Irritable Stomach: Causes, Symptoms & Treatment

An irritable stomach or functional dyspepsia is a disease of the stomach. In this case, a functional disorder occurs, whereby a pathological change can occur within the stomach due to external and internal stimuli. Typical signs of an irritable stomach are a feeling of fullness, stomach pain in the upper abdomen, nausea and occasionally vomiting. The exact causes have not yet been fully clarified. However, one assumes mainly psychological causes and stresses.

What is irritable stomach?

An irritable stomach, medically also called functional dyspepsia, is present when human digestion is disturbed. It is a medical condition characterized by chronic or recurrent pain in the upper abdomen. A significant feeling of fullness, even with little food intake, also indicates an irritable stomach if it occurs repeatedly. Accompanying symptoms may include flatulence, frequent belching, nausea, or heartburn.

Causes

Irritable stomach is a common phenomenon and quite often results from gastroesophageal reflux disease or gastritis. Incorrect dietary habits also play a major role. Fatty foods, spicy foods or foods with artificial additives, as well as alcohol and caffeine are considered common triggers. Occasionally, medications can also cause an irritable stomach, such as calcium antagonists used for angina or high blood pressure. Theophylline for lung disease, bisphosphonates for osteoporosis, or corticosteroids and other anti-inflammatory drugs used as pain relievers can also be triggers for an irritable stomach with long-term use, requiring treatment. Sometimes the reason for an irritable stomach also lies in the psychological sphere, e.g. if constant stress puts a strain on the person affected or crisis situations overwhelm him. However, an irritable stomach can also be the first sign of a stomach ulcer in some cases and of stomach cancer in rare cases. This means that the first or unexpected appearance of an irritable stomach should definitely be a sign of alarm and give cause for further investigation.

Symptoms, complaints and signs

With an irritable stomach, numerous symptoms can occur that cause a noticeable restriction of the quality of life. At the same time, the complaints are not limited to the area of the stomach, abdomen and digestion. As a symptom of an irritable stomach (functional dyspepsia), there may be a feeling of pressure in the upper abdomen that intensifies. This may be followed by girdling radiating pain. Signs of an irritable stomach can also include heartburn and acid regurgitation. In addition, flatulence and irregular bowel movements may occur. Nausea and vomiting can also indicate an irritable stomach. Those affected report a loss of appetite and an aversion to specific foods. One of the typical perceptions of an irritable stomach is the feeling as if there were a stone in the stomach. Further signs of an irritable stomach can be a premature feeling of satiety and a feeling of fullness. The symptoms can occur individually or in combination. They may occur depending on or independent of the diet. Signs of a nervous stomach may also include headaches, nervousness and inner restlessness, as well as sleep disturbances, dizziness or poor concentration. The condition may also be accompanied by vegetative disorders such as palpitations, heart palpitations and circulatory problems, as well as excessive sweating. The symptoms of an irritable stomach also include back pain and joint problems. Other atypical symptoms of irritable stomach include difficulty swallowing and weight loss. Painful discomfort caused by an irritable stomach is aggravated by exertion.

Course of the disease

Characteristic of the course of the disease in irritable stomach is an increase in pain with exertion, excessive sweating, and increasing sensitivity when touching or palpating the abdominal wall. Occasionally, severe swallowing difficulties, weight loss or gastrointestinal bleeding occur. In such cases, immediate consultation with a physician is indicated in the case of irritable stomach. The prognosis for irritable stomach is generally good. In any case, people with irritable stomach are not at increased risk of developing an ulcer or malignant stomach disease.

Complications

If irritable stomach remains untreated for a long period of time, chronic stomach pain and other gastrointestinal complaints may develop. Frequently, for example, heartburn or diarrhea occur, both of which are associated with risks and possible sequelae (for example, intestinal infections and esophageal cancer). Infection with Helicobacter pylori may later develop gastritis. Gastritis is associated with an increased risk of stomach cancer. Occasionally, irritable stomach can also cause difficulty swallowing or gastrointestinal bleeding. The latter can lead to anemia and subsequently to life-threatening complications. The often accompanying weight loss can result in deficiency symptoms and dehydration. A chronic irritable stomach has psychological consequences and may cause depression or anxiety disorders. Complications can also arise during treatment. Medications such as omeprazole or pantoprazole often cause gastrointestinal discomfort, muscle and limb pain, and a number of other side effects and interactions. Addictive behavior can also develop if these drugs are taken in excess. As part of a surgical procedure required for a resulting cancer, nerve injury, bleeding, rebleeding, wound healing problems, infections, and other problems may occur.

When should you see a doctor?

Persistent or recurrent stomach discomfort should be examined and evaluated by a doctor. If there is pain, nausea or vomiting, this is considered worrisome and should be presented to a doctor. A loss of appetite, refusal to eat, and a loss of weight are signs that indicate a health disorder. A doctor is needed as soon as the complaints persist for several days or increase in intensity and extent. Flatulence, a feeling of sickness as well as an inner weakness are further symptoms that make a visit to the doctor necessary. If the affected person suffers from sleep disturbances, dizziness as well as a decrease in physical and mental performance, an investigation of the cause is needed. Problems of the cardiovascular system, heartburn or a feeling of pressure in the stomach area must be investigated. If the daily obligations can no longer be fulfilled or if a restriction of the usual way of life sets in, there is a need for action. Excessive sweating, an increased body temperature, diarrhea, an inner restlessness and complaints of the swallowing act must be medically clarified. Cramps, irregularity of the joints and concentration problems lead to a reduction in well-being. Medical care is needed to prevent further deterioration. If the discomfort is due to an unhealthy meal, in many cases a doctor is not needed. Once the food has been digested, spontaneous healing occurs.

Treatment and therapy

Patients younger than 55 years of age can usually be treated for irritable stomach without further examination. At most, infection with Helicobacter pylori should be excluded. In individuals older than 55 years, gastrointestinal endoscopy of the upper abdominal region is recommended to rule out gastric or duodenal ulcer or other rare malignancies, as well as in drug-induced irritable stomach. Treatment of irritable stomach depends on the exact manifestation of the symptoms, i.e. whether they are functional or subjectively perceived as unpleasant. Proton pump inhibitors (PPIs) such as omeprazole or pantoprazole usually provide rapid relief from heartburn, a major symptom of irritable stomach. H2 antagonists such as cimetidine or simple chewable tablets containing the active ingredient simeticon help relieve flatulence and bloating. Over-the-counter preparations containing ranitidine can be used to counter unpleasant symptoms such as belching, reflux or stomach acidity. Sometimes proven herbs and home remedies such as peppermint, caraway and aniseed are also sufficient to effectively counter irritable stomach.

Prevention

An irritable stomach can be prevented by changing your diet accordingly. This means avoiding hot spices, as well as coffee or other “acidic” foods. From the menu, susceptible people should also take highly fatty and flatulent foods and alcohol.Sustained stress reduction and relaxation techniques can support the treatment of irritable stomach. Note: In the case of irritable stomach, it is important to distinguish between harmless symptoms that are relatively easy to manage with or without medical advice, and serious illnesses such as gastritis. An acute or chronic inflammation of the stomach or digestive tract that requires medical treatment with antibiotics.

Follow-up

After an acute episode of the disease, a sparing diet is indicated after one or two days of abstinence from food. Adequate fluid intake should always be ensured. Still mineral water and unsweetened tea are particularly suitable for this purpose. When eating, it is advisable to start with small amounts of unseasoned and unsweetened food. Rusk, crispbread, bananas, cooked potatoes or rice hardly burden the stomach. Fruit with a lot of fruit acid and flatulent vegetables should still be eaten with restraint. In the further course and if the consumed food was well tolerated, chicken meat and bread can extend the menu. After a few days, normal eating can be resumed. Psychological stress, stress and hectic pace favor an aggravation of the irritable stomach and should be avoided. Luxury foods such as alcohol, tobacco, coffee and sweets are contraindicated. This also applies to foods that are very high in fat and difficult to digest. A diet rich in vitamins and light, with vegetables and fish, has the best effect on functional dyspepsia. Hyperacidity should be avoided. Regulated meal times with small portions, sufficient sleep and exercise can ensure a less irritated stomach. If food intolerances are the trigger, these foods should generally be avoided.

What you can do yourself

Affected persons of an irritable stomach are restricted in everyday life. Especially when it comes to nutrition, some things should be considered. Affected people can help themselves with the help of “self-help tips” and alleviate the symptoms and discomfort caused by irritable stomach. Firstly, no spicy or highly seasoned foods should be consumed. These irritate the stomach even more and even lead to an aggravation of the symptoms. Furthermore, sufferers of irritable stomach should avoid carbonated drinks. These stimulate acid production in the stomach and thus again lead to irritation of the mucous membranes in the stomach. A varied and healthy diet should be aimed for. Exercise is also advisable. Small walks in the fresh air or yoga help to reduce stress. Many sufferers do not know that stress can also contribute to an aggravation of irritable stomach. Natural remedies can also be supportive in treatment. Herbal teas soothe the stomach and its mucous membranes so that cramps or heartburn can be relieved. Lightly dosed medicines can also be helpful. If symptoms worsen, a trip to the doctor is unavoidable.