, says David Peura, M.D., former chairman of the National Heartburn Alliance.
Fix it: If you feel the burn only a few times a year, treat it with antacids like Tums. If you get it a couple of times a week, you could have gastroesophageal reflux disease (GERD). A doctor can determine whether a medication to reduce acid production will help you.
What it is: Inflammation of the appendix, a narrow fingerlike pouch attached to the colon. About 10 percent of people will have trouble with it sometime in their lives.
What it feels like: A dull discomfort around your belly button that moves to your lower right abdomen. It becomes extremely painful as time passes—and walking makes the pain worse.
Fix it: Go to the emergency room immediately! You need surgery to yank your appendix. If you wait too long, it can rupture, spewing bacteria all over your innards—disgusting and life threatening.
What they are: Pea- to golf ball-size nuggets in the gallbladder, a sac connected to the liver and small intestine. Made of hardened cholesterol and bile (a fluid that helps digest fat), they're caused by a high-fat diet or a gallbladder that doesn't empty properly. Women are more likely than men to develop them—up to 20 percent of women have them at some time.
What they feel like: A sharp pain in your upper middle abdomen that moves to your right side, under your rib cage. The pain can worsen after eating.
Fix it: If the pain doesn't go away in a few hours or you're running a fever or vomiting, go to the doctor. She can diagnose gallstones via CT scan or ultrasound. You may need surgery to remove the gallbladder.
4. Irritable Bowel Syndrome (IBS)
What it is: A malfunction of the nerves that control the intestines, experienced by 20 percent of adults.
What it feels like: Nausea, bloating, diarrhea, or constipation and cramps in the lower part of your abdomen. These symptoms tend to lessen when you move your bowels, says Lauren Gerson, M.D., assistant professor of medicine at Stanford University School of Medicine.
Fix it: Visit the doctor, who will probably prescribe an antispasmodic drug to regulate your impulse to go and relieve the general discomfort as well.
What it is: A sore on the stomach lining. Ten percent of the population will have one at some point in their lives.
What it feels like: Burning pain in your stomach that comes and goes but feels worse when you're hungry.
Fix it: If you're taking nonsteroidal drugs such as aspirin or ibuprofen, stop immediately, Peura says these medications eat away at the stomach lining. See your doctor; you may need antibiotics to kill ulcer-causing bacteria, or even surgery.
6. Lactose Intolerance
What it is: Discomfort after consuming milk products due to a deficit in the enzyme that digests lactose, the sugar found in dairy products.
What if feels like: Nausea, cramps, bloating, gas, and/or diarrhea 30 minutes to two hours after eating or drinking foods containing lactose.
Fix it: Drink less milk, or have it with other foods to slow the digestion process. Try experimenting with an assortment of dairy products. Hard cheeses such as Swiss or cheddar have small amounts of lactose and generally don't cause symptoms. Important note for the lactose intolerant: because dairy products are some of the most common sources of calcium, make sure you're getting enough of that essential mineral elsewhere in your diet.
7. Crohn's Disease
What it is: The most common of a group of diseases called inflammatory bowl disease. Crohn's usually affects the end of the small intestine and the colon.
What it feels like: Persistent abdominal pain, diarrhea, weight loss, sometimes fever. You might find blood in your stools.
Fix it: Crohn's is most common in people under age 30. Though treatable, there is no cure. Treatments include anti-inflammatory medicines and steroids, which you might have to take for a few years or for a lifetime.
What it is: A common type of inflammatory bowel disease that affects only the colon and rectum. A young person's disease, most cases are diagnosed by age 30.
What it feels like: Belly pain or cramps, bloody diarrhea, an urgent need to have a bowel movement, weight loss, nausea, and sometimes vomiting.
Fix it: If mild, treat the symptoms with over-the-counter medications. In severe cases, you might have to take anti-inflammatory medicines or steroids.
9. Celiac Disease
What it is: A digestive disease that damages the small intestine due to an intolerance to gluten, the protein found in wheat, rye, and barley. Often misdiagnosed as IBS, celiac disease is now considered one of the most common gastrointestinal disorders.
What it feels like: Cramping, bloating, and diarrhea. More serious symptoms include anemia, osteoporosis, and even infertility.
Fix it: Avoid that pizza—the remedy for celiac disease is a gluten-free diet. Fortunately, there are plenty of great gluten-free products available these days.
10. Thyroid Disease
What it is: A deficit or an overabundance of the hormones secreted by the thyroid gland. Too much can kick your metabolism into high gear; too little can make it sluggish.
What it feels like: A hyperactive thyroid can cause diarrhea; a sluggish thyroid can cause constipation. Other symptoms vary widely for both hyper- and hypothyroidism, but can include weight loss or weight gain, a racing heartbeat or low energy, nervousness or depression, hair loss, and more.
Fix it: Your doctor will probably prescribe a hormonal drug to regulate your thyroid. Occasionally surgery is necessary in severe cases.