Why does my stomach hurt when I’m hungry?

Stomach pain when hungry is primarily associated with two causes. First, stomach pain upon hunger may occur when the body is in a state of extreme hunger, triggering excessive gastric acid secretion that irritates the gastric mucosa and causes pain. Second, such pain may indicate an underlying gastric disorder—such as gastric erosion or gastric ulcer—in which the gastric mucosa is already damaged; subsequent hunger-induced surges in gastric acid secretion further erode the mucosa, exacerbating the injury and resulting in pain.