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us Health & medical scares sudden upper abdominal pain • severe upper stomach pain • upper abdominal pain with nausea • nausea that will not settle • severe epigastric pain • pain under ribs nausea • upper abdominal pain radiating to back • severe belly pain sudden onset • persistent nausea and stomach pain • sharp upper abdomen pain • intense stomach pain emergency • severe abdominal pain er now • stomach pain with chest pain • upper abdominal pain with fever • worried it is pancreatitis • worried it is gallbladder attack • vomiting feeling with stomach pain • can’t keep fluids down nausea

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, sudden, worsening, or you feel very unwell, call 911 or go to the Emergency Room (ER) now.

Do not do these things

  • Do not try to “sleep it off” if pain is severe, sudden, worsening, or making it hard to function or move normally.
  • Do not drive yourself if you’re in severe pain, dizzy, faint, weak, confused, or vomiting—call 911 or have someone else drive.
  • Do not keep eating to “settle your stomach” when nausea won’t stop.
  • Do not take extra doses of painkillers, mix medications, or combine alcohol with meds to blunt the pain.
  • Do not use “home care” steps as a reason to delay urgent evaluation when pain is severe or not settling.

What to do now

  1. Decide 911/ER vs. urgent transport based on red flags — then act immediately.
    Call 911 (or go to the ER) if any apply:
    • pain is severe, sudden/sharp, or unrelenting
    • pressure or pain in your chest, or pain in chest/neck/shoulder
    • difficulty breathing
    • you fainted, feel like you might pass out, are confused, or very weak
    • vomiting blood, vomit that looks like coffee grounds, blood in stool, or black/tarry stool
    • your belly is very tender, or rigid/hard to the touch
    • you are unable to pass stool, especially if you are also vomiting
    • pain in (or between) your shoulder blades with nausea
    • you are pregnant or could be pregnant
    • pain follows an accident/injury to the abdomen
  2. If you’re not calling 911 but it’s still severe/persistent: go to an ER rather than waiting for a routine appointment.
    If you can’t safely get to an ER, call 911.
  3. Make yourself safer while you’re getting help (this is not to delay going in).
    • Sit upright or lie on your side with knees bent—pick the position that reduces pain.
    • Avoid food. If you can tolerate it and you’re not actively vomiting, take only small sips of water.
  4. Get a second person involved.
    If you can, have someone stay with you or be on speakerphone while you arrange care. If you suddenly worsen, they can call 911.
  5. Prepare a quick “ER handoff” list (it speeds triage).
    Write down: when it started, exact location (upper middle/right/left), whether it radiates to back/shoulder, fever/chills, vomiting/diarrhea, pregnancy possibility, alcohol intake, all meds/supplements (especially pain meds), allergies, and major conditions (diabetes, heart disease).
  6. If you have diabetes and can’t keep fluids down or are vomiting repeatedly: tell 911/ER staff right away (this changes urgency).

What can wait

  • You do not need to figure out the cause before going in.
  • You do not need to decide about tests, imaging, or treatments right now—start with getting assessed.
  • You do not need to call multiple places for opinions; pick the safe route (ER/911) and go.

Important reassurance

This combination of symptoms is scary, and it’s common to doubt yourself when you can’t explain it. Seeking urgent assessment is the safe move—serious and non-serious causes can feel very similar early on, and clinicians rely on exam/vitals/tests to sort them out.

Scope note

This guide covers first steps to reduce risk and get you to appropriate urgent care. Next steps should be decided with a clinician after evaluation.

Important note

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

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