The article has been reviewed by Dr. Lok Ka Ho, Specialist in Gastroenterology & Hepatology, and Head of Endoscopy Centre, St. Paul's Hospital
Stomach pain is a common discomfort that can arise from various causes, ranging from simple indigestion to serious gastric diseases. Understanding the causes, symptoms, and diagnostic methods of stomach pain is crucial for timely management and prevention. This article will provide detailed information and practical handling suggestions.
Common Causes of Stomach Pain
Gastrointestinal diseases
Stomach pain may be associated with various gastrointestinal diseases, such as gastritis, gastric ulcers, duodenal ulcers, and gastroesophageal reflux disease (GERD). These conditions can be caused by factors such as Helicobacter pylori infection, long-term use of certain medications (like aspirin), and poor dietary habits.
Lifestyle factors
Long-term anxiety or stress can affect gastrointestinal function, leading to stomach pain or indigestion. Additionally, excessive alcohol consumption and smoking can irritate the stomach; alcohol and nicotine may damage the gastric mucosa, increasing the risk of gastric ulcers and stomach pain. Irregular eating habits, such as prolonged fasting, binge eating, or eating too quickly, can also cause abnormal gastric acid secretion, resulting in discomfort or even pain.
Dietary types
Dietary habits have a profound impact on stomach health, as certain foods may exacerbate stomach pain or trigger discomfort. For example, spicy, acidic, or high-fat foods can stimulate gastric acid secretion, increasing the risk of burning sensations and pain in the stomach. Moreover, excessive caffeine intake can affect the gastric mucosa; caffeinated beverages like coffee and strong tea may cause stomach discomfort or worsen acid reflux. Lactose intolerance is also a common cause of stomach discomfort, as some individuals lack the enzyme to break down lactose, leading to bloating or abdominal pain after consuming dairy products. Additionally, eating contaminated food can result in bacterial infections of the gastrointestinal tract or bloodstream, potentially causing acute stomach pain.
Possibility of stomach cancer
Although rare, stomach pain can be an early symptom of stomach cancer. If persistent stomach pain, unexplained weight loss, loss of appetite, or black stools occur, it is important to seek immediate medical attention for examination.
Main Symptoms of Stomach Pain?
Bloating
Bloating is one of the common symptoms associated with stomach pain, which may indicate indigestion or the accumulation of gas in the intestines, often accompanied by burping or flatulence.
Abdominal fullness
Feeling a sense of fullness in the abdomen after eating may be related to gastroesophageal reflux, gastritis, or gastric ulcers, especially noticeable after meals.
Spasms or pain in the stomach or abdomen
Sudden or intermittent abdominal pain may be caused by gastritis, gastric ulcers, or gastroesophageal reflux. The nature of the pain may be described as burning, stabbing, or cramping.
Diarrhea or constipation
These symptoms may be related to irritable bowel syndrome or gastrointestinal diseases, particularly when stomach pain is accompanied by diarrhea or constipation. They may be associated with gastrointestinal infections, irritable bowel syndrome, or food intolerances, warranting further investigation.
Diagnosis Methods for Stomach Pain
Where is the stomach pain located?
The location of stomach pain can provide important diagnostic clues, as pain in different areas may correspond to various health issues.
- Upper abdominal pain: Commonly associated with gastritis, gastric ulcers, or gastroesophageal reflux, and may be accompanied by a burning sensation or nausea.
- Lower abdominal pain: May be related to abnormal gastrointestinal motility, irritable bowel syndrome, intestinal infections, or constipation.
- Right side abdominal pain: Could be associated with cholecystitis, gallstones, or liver problems.
- Left side abdominal pain: May involve gastrointestinal spasms, spleen issues, or colon diseases.
Abdominal Pain is Not Always Stomach Pain! Various Organ Issues Can Cause Abdominal Discomfort
Many people instinctively think of "stomach pain" when experiencing abdominal pain, but the causes of abdominal pain are quite diverse. In addition to gastric diseases, issues with the small intestine, large intestine, pancreas, liver, gallbladder, and even the heart or urinary tract can manifest as abdominal or stomach pain.
For example:
- Upper abdominal pain: Besides common issues like gastric ulcers and gastroesophageal reflux, it could also be related to acute pancreatitis or myocardial infarction.
- Right upper abdominal pain: May be associated with cholecystitis or hepatitis.
- Lower abdominal pain: Could indicate problems with the urinary system or intestines.
Management and warning signs for mild abdominal pain
Most mild abdominal pain, if there is a clear diagnosis (e.g., gastroesophageal reflux, constipation), can be managed with medication as advised or through self-relief methods. However, if the pain is severe, persistent, or accompanied by abnormal symptoms such as fever, vomiting, jaundice, blood in stools, or changes in bowel habits, it may indicate serious conditions like acute appendicitis, peritonitis, or pancreatitis, requiring immediate medical attention. Do not delay seeking care.
There are many possible causes of stomach pain – seek a doctor's advice for an accurate diagnosis
Stomach pain does not necessarily indicate a gastric problem; it could also stem from issues with the heart, gallbladder, urinary tract, or other organs. Therefore, if abdominal or stomach pain recurs, is located unusually, or is accompanied by other alarming symptoms, seek medical diagnosis promptly to avoid missing critical treatment opportunities.
If pain persists or is accompanied by other symptoms, it is advisable to seek medical evaluation early to ensure timely diagnosis and treatment. Relevant examinations can be conducted at the Integrated Specialist Centre at St. Paul's Hospital, and if there are gastrointestinal symptoms, further examination and treatment will be arranged at the Endoscopy Centre .
Different causes of stomach pain when full vs. empty
The timing of stomach pain is related to eating habits, and pain occurring at different times may suggest different underlying causes:
- Stomach Pain on an Empty Stomach: Commonly associated with duodenal ulcers, pain may worsen when fasting or at night. It may also relate to excessive gastric acid secretion or gastric ulcers, as stomach acid can directly irritate the gastric or duodenal mucosa, leading to pain.
- Stomach Pain After Eating: This may relate to gastroesophageal reflux or gastric ulcers, especially if pain occurs within 1-2 hours after eating. Additionally, it could be linked to indigestion, gallbladder disease, or acid reflux, which can worsen when the stomach is under increased load.
The specific cause of stomach pain needs to be assessed in conjunction with personal symptoms, dietary habits, and lifestyle. Professional examinations may be necessary to determine the underlying cause.
How to Manage Stomach Pain? What to Eat for Stomach Pain?
Avoid high-fat foods
High-fat foods are difficult to digest and can increase the burden on the stomach, leading to excessive gastric acid secretion and worsening stomach pain. It is recommended to avoid fried foods, fatty meats, butter, and other high-fat items during periods of stomach pain. Instead, opt for light and easily digestible foods, such as plain congee, steamed fish, tofu, or cooked vegetables.
Avoid highly spicy foods
Spicy foods can irritate the gastric mucosa and increase gastric acid secretion, which can trigger or worsen stomach pain. It is advisable to avoid spicy items like chili peppers, black pepper, and garlic, as well as stimulants like coffee, alcohol, and carbonated drinks during episodes of stomach pain. Choose mild and light beverages, such as warm water or herbal tea.
Reduce meal portions
Overeating can increase the burden on the stomach, leading to excessive gastric acid secretion and causing stomach pain. It is advisable to maintain regular meal times and portions, avoiding extreme hunger or binge eating. Aim to eat until you are about 70% full at each meal.
Use prescription medications under medical guidance
If stomach pain persists or worsens, it is recommended to use medications such as antacids, inhibitors, gastric mucosal protectants, or antibiotics under the guidance of a doctor.
When should you seek medical help?
Common stomach pain may simply be due to indigestion or mild discomfort, but if the following situations arise, seek medical attention promptly to prevent potential serious health issues.
Difficulty with bowel movements or sudden changes in bowel habits
If there are sudden changes in bowel habits, such as persistent constipation, diarrhea, or a feeling of incomplete evacuation, it may be related to gastrointestinal dysfunction or bowel diseases. Immediate medical consultation is advised.
Unexplained weight loss leading to significant thinness
If unexplained weight loss occurs, it may indicate underlying health issues such as gastric or intestinal diseases, and could even be related to malignancies. This is particularly concerning if accompanied by stomach pain, and medical attention should be sought urgently.
Persistent stomach pain or frequent abdominal pain
If stomach pain persists without relief for several weeks or recurs frequently, particularly after eating or on an empty stomach, it may involve conditions like gastric ulcers, gastritis, or gastric cancer, necessitating thorough examination.
Symptoms of jaundice in skin or eyes
Jaundice (yellowing of the skin and eyes) may be associated with liver, gallbladder, or bile duct problems, such as gallstones or liver disease, and may also relate to digestive system issues. Prompt examination is required.
Abdominal bloating accompanied by edema and weight gain
If the stomach or abdomen is abnormally distended and accompanied by edema and weight gain, it could indicate heart disease, kidney disease, or other chronic conditions. Timely examination is necessary to rule out liver, kidney, or cardiovascular diseases.
Impact on drinking and eating
If stomach pain, nausea, or difficulty swallowing affects your ability to eat and drink, it may lead to malnutrition or dehydration. Seek medical help promptly to ensure normal bodily function.
If you experience any of the above situations, it is advisable to make an appointment with our gastroenterology & hepatology specialists at the Integrated Specialist Centre of St. Paul's Hospital for further examination.
Treatment Methods for Stomach Pain
The treatment methods for stomach pain depend on its causes. If symptoms are mild, dietary adjustments and improvements in lifestyle can help alleviate discomfort. However, if stomach pain persists or significantly affects daily life, medication may be necessary to relieve discomfort and address underlying issues.
Medication treatment
Medication treatment is a common approach. Doctors may prescribe suitable medications based on the different causes of stomach pain. Commonly used medications include:
- Antacids: Neutralize stomach acid to relieve heartburn and indigestion, such as aluminum hydroxide and magnesium hydroxide.
- H2 Blockers: Reduce stomach acid secretion, such as ranitidine and famotidine.
- Proton Pump Inhibitors (PPIs): Effectively inhibit stomach acid secretion, suitable for gastric ulcers and gastroesophageal reflux, such as omeprazole and esomeprazole.
- Gastrointestinal Motility Agents: Such as domperidone and mosapride, help improve bloating, indigestion, and abnormal gastric emptying.
- Gastric Mucosal Protectants: Such as sucralfate and bismuth, protect the gastric mucosa and reduce damage to the stomach wall from acid, suitable for patients with gastritis or gastric ulcers.
- Antibiotics: If stomach pain is related to Helicobacter pylori infection, antibiotics (such as amoxicillin, clarithromycin, and metronidazole) may be needed to eradicate the bacteria.
Gastroscopy
When experiencing recurrent stomach pain, indigestion, difficulty swallowing, vomiting blood, black stools, or suspected conditions like gastric ulcers, gastritis, or stomach cancer, doctors often recommend a gastroscopy (oesophagogastroduodenoscopy, OGD). Gastroscopy is a safe and accurate endoscopic procedure that allows direct observation of the inner walls of the esophagus, stomach, and duodenum, and can facilitate immediate biopsy or treatment.
The main uses of gastroscopy include:
- Investigating the causes of stomach pain, bloating, and indigestion
- Detecting and diagnosing conditions such as gastritis, gastric ulcers, polyps, and stomach cancer
- Identifying and managing upper gastrointestinal bleeding
- Tumor biopsy
Gastroscopy is generally performed under local anesthesia or sedation. The doctor will insert a thin endoscope through the mouth into the esophagus, stomach, and duodenum. The procedure typically takes about 5 to 20 minutes, and patients can usually go home the same day.
If you have persistent gastrointestinal discomfort or if your doctor recommends a gastroscopy, feel free to learn about the gastroscopy services at Endoscopy Centre of St. Paul's Hospital. Our professional team provides safe and comfortable endoscopic examinations with comprehensive follow-up care. For doctor consultation appointments or inquiries, please visit the Integrated Specialist Centre or call for more information.
Methods to Relieve and Prevent Stomach Pain
A good dietary habits and lifestyle can effectively reduce the occurrence of stomach pain and maintain gastrointestinal health.
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Reduce stress
Excessive stress can affect gastrointestinal motility and gastric acid secretion, increasing the risk of stomach pain. Stress relief can be achieved through exercise, deep breathing, meditation, and yoga, helping to maintain mental health and prevent emotions from impacting stomach function.
Regular meal times with consistent portions
Irregular eating habits can lead to abnormal gastric acid secretion, irritating the stomach lining and triggering pain. It is recommended to eat at regular times each day, avoiding overeating or prolonged fasting to ensure stable gastrointestinal function.
Easily digestible foods
To reduce the burden on the stomach, choose low-fat, easily digestible foods such as porridge, steamed eggs, well-cooked vegetables, and lean meats. Avoid excessively cold, hot, or high-fiber foods to prevent irritation of the stomach.
Foods to avoid
Certain foods may exacerbate stomach discomfort and should be minimized, including spicy, high-fat, and highly acidic foods, as well as beverages containing caffeine.
Avoid lying down or engaging in intense exercise immediately after eating
After meals, it's best to remain seated or engage in light activity for at least half an hour to an hour to aid digestion and reduce the likelihood of acid reflux. Avoid vigorous exercise, such as running or jumping, to prevent pressure on the stomach that can hinder digestion.
Frequently Asked Questions
Is stomach pain caused by excessive stomach acid?
Stomach pain is not necessarily due to excessive stomach acid; it could also be related to gastroesophageal reflux, gastric ulcers, duodenal ulcers, or functional dyspepsia. If symptoms persist, it is important to undergo examination to determine the cause. However, insufficient stomach acid can also lead to stomach pain, as inadequate acid affects food digestion, resulting in prolonged retention in the stomach and discomfort.
Is stomach pain related to emotions or mental health issues?
Yes, emotions and psychological states are closely linked to gastrointestinal health. Emotional issues such as stress, anxiety, and depression can affect gastrointestinal motility and gastric acid secretion, leading to stomach pain or indigestion.
Can stomach pain worsen over time and potentially lead to ulcers, cancer, or other diseases?
Stomach pain itself is not a disease but a symptom of various gastrointestinal issues. Some stomach pain may be temporary or functional, not warranting excessive concern. However, if stomach pain persists or occurs frequently, it may be related to serious conditions. If not addressed in a timely manner, there is indeed a risk of worsening, potentially developing into ulcers or cancer.
