Sudden severe stomach pain and diarrhea can be quite scary.

“Acute severe abdominal pain and diarrhea implies severe intestinal inflammation,” says Larry Good, MDa practicing gastroenterologist for 40+ years. He has a private practice based in Lynbrook, NY and is affiliated with Concierge Choice Physicians, a leading provider of personalized care in the U.S.

“It is important to understand the difference between the stomach (one organ) and the abdomen,” continues Dr. Good.

Of course, when a person feels intense pain in this area, the term “stomach” and “abdominal” become interchangeable to that person, because the way they see it, “stomach” refers to the section of their body between their bellybutton and sternum.

“Severe abdominal pain with urgency to defecate [diarrhea] is usually caused by an intestinal infection (viral, bacterial, food poisoning) or by a chronic inflammatory disorder like ulcerative colitis or Crohn’s disease.”

Sudden Severe Stomach Pain: Benign Form of Colitis

Another inflammatory disorder that can cause these symptoms is microscopic colitis. Like ulcerative colitis and Crohn’s, this is an inflammatory bowel disease, but it’s far more benign.

You can have it and not even know it, depending on the frequency of the diarrhea and how “normal” it looks.

One of the key features of microscopic colitis is that the diarrhea may be nocturnal.

I have MC (the very intermittent kind), and one time in the middle of the night, I was awakened by a lower abdominal cramp and the urge to have a bowel movement.

Once I sat on the toilet, I was overcome with severe lower abdominal pain—not the typical “pain” you feel when you have a lot of hard BMs to void. It was so intense I felt nauseous.

And then the diarrhea came (not a lot), and poof, the pain was gone! This was a one-time flare, unrelated to previous food intake.

Chronic abdominal pain, urgency and diarrhea including fecal incontinence is frequently caused by diarrhea-predominant irritable bowel syndrome,” says Dr. Good.

Dr. Good has additional expertise in the diagnosis/treatment of IBS and inflammatory bowel disease, and is extremely proactive in genetic testing, individualization of pharmacologic treatment, and risk mitigation in cancer screening/prevention. Concierge Choice Physicians
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 



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