There are many types of stomach problems. Patients with mild conditions like gastritis or gastric ulcers typically do not need hospitalization. However, for serious conditions such as severe GERD, perforated peptic ulcers, or esophageal and gastric varices, the need for hospital admission depends on the symptoms and any complications.

The seriousness of a stomach condition isn’t just about the disease itself. You should be alert for warning signs like sudden severe abdominal pain, black stools, vomiting material that looks like coffee grounds, severe vomiting, or an inability to pass stool or gas. These can indicate serious issues like stomach bleeding, perforation, or intestinal obstruction, which generally require hospitalization.

1. Severe GERD (Gastroesophageal Reflux Disease): GERD occurs when stomach or duodenal contents flow back into the esophagus due to a weakened anti-reflux barrier, causing classic symptoms like heartburn and acid regurgitation. Treatment usually involves proton pump inhibitors and prokinetic agents. If symptoms are severe and don’t respond to medication, anti-reflux surgery might be necessary, which requires a hospital stay.
2. Perforated Peptic Ulcer: While less common due to widespread use of proton pump inhibitors, perforations can still occur, especially in people who heavily consume alcohol, the elderly, or those under prolonged emotional stress. A sudden worsening of abdominal pain, accompanied by tenderness and rebound tenderness (signs of peritonitis), and sometimes signs of gastrointestinal bleeding, suggests this condition. Immediate hospitalization is required for diagnosis and treatment.
3. Esophageal and Gastric Varices: These are enlarged veins that can rupture from eating hard or very hot food. A variceal rupture can cause massive bleeding, which is a life-threatening emergency requiring immediate hospitalization.

Beyond these, conditions like stomach cancer or large gastrointestinal stromal tumors (GISTs) may require hospitalization based on the patient’s specific situation and treatment plan. Early-stage stomach cancer found during an endoscopy might be treated in an outpatient setting. However, advanced cancer or high-risk endoscopic procedures will require a hospital stay. In daily life, it’s important to eat a soft, easy-to-digest diet, avoid spicy, very hot, or hard foods, and quit smoking and alcohol to prevent the condition from worsening.