Stomach Pain and Stomach Disorders

According to Dr. Douglas Drossman, co-director of the University of North Carolina’s Center for Functional GI and Motility Disorders, stomach pain is part of life.

Often, a stomachache is just a stomachache. But if you’ve had pain for six months, or experienced serious symptoms such as blood in the stool or unexplained weight loss, better see a doctor.

There are more than 100 possible causes for your pain. So, how do you know if your stomachache is the result of pathogen, overindulgence, stress, an allergy or some rare disorder?

Irritable Bowel Syndrome

IBS is one of the toughest disorders to diagnose and treat. Once diagnosed, doctor may suggest dietary changes, such as eating more fiber. It is important to note that the increase of fiber must be gradual, since an excess can cause bloating. Doctors may also prescribe antibiotics—to reduce bacteria in the intestinal tract, or probiotics—to shore up healthy bacteria.

Celiac Disease

Celiac disease is a sensitivity or allergy to gluten—a family of proteins found mostly in grains, including wheat, barley and rye. Some sufferers also have trouble with oats.

It may cause:

• Stomach pain

• Diarrhea

• Bloating

• Weight loss

• Anemia

• Just a vague not-so-good feeling.

According to Dr. Amy Foxx-Orenstein, president of the American College of Gastroenterology, the healthy intestine is lined with villi, fingerlike projections that absorb nutrient and fluids. In celiac disease, the villi get lost or damaged, so your body doesn’t absorb much of anything.

Eliminating gluten from your diet will help the villi return and your symptoms go away over time. If you think you have celiac disease, see your doctor before you cut out these foods.

Stress Connection

When you’re stressed, there are an abnormal number of signals firing away, which can cause discomfort on your stomach. The Enteric Nervous System (ENS)—the gut’s brain—has its own muscles, nerves, neurotransmitters, which tell the gut to move its content through the body. The ENS is always communicating with your brain, sending signals back and forth.

According to Dr. Mehmet Oz, director of the Cardiovascular Institute at Columbia University Medical Center in New York City and co-author of the “You” health books, there’s a very close connection between our brain and our gut, so it’s not surprising to think that if our brain is overstressed, the same thing is happening to our gut.

Tips to Reduce Stress and Ease Stomach Pain Symptoms

• Deep Breathing

• Exercise

• Meditation 

• Yoga

Crohn’s Disease

Crohn’s disease is a form of inflammatory bowel disease, a group of conditions in which the GI tract is chronically inflamed. Crohn’s symptoms are similar to those of IBS, but unlike IBS, there’s no detectable damage to the digestive system, Crohn’s causes intestine to be inflamed.

According to Dr. Howden, the inflamed intestine can narrow the end of small intestine, so it has to work harder to push waste through, causing:

• Stomach Pain (especially while eating)

• Diarrhea

• Vomiting 

• Weight Loss (tend not to eat much cause it hurts to do so)

It is diagnosed in several ways:

• Doctor may feel a mass in abdominal cavity

• May have abnormal blood tests

• Other tests may reveal nutrient deficiencies or ulcers

Endoscopy, X-rays, or an intestinal biopsy can confirm the diagnosis.

Some Tips to Help Avoid the Pain

• Eat more protein

• Avoid foods that take a long time to break down

Food Poisoning

Gastrointestinal disorders tend to start slowly and gradually worsen, but food poisoning hits from four to 24 hours after eating, and comes with a lot of symptoms:

• Stomach Pain

• Nausea 

• Vomiting

• Fever

• Diarrhea

If more than 12 to 24 hours and you can’t keep fluids down and have watery diarrhea, or too much discomfort, see a doctor or go to the ER for pain relief and hydration.

What about Gas Problem?

The average person passes gas between 14 and 23 times a day. When you’re struck with painful bloating gas try taking an antacid or Pepto-Bismol to coat your stomach, or probiotics to ease your symptoms.

Tips To Avoid Gas Problem

• Chew food thoroughly and eat leisurely 

• Avoid overeating

• Don’t lie down after eating; get up and take a 20-minute walk

• Don’t drink water with meals

• Avoid gaseous foods, including soda, gum, mints, candy, Brussel sprouts and cabbage

Note: For more lists of Gaseous Foods See Gas-Forming Foods and For More Tips on Digestion Efficiency See The Suggested Meal Pattern

Reference: Patricia Curtis, Quit Your Belly Aching, p. 65-69, Reader’s Digest, February 2008

Common Digestive Disorders

Digestive disorders encompass a wide array of conditions that affect the gastrointestinal (GI) tract. These disorders vary in severity, from minor annoyances (such as mild heartburn) to potentially life-threatening illnesses (such as a perforated ulcer).

Here are some of the more common digestive disorders:

GastroEsophageal Reflux Disease (GERD)

GERD occurs when the lower esophageal sphincter relaxes at the wrong times, allowing acid from the stomach to enter the esophagus. One possible cause of GERD is a hiatal hernia—a protrusion of this same sphincter and the upper portion of the stomach into the chest cavity.

Gastritis and Gastric Ulcers

Gastritis (the inflammation of the stomach lining) and gastric ulcers (breaks or open sores in the lining) are most commonly caused by infections or the use of medications.

(Duodenal) Ulcers

Ulcers can also occur in the duodenum when stones that form in the gallbladder keep bile out.

Crohn’s Disease

Chron’s disease is an inflammatory disorder that primarily affects the small intestine. It may also damage the large intestine and any other part of the digestive system.

Ulcerative Colitis

Ulcerative colitis is an inflammatory disease that affects only the large intestine. Diarrhea occurs when waste products move through the large intestine too quickly, while constipation results when the waste products movement is too slow.

Diverticulitis

Diverticulitis is a condition where diverticula (small pouches) can bulge outward through weak spots in the wall of the large intestine. It is the infection or inflammation of diverticula.

Hemorrhoids

Hemorrhoids are clusters of swollen veins, and are thought to result from increased pressure in the veins of the rectum and/or anus.

Reference: Recognising Common Digestive Disorders, p. 144 Readers Digest, September 2008

Peptic Ulcer

Peptic Ulcer is a general term given to an erosion in the lining of the stomach (gastric) or small intestines (duodenal) or lower end of the esophagus (esophageal). An ulcer may be simple involving only lining. It may be penetrating involving the muscles under the lining. Or, it may be perforating where the wound penetrates through the tissue of the stomach or intestinal wall, and contents of the stomach or intestines get into the abdominal cavity. This becomes a serious condition.

Probable Causes

• Excessive intake of alcohol

• Smoking

• Faulty eating habits such as hurried and irregular meals and improper food selection like spicy or caffeine-containing foods

• Drugs

• Heredity (more people with type O blood have ulcers than do persons with other blood types)

• Overtaxed bodies (lack of rest) resulting in lowered resistance

Note: Highly nervous and emotional individuals (Type A personality because they are always on the go) are more prone to developing peptic ulcer.

Probable Symptoms

• Burning, piercing and periodic pain in the upper abdominal area

• Hyperacidity

• Presence of dark blood in stool

• Nausea

• Vomiting

Helpful Dietary Management

• Serve bland diet in 3 regular meals.

• Eat meals in a relaxed atmosphere.

• Avoid bedtime snack.

• Say “no” to alcohol, coffee, soft drinks, chocolates, and tea.

• Avoid spices.

• Drink water instead of milk in between meals. (See The Importance of Water)

• Avoid milk and cream. They have been found to stimulate further acid secretion.

• Avoid sour juices before meal.

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.32 & 33 © 2003 Philippine Publishing House ISBN 971-581-013-6

Loose Bowel Movement (LBM, Diarrhea)

Loose Bowel Movement refers to the passage of loose or watery stools at frequent intervals along the digestive tract making complete digestion and effective absorption of food and liquid less possible—a common symptom of a distorted digestive system.

Probable Causes

Functional Diarrhea

• Overeating or eating spoiled, putrefied foods

• Incomplete digestion

• Habitual use of cathartics

• Nervous tension

• Endocrine disturbance

• Diarrhea associated with disease such as sprue and pellagra

Organic Diarrhea

• External poison

• Bacterial or protozoan invasion

• May accompany certain diseases such as tuberculosis, amoebic dysentery, typhoid fever, viral hepatitis, chronic ulcerative colitis, regional ileitis (gastrointestinal tract malignancy/tumor) and enteritis or enzyme deficiencies which result in poor digestion and absorption of carbohydrates

Probable Symptoms

• Sudden onset of frequent stools of watery consistency

• Abdominal pain

• Cramping

• Weakness

• Fever

• Vomiting

Note: Acute episode may last from 1 to 3 days.

Helpful Dietary Management 

• Liberally drink clear liquid to replace fluid loss in vomiting and defecating. This is done to prevent dehydration.

• Give Oral Rehydration Solution (ORESOL) to prevent water as well as electrolyte imbalance.

• Progress from clear liquid to constipating diet as stool consistency improves.

• Eat foods rich in pectin such as banana and apple. They aid in stool formation.

• See your physician immediately if diarrhea does not improve within 24 hours. 

Stages of Dehydration

Look At: Condition Eyes Tears Mouth and Tongue Thirst	Well, alert Normal Present Moist Drinks normally, not thirsty	*Restless, irritable Sunken Absent Dry *Thirsty, drinks eagerly	*Lethargic or unconscious; floppy Very sunken and dry Absent Very dry *Drinks poorly or not able to drink
Feel: Skin Pinch	Goes back quickly	*Goes back slowly	*Goes back very slowly
Decide:	The patient has no sign of dehydration.	If the patient has two or more signs, including at least one *sign* there is some dehydration.	If the patient has two or more signs, at least one *sign* there is severe dehydration.
Advice:	Consult your doctor. Follow Helpful Dietary Management. Home Management	Consult your doctor. Follow Helpful Dietary Management.	Consult your doctor. Hospital management is needed.

        Adapted from: World Health Organization’s management of the patient with diarrhea

ORESOL Formula (World Health Organization)

¾ teaspoon table salt

1 teaspoon baking soda

1 cup orange juice

4 tablespoons table sugar

4 liter (1.06 quarts) clean water, boiled for 10 minutes (or distilled water)

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.30-31 & 246 © 2003 Philippine Publishing House ISBN 971-581-013-6

Constipation

Constipation refers to difficult bowel movement. It is usually the infrequent passage of feces which are unduly hard and dry.

Probable Causes

• No regular bowel movement

• Improper diet (low fiber with very little fluid intake)

• Intestinal obstructions

• Tumors

• Excessive use of laxatives or cathartics

• Weakness of intestinal muscles

• Use of certain drugs

• Presence of lesions in the anus

• Worry

• Anxiety

• Fear

• Sedentary lifestyle (lack of physical activity)

Probable Symptoms

• Uneasiness

• Indisposition

• Lower abdominal pain

• Headache

• Coated tongue

• Foul breath

• Lack of appetite

Note: These symptoms usually disappear after satisfactory defecation has taken place.

Helpful Dietary Management

• Eat a high-fiber diet.

• Drink milk and plenty of water. (See The Importance of Water)

• Make every meal time a relaxed experience. Do not eat when under the influence of strong emotion such as hatred, fear and worry.

 

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.26 & 27 © 2003 Philippine Publishing House ISBN 971-581-013-6

Gastritis

Gastritis is an acute or chronic inflammation of the stomach lining.

Probable Causes

• Toxins of infectious diseases

• Toxins from ingested spoiled food

• Overeating

• Allergy to foods

• Eating when overtired or emotionally upset

• Use of too much alcohol

• Tobacco

• Highly seasoned foods

• Iron deficiency

Note: Gastritis often accompanies gastric lesions such as cancer and ulcer.

Probable Symptoms

• Anorexia nervosa (See Underweight)

• Vague upper abdominal discomfort

• Heartburn

• Severe vomiting (See Vomiting)

Note: The diagnosis of gastritis is based on biopsies of the gastric mucosa (stomach lining).

Helpful Dietary Management

For acute attack:

• Nothing by mouth for 24 to 48 hours.

• Provide intravenous nutrition (administration under the supervision of a physician).

• Use only cracked ice to be held in the mouth to relieve thirst.

• Add full liquid diet as tolerated on the second or third day, depending on the patient’s condition.

• Avoid stimulating and highly seasoned foods.

• Progress from soft diet to bland diet.

For chronic attack:

• Eat a low fiber and bland diet.

• Correct faulty eating habits.

 

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.28 & 29 © 2003 Philippine Publishing House ISBN 971-581-013-6

Vomiting

Vomiting is the ejection of the stomach content through the mouth.

Probable Causes

• Toxins from drugs, uremia, and specific fevers

• Brain tumors and meningitis

• Stomach diseases

• Reflex from pregnancy’s uterine or ovarian disease

• Intestinal obstruction

• Motion sickness

• Nervous involvement (hysteria and migraine)

• Esophageal obstruction

Probable Symptoms

• Nausea

• Cold sweating

• General weakness

Helpful Dietary Management

• Give clear liquid diet by mouth if acceptable to patient.

• If vomiting continues, administer intravenous fluids under the supervision of a physician to replace vomitus loss.

In pregnancy:

• Give a dry diet high in carbohydrates and protein.

• Drink water and liquids between meals, not at mealtime.

• Have frequent small meals instead of big far-in-between ones.

• Follow the guidelines for balanced diet.

Helpful Tips for Minimizing Nausea and Vomiting

• Eat small meals.

• Avoid high-fat foods.

• Sip clear liquids or suck popsicles to prevent dehydration.(See Clear Liquid Diet)

• Lie down after eating.

• Loosen clothing after eating.

• Get fresh air.

• Avoid smells that cause nausea.

• Avoid favorite foods if nausea occurs at the time you eat those foods. (Favorite foods may turn out to be dreaded foods!)

 

Reference: Healing Wonders of Diet Effective Guide to Diet Therapy p.34 & 246 © 2003 Philippine Publishing House ISBN 971-581-013-6