Many times abdominal pain is nothing to worry about. What about those times when belly pain can be concerning, even life threatening?

Not every one with a heart attack will have chest pain. If the area of the heart attack is near the bottom of the heart, a patient might only have belly pain up high and nothing else. If you are at risk for a heart attack (high blood pressure, diabetes, high cholesterol, known history of heart disease, smoker and family history) then if you develop some even minor pain just below the rib cages, it could be something more serious.

An aneurysm of the aorta means that the aorta is dilated. If it dilates too much, it can rupture or dissect. Either condition can lead to belly pain. The pain will usually be severe, come on suddenly and can be associated with weakness, chest pain, sweating and bloody urine, among other symptoms. Smokers over the age of 55, those who have known high blood pressure and patients with certain diseases such as Marfans syndrome are at higher risk of an aortic aneurysm.

If the gut does not get enough blood supply, a condition known as ischemic colitis can result. This will present with severe, unrelenting belly pain and is more likely to occur in patients who have atrial fibrillation, are severely dehydrated or have severe atherosclerosis.

A perforated bowel will lead to peritonitis. So too will a ruptured abscess or pus pocket. Patients who have ascites (from liver failure among many causes) are at high risk of peritonitis as well. This condition presents with severe belly pain, fever, rigid belly and weakness.

Pneumonia in the lower lobes of the lung can lead to belly pain. Here the patient will often have a cough and shortness of breath as well.

Bottom line is if the belly pain is severe, you feel weak and you are at risk for serious conditions, go right away to the ER. It just might save your life.