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What to do if…
you have sudden severe pain in your upper abdomen with nausea that will not settle

Short answer

Treat this as urgent. If the pain is severe, came on suddenly, or you feel very unwell, call 999 (or 112) or go to A&E now.

Do not do these things

  • Do not “wait it out” if the pain is severe, sudden, worsening, or stopping you from moving/standing normally.
  • Do not drive yourself to A&E if you’re in severe pain, dizzy, faint, or vomiting—use 999/112 or get someone else to take you.
  • Do not keep eating or drinking to “settle it” if nausea won’t stop (it can make some causes worse).
  • Do not take extra doses of painkillers or mix medicines beyond the label to try to overpower the pain.
  • Do not ignore chest pain, trouble breathing, collapse/fainting, or pain spreading to your back/shoulder.

What to do now

  1. Check for “call 999/112 / go to A&E now” signs — and act on them.
    Call 999/112 (or go to A&E) if any apply:
    • the pain came on very suddenly or is severe
    • it hurts when you touch your stomach
    • you have chest pain or you cannot breathe properly
    • you feel faint, someone has collapsed, or you’re becoming confused
    • you’re vomiting blood (or vomit looks like coffee grounds)
    • your poo is bloody or black and sticky
    • you cannot pee, or you cannot poo or fart
    • you have diabetes and you’re vomiting
    • you are pregnant or could be pregnant and the pain is severe, worsening, or you feel unwell
  2. If none of the above but it’s still severe/persistent: contact NHS 111 now (phone or online) for urgent triage.
    Say clearly: “sudden severe upper abdominal pain with nausea that won’t settle”, and tell them how long it’s lasted and whether it’s worsening.
  3. Make yourself safer while help is arranged (this is not to delay getting assessed).
    • Sit upright or lie on your side with knees bent—choose the position that eases pain most.
    • Avoid food. If you can tolerate it and you’re not actively vomiting, take only small sips of water for comfort.
  4. Prepare information for the clinician/call-handler (it speeds decisions).
    Write down: when it started, exact location (upper middle / right / left), if it spreads to back/shoulder, any fever/shivers, vomiting, pregnancy possibility, recent heavy alcohol intake, new meds (especially painkillers), and past gallstones/ulcers/pancreatitis.
  5. If you’re alone: message/call someone to stay with you or be on the phone while you call 111/999. If you become faint/confused, that person can call for help.

What can wait

  • You do not need to figure out the cause right now.
  • You do not need to decide today about tests, surgery, or long-term changes.
  • You do not need to “prove” it’s serious before seeking help—your job is to get assessed safely.

Important reassurance

Severe upper abdominal pain with nausea can feel frightening and overwhelming, especially when it won’t settle. Getting urgent assessment is a protective, sensible step—many serious causes look similar early on, and it’s not something you can safely sort out alone in the moment.

Scope note

This is first-steps-only guidance to keep you safe and get you to the right service. Further decisions should be made with a clinician after assessment.

Important note

This is general information, not a diagnosis. If symptoms are severe, sudden, worsening, or you feel very unwell, seek urgent medical help immediately.

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