When I Cough My Tummy Hurts

Coughing is the body’s way of keeping the lungs and airways clear. On its own, an occasional bout of cough or cold might just be your run-of-the-mill illness. However, when coughing is accompanied by other symptoms like fever, chest tightness, or a stomach ache, there might be a deeper underlying problem. Sometimes you might experience stomach pain.

There are plenty of organs in the abdomen that may cause your stomach to hurt when coughing. Infection, obstruction, and masses can cause your stomach to ache, which may be further aggravated by coughing. The pain can often range from a dull ache that you cannot exactly place to a sharp shooting pain that you can definitely pinpoint. Coughing, laughing, and even sneezing can aggravate the stomach pain. Read on to learn more about why your stomach hurts when you cough.

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To determine the underlying cause, pay attention to the pain’s characteristics:

• Where is the pain located? – Can you point to it exactly or is it the general abdomen? Certain locations can give your doctor helpful clues that will aid in diagnosis.
• Describe the pain – Is it dull and crampy, sharp and shooting? Does it hurt more or less in certain positions, like sitting down or when moving?
• Rate the pain on a scale from 1 to 10, with 1 being the least painful and 10 as very painful – Pain severity will help your physician determine whether the situation is an emergency or a case that can be handled on an outpatient basis.
• For people who menstruate, remember the dates of your monthly menstrual cycle as certain conditions may coincide with menstruation.

Knowing all these, below are the most common conditions that could explain why your stomach hurts when coughing.

Appendicitis

Appendicitis is an inflammation of the appendix1. It is one of the most common causes of abdominal pain.

The pain usually begins in the middle of your stomach and then migrates to the right lower side of your abdomen. If you have appendicitis, you will likely feel a sudden sharp shooting pain that may be worsened by coughing or performing strenuous tasks2. Symptoms include bloating, abdominal pain, nausea or vomiting, fever, decrease in appetite, and changes in bowel movement.

If you think you have appendicitis, this is a medical emergency and you should proceed to the hospital immediately .

Gallstones

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The buildup of bile, bilirubin, and cholesterol can cause formation of stones in your gallbladder3. People with gallstones may not present with any symptoms at all, but if they do, it usually manifests as a sharp pain on the right upper side of your stomach4. It may also be worsened by the intake of fatty food as this compounds the buildup of cholesterol in the gallbladder.

General symptoms of gallstones include sharp and severe abdominal pain, pain that radiates to your upper back or shoulder, fever, chills, jaundice or yellowing of the whites of the eyes and skin, indigestion, and nausea or vomiting. Laboratory testing and imaging may be requested to assess the severity and size of the gallstones. If large enough to cause significant pain, the gallstones along with the gallbladder may need to be surgically removed.

Cystitis

Urinary tract infections like cystitis can also cause pain in your stomach when you cough5. Symptoms of cystitis include frequently needing to urinate, cloudy or foul-smelling urine, pain upon urination, and bloody urine. Generally, symptoms resolve on their own after a few days without medications. However, in severe cases, your physician may prescribe antibiotics to address the infection.

Pancreatitis

Pancreatitis occurs when the pancreas is inflamed6. Coughing may worsen the already inflamed organ. The pain is usually sharp and severe, sometimes causing people to double over in pain. Symptoms include worsening pain that radiates to the lower back, foul-smelling stools, swelling in your abdomen, and unintentional weight loss 7. Pancreatitis requires immediate medical treatment and can have detrimental consequences if left untreated.

Kidney Stones

Deposits of minerals in urine can come together to form kidney stones8. In benign cases, you may be able to pass the kidney stone when you urinate. However, if the stones are large, they can cause severe pain on the flanks or sides of your abdomen, cloudy or bloody urine, fever, chills, nausea, and vomiting. Surgery may be warranted to remove the kidney stones.

Diverticular Disease

Weak spots in your colon (digestive tract) can bulge and form small sacs known as diverticula. When this condition flares up and becomes inflamed, it can cause bloating, stomach pain, nausea and vomiting, fever, chills, abnormal bowel movement, and bloody stools9. To treat diverticular disease, your doctor may recommend a high-fiber diet and probiotics10. This will not only soften stools but also bulk them up so it will be easier to pass.

Hernia

Weakness in the muscles of the stomach can cause an outpouching of your gut known as a hernia11. People with hernias will usually have a painful bulge in the belly or groin area. The pain may be worsened with straining, coughing, sneezing, running, during a bowel movement, and when performing heavy lifting. Surgery may be necessary to repair the defect in the abdomen and prevent further weakening of the structures surrounding the hernia.

GERD

Gastroesophageal reflux disease (GERD) is a condition wherein the contents of the stomach reflux back up into the esophagus, causing stomach pain12. It usually causes a burning sensation in the chest or heartburn and coughing. Other symptoms of GERD include wheezing, difficulty swallowing, belching, and persistent cough. To address GERD, your doctor may recommend medications to counter the acidity in your stomach. Lifestyle modifications such as maintaining a healthy weight, quitting smoking, and avoiding triggering foods can also help relieve symptoms. Food to avoid when you have GERD includes alcohol, caffeine, citrus fruits, fried or fatty food, chocolate, and spicy food.

Endometriosis

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Endometriosis is a condition wherein the cells that normally line the uterus appear elsewhere13. This leads to severe abdominal pain that is worsend by sex, periods, urination, and bowel movements.

While there is no cure for endometriosis, there are treatments for the symptoms. Medications such as pain relievers and hormone therapy can help manage the symptoms. Surgery is an option to remove patches of endometrial tissue or to sever painful nerves.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs in the ovaries14. They often are not a cause for concern, as most are small and symptomless15. However, some women may develop large cysts that may cause sharp, debilitating abdominal pain, swelling, bloating, heavy menstrual bleeding, nausea and vomiting, fever, dizziness, and fainting. Additionally, the cysts can burst, which causes worse symptoms16. In mild cases, oral contraceptive pills may help regulate the hormonal imbalances that cause ovarian cysts. In severe cases, surgery is indicated for large or cancerous cysts that do not respond to medications.

When to See a Doctor

Mild abdominal pain when coughing may not be very concerning. However, if you experience sudden sharp pain, fever, nausea, vomiting, bloody excretions, difficulty breathing, chest pain, and menstrual changes, consult your doctor immediately.

Conclusion

Because there are multiple organs in the abdomen, there are many reasons why your stomach hurts when coughing. Infections like appendicitis, pancreatitis, and cystitis can irritate organ linings that may be aggravated by the movement of coughing. Obstructions such as kidney stones and gallstones may also cause abdominal pain when coughing as the surrounding walls can be compressed onto the obstruction; this is similar to a hernia being compressed by the chest movement from coughing.

Indulging in triggering foods that contribute to GERD can lead to both more coughing and greater abdominal pain. Lastly, endometriosis and ovarian cysts are possible causes of abdominal pain that women often experience.

You can also experience other pain when coughing, including back pain.

It is best to take note of the characteristics of your symptoms as well as the character and severity of the pain. These can prove to be helpful diagnostic clues that will aid your doctor in determining the appropriate tests and management to initiate.

1. National Institute of Diabetes and Digestive and Kidney Diseases. (June 2021). Definition & Facts for Appendicitis – NIDDK. Access from https://www.niddk.nih.gov/health-information/digestive-diseases/appendicitis/definition-facts[↩]
2. National Institute of Diabetes and Digestive and Kidney Diseases. (July 2021). Symptoms & Causes of Appendicitis – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/appendicitis/symptoms-causes[↩]
3. National Institute of Diabetes and Digestive and Kidney Diseases. (November 2017). Definition & Facts for Gallstones – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/definition-facts[↩]
4. National Institute of Diabetes and Digestive and Kidney Diseases. (November 2017). Symptoms & Causes of Gallstones – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/symptoms-causes[↩]
5. Luna-Gonzales, Hortencia. (2023). Why Am I Experiencing Stomach Pain When Coughing?. Accessed from https://villageec.com/blog/stomach-pain-when-coughing/[↩]
6. National Institute of Diabetes and Digestive and Kidney Diseases. (November 2017). Definition & Facts for Pancreatis – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/definition-facts[↩]
7. National Institute of Diabetes and Digestive and Kidney Diseases. (November 2017). Symptoms & Causes of Pancreatitis – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/symptoms-causes[↩]
8. National Institute of Diabetes and Digestive and Kidney Diseases. (May 2017). Definition & Facts for Kidney Stones – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones/definition-facts[↩]
9. National Institute of Diabetes and Digestive and Kidney Diseases. (August 2021). Definition & Facts for Diverticular Disease – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/definition-facts[↩]
10. Luna-Gonzales, Hortencia. (2023). Why Am I Experiencing Stomach Pain When Coughing?. Accessed from https://villageec.com/blog/stomach-pain-when-coughing/[↩]
11. National Institute of Diabetes and Digestive and Kidney Diseases. (September 2019). Inguinal Hernia – NIDDK. Accessed from https://www.niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia[↩]
12. Kauvery Hospital. (2021). What is the Relationship Between Coughing and the Stomach?. Accessed from https://kauveryhospital.com/blog/gastroenterology/what-is-the-relationship-between-coughing-and-the-stomach/[↩]
13. National Library of Medicine. (March 2022). Endometriosis ¦ Endo ¦ MedlinePlus. Accessed from https://medlineplus.gov/endometriosis.html[↩]
14. Office on Women’s Health. (February 2022). Ovarian cysts ¦ Office on Women’s Health. Accessed from https://www.womenshealth.gov/a-z-topics/ovarian-cysts[↩]
15. National Library of Medicine. (June 2016). Ovarian Cysts ¦ Polycystic Ovary Syndrome ¦ MedlinePlus. Accessed from https://medlineplus.gov/ovariancysts.html[↩]
16. National Library of Medicine. (June 2016). Ovarian Cysts ¦ Polycystic Ovary Syndrome ¦ MedlinePlus. Accessed from https://medlineplus.gov/ovariancysts.html[↩]

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