Why Does Your Stomach Hurt When You Cough? Causes and Treatment

Why Does Your Stomach Hurt When Coughing?

It's not uncommon to experience abdominal pain when coughing. The abdominal muscles are directly connected to the diaphragm, which is the main muscle involved in coughing. Forceful contractions of the diaphragm can strain the abdominal muscles, causing pain or discomfort in the stomach area.

Most of the time, minor stomach pain when coughing is not anything to worry about. However, persistent or severe pain could signal an underlying medical issue that requires treatment. Let's explore some of the most common reasons why your stomach may hurt when you cough.

1. Muscle Strain

As mentioned, the vigorous contractions of the diaphragm during coughing can place strain on the abdominal muscles. This results in soreness or cramping in the stomach region, similar to an abdominal workout. It may feel like your stomach is bruised when you cough. The pain should subside once the coughing spell ends.

Those with weaker abdominal muscles are more prone to muscle strain when coughing. Older adults, people recovering from surgery, and individuals with conditions like hiatal hernia may be more likely to experience this type of discomfort.

2. Gastroesophageal Reflux Disease (GERD)

GERD occurs when stomach acid frequently flows back up into the esophagus. The esophagus is the tube connecting the mouth to the stomach. This backwash of acid can irritate the lining of the esophagus, causing painful burning in the chest or throat.

When you cough with GERD, it causes abrupt pressure changes in the abdomen. This can force small amounts of stomach acid into the esophagus, resulting in pain. Those with severe GERD may feel this stomach discomfort every time they cough, especially when lying down.

3. Peptic Ulcer Disease

Peptic ulcers are open, painful sores that develop on the inside lining of the stomach, esophagus or small intestine. Ulcers form when there is too much acid production in the stomach or when the mucus layer protecting the lining is disrupted. The main cause is infection from H. pylori bacteria.

The high intra-abdominal pressure produced by coughing can worsen existing ulcer pain. The forceful contractions can essentially “squeeze” an ulcer. This temporary pressure on the ulcer typically causes a short, stabbing pain in the stomach when coughing.

4. Gas and Bloating

Trapped intestinal gas can also make your stomach hurt when you cough. When you cough, your abdominal muscles contract forcefully. If you have a buildup of intestinal gas, this contraction can squeeze the gas pocket, causing discomfort or pain.

Some people naturally produce more gas due to conditions like irritable bowel syndrome. Others may experience increased gas and bloating after eating gas-producing foods. The pain should fade once the gas pocket moves through the digestive tract.

5. Constipation

Severe constipation can sometimes cause abdominal cramping that worsens with coughing. That’s because the pressure from coughing pushes against the backed-up stool. This either compresses or stretches the colon, potentially causing pain.

In most cases, the constipation-related pain is more of a general stomach ache rather than a localized stabbing sensation. It may feel like your stomach is very full and bloated. The discomfort normally improves once you are able to have a bowel movement.

When to See a Doctor

Occasional stomach pain when coughing usually isn’t cause for concern. However, you should make an appointment with your doctor if you experience:

• Severe, persistent, or worsening pain when coughing
• Frequent stomach pain unrelated to coughing
• Pain accompanied by symptoms like heartburn, nausea, vomiting or unintended weight loss
• Blood in your cough, vomit or stool
• Difficulty eating or swallowing
• Pain that interferes with your daily activities

These signs could indicate a more serious underlying condition that requires medical evaluation. It’s important to call your doctor whenever stomach pain is affecting your quality of life.

Possible Causes of Severe Stomach Pain When Coughing

There are several potentially serious medical conditions that can cause stomach pain when coughing, such as:

• Ulcers - Severe, worsening pain may indicate an ulcer is perforating or penetrating deeper into the digestive tract.
• GERD - Frequent burning upper abdominal pain can be a sign of poorly controlled GERD damaging the esophagus.
• Hernia - Increased abdominal pressure from coughing could worsen symptoms of a hernia in the stomach/hiatal region.
• Blockage - A partial intestinal obstruction may cause cramping that’s exacerbated by coughing.
• Pancreatitis - Inflammation of the pancreas can cause abdominal pain that radiates to the back.
• Gallstones - A blocked bile duct resulting from a gallstone may cause right upper quadrant stomach pain.

Other alarming causes include pneumonia, kidney stones, appendicitis, ovarian cysts, and stomach cancer, among others. Let your doctor determine if your symptoms are related to any dangerous underlying problems.

How to Help Relieve Stomach Pain When Coughing

To help soothe minor stomach discomfort when coughing, try these self-care tips:

Take Over-the-Counter Pain Medication

Anti-inflammatories like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce abdominal muscle strain and discomfort. Acetaminophen (Tylenol) also eases pain but doesn’t reduce inflammation. Follow medication dosage instructions carefully.

Apply Heat

A heating pad or hot water bottle placed over the painful area can help muscles relax. Heat stimulates blood flow and may diminish muscle spasms. Avoid direct contact between heat and bare skin.

Massage the Area

Gently massaging the sore abdominal muscles may provide some relief. Use light to medium pressure and small circular motions. Don't massage over any extremely painful spots.

Bend Your Knees

Lying down with your knees bent takes tension off abdominal muscles. Elevating your head with pillows can also minimize strain while reclining.

Pass Gas if Needed

Walking around, doing light exercise, or taking an over-the-counter product containing simethicone can help you pass gas that may be trapped. This may relieve bloating and discomfort.

Improve Your Posture

Standing up straight or sitting with your shoulders back can prevent unnecessary strain on your stomach muscles. Proper posture may make coughing feel easier.

Practice Relaxed Breathing

Pursed-lip breathing allows you to inhale deeply through your nose and exhale slowly through barely parted lips. This controlled breathing can relax tight muscles.

When to Seek Emergency Medical Attention

Seek prompt emergency care if you experience:

• Sudden, severe abdominal pain, especially if concentrated in one area
• Pain along with symptoms like chest pain, sweating, lightheadedness or fainting
• Inability to pass gas or have a bowel movement combined with pain and bloating
• High fever (over 101°F) with nausea, vomiting or shaking chills
• Hard, swollen, extremely tender abdomen
• Blood in vomit or black, tarry stools

These can indicate a medical emergency like a perforated ulcer, bowel obstruction, appendicitis or other condition requiring surgery. Emergency medical care is crucial to prevent life-threatening complications.

When to See a Gastroenterologist

Make an appointment with a gastroenterologist if you have recurring or persistent stomach pain when coughing. A gastroenterologist specializes in digestive diseases. They can perform tests to identify the cause of your symptoms.

Testing often includes:

• Blood tests to look for inflammation or infection
• Stool tests to check for blood or unusual bacteria
• Endoscopy to examine the upper digestive tract lining
• Imaging tests like an abdominal ultrasound, CT scan or MRI

Based on test results, your doctor will determine appropriate treatment options. This may include medication, dietary changes, surgery or other interventions to resolve the underlying problem.

When to Visit Your Primary Care Doctor

You should schedule an appointment with your primary care physician for evaluation if:

• Pain when coughing persists beyond a few days
• OTC medication, heating pads and other self-care provide little relief
• Pain disrupts your daily activities or sleep
• You have other concerning symptoms like recurrent heartburn or nausea
• Existing medical conditions could be worsening

Your primary care doctor can perform an exam, order tests if needed, provide a diagnosis, and outline the appropriate treatment plan. They may prescribe stronger medication, refer you to a specialist, or recommend specific lifestyle/diet changes to resolve your symptoms.

Preventing Stomach Pain When Coughing

You can take certain steps to avoid stomach discomfort when coughing, including:

• Treating any underlying conditions, like GERD or constipation
• Improving posture and abdominal muscle tone
• Quitting smoking to prevent coughing fits
• Eating smaller meals to prevent abdominal pressure
• Avoiding triggers like spicy foods that may worsen GERD or gas

Practicing proper cough etiquette, such as coughing into your elbow rather than your hands, can help prevent respiratory illness that leads to frequent coughing. Talk to your doctor if lifestyle measures don't reduce your coughing and associated stomach pain.

What Does It Mean If Your Stomach Doesn't Hurt When Coughing?

It's also possible for your stomach to not hurt when coughing. There are a few reasons this may occur:

• You have very strong abdominal muscles that withstand repeated contractions.
• You don't have excessive gas buildup or constipation.
• You don't have underlying GERD, ulcers or other gastrointestinal issues.
• You are coughing very lightly or infrequently.
• You may have a high pain tolerance.

While lack of pain could be perfectly normal, it's important not to ignore severe or prolonged coughing. Chronically coughing up mucus or phlegm, coughing after eating, and coughing that disrupts sleep warrant medical assessment. A persistent cough may stem from an underlying lung infection, asthma, chronic obstructive pulmonary disease (COPD) or other treatable issues. Don’t assume a lack of stomach pain with coughing means there isn’t a problem.

The Bottom Line

It's common for your stomach to hurt when coughing. Minor pain results from vigorous contractions of the diaphragm straining abdominal muscles. However, severe, persistent pain, or pain along with other concerning symptoms, needs medical evaluation. Your doctor can diagnose and properly treat any underlying conditions contributing to stomach discomfort when coughing.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.