More and more people suffer from a condition for which doctors cannot find a cause: an irritable stomach. This disease is accompanied by non-specific symptoms such as stomach pain, bloating or nausea, which makes the diagnosis difficult. But even if an irritable stomach cannot be easily diagnosed, there are numerous tips through which the symptoms can be alleviated or even disappear. Read here how to recognize an irritable stomach and what helps against it.
What is an irritable stomach?
Irritable stomach, or “non-ulcer dyspepsia” or “functional dyspepsia,” is a collective term for upper abdominal symptoms for which no cause can be found either in imaging procedures or by means of laboratory tests. The leading symptom of irritable stomach is vague discomfort in the middle upper abdomen. This is where the stomach, among other organs, is located. The disease is diagnosed when all tests for possible other diseases are negative, i.e. give no indication of another disease. The cause of the clinical picture is often psychological strain and stressful situations, which is why it is also referred to as a “stress stomach”. Mental illnesses, such as depression and anxiety disorders, can also be a possible cause. The “sensitive stomach” often occurs in connection with irritable bowel syndrome. This clinical picture is characterized by abdominal pain and/or stool irregularities, for which also no organic cause can be found.
The multiple causes of irritable stomach syndrome.
Irritable stomach syndrome is also referred to as a “sensitive” or “nervous” stomach because the nervous system of the affected person in the upper gastrointestinal tract reacts more sensitively to both external and internal stimuli than in a healthy person. In particular, the stomach can react sensitively to gastric acid. Its formation is stimulated by caffeine, for example, which is why coffee consumption can have a negative effect on the health of the gastric mucosa. The drug aspirin can also harm the stomach lining by reducing the production of hormones that protect the mucous membrane. Another possible cause is a disorder of gastric motility. Insufficient stomach movement causes food to remain in the stomach longer, which can lead to the typical symptoms of irritable stomach. A connection with an infection with the bacterium Helicobacter pylori is also discussed. This is a bacterium that can colonize the stomach and cause inflammation in it.
What are the symptoms of irritable stomach?
The possible symptoms of irritable stomach include:
- Upper abdominal pain, or stomach pain or pressure in the stomach area.
- Nausea
- Feeling of fullness
- Increased belching
- Vomiting, the food does not stay in the stomach
- Abdominal cramps
- Flatulence
- Heartburn
- Rapid satiety during food intake
- Drilling feeling of hunger, at the same time decreased appetite
- Greasy food is no longer tolerated
The abdominal pain often can not be precisely localized and may even radiate into the back to the extent that sufferers complain of back pain.
This speaks against the classic irritable stomach syndrome.
While irritable stomach can only be diagnosed by ruling out other diseases, conversely, there are also symptoms that usually speak against the diagnosis of irritable stomach. These include:
- Fever
- Weight loss, despite consistent food intake.
- Night sweats
- Diarrhea at night
- Black stool (“tarry stools”, melena)
These symptoms usually indicate other diseases. Black stool can occur, for example, due to bleeding in the upper gastrointestinal tract, so especially in the stomach, small intestine or esophagus. But the stool also turns black when iron tablets are taken. Fever, weight loss and night sweats can be summarized in medicine as “B symptoms” and may be related to infections and cancers. Nighttime diarrhea may indicate chronic intestinal inflammation, such as microscopic colitis. This can be diagnosed by microscopy of samples taken during a colonoscopy. The symptoms of irritable stomach syndrome are therefore varied and require an individual diagnosis.
Diagnosis of irritable stomach – no classic test available
Irritable stomach is a diagnosis of exclusion. This means that there is no classic test for the diagnosis of the disease and can only be said to be irritable stomach syndrome if an organic cause of the symptoms has been ruled out. For this purpose, the attending physician will arrange for examinations such as ultrasound examination of the abdomen, gastroscopy, stool examinations and/or laboratory tests of the blood. Only if the symptoms persist for at least three months and the examinations performed by the physician do not yield a result can the diagnosis of irritable stomach syndrome be made.
Diseases with similar symptoms
Other possible diseases with similar symptoms, but which can usually be diagnosed by means of examinations, include:
- Gastric ulcer (ulcer)
- Chronic inflammation of the stomach or gastritis (gastritis)
- Reflux
- Food intolerances (for example, celiac disease, lactose intolerance or food allergies).
- Gastrointestinal infection
- Cancer of the upper gastrointestinal tract (stomach cancer).
The right diet: fat-free and fresh
The therapy of an irritable stomach includes, among other things, dietary measures. The foods that increase the discomfort (for example, greasy food) should be omitted. Also, smaller and more frequent meals often have a positive effect on recovery. A change in eating habits can often help to alleviate the symptoms. Care should be taken to eat freshly cooked meals as much as possible and to avoid convenience foods as much as possible. Cooked vegetables and lean meat (for example, turkey and chicken), cooked rice and pasta, and low-fat sausage, cheese and fish can usually be well tolerated and thus eaten.
What food for irritable stomach? The low-FODMAP diet
A special form of diet with which many sufferers have good experiences is the so-called low-FODMAP diet. With this one is to be renounced above all on different, with difficulty digestible, multiple sugars. The low FODMAP diet already has high success rates in the therapy of irritable bowel syndrome and can also help with irritable stomach. Some products to avoid during this diet include:
- Lactose (in dairy products)
- Fructose (in fruits and many soft drinks).
- Some cereals
- Legumes
For six to eight weeks, the hard-to-digest foods must be completely avoided, then they may be reincorporated into the diet bit by bit.
What should be avoided in irritable stomach syndrome?
As poorly tolerated are considered in an irritable stomach:
- Generally high-fat dishes
- Foods that can cause flatulence, such as garlic, legumes, onions, and cabbage
- Spicy food
- Caffeine and aspirin
What really helps is different for each individual
From person to person, different foods can be better or worse tolerated. To find out what is personally best tolerated, it is recommended to keep a so-called “symptom diary”. In doing so, the meals and the following complaints should be documented daily in order to uncover a connection between certain foods and the symptoms that follow. By subsequently abstaining from the corresponding foods, the “weak stomach” can be strengthened, resulting in an improvement of the symptoms. Thus, to get rid of irritable stomach syndrome, what is needed above all is a consistent change in lifestyle and dietary habits.
What to do for irritable stomach? This also helps!
In addition to adjusting the diet, the consumption of nicotine and alcohol should also be avoided in the case of an irritable stomach. Also overweight can promote the clinical picture of the “weak stomach”. It is therefore advisable to exercise and get enough exercise to counteract both possible excess weight and any psychological stress. Getting enough sleep and relaxation techniques, such as yoga, can also help against stress. In the case of a possible mental illness, psychotherapy is recommended.
What home remedies can help?
Tea is among the home remedies that can help. But which tea is best for irritable stomach syndrome?Especially chamomile tea, peppermint tea, fennel tea or sage tea can help to soothe the stomach and relieve cramps. A hot water bottle or a light stomach massage can also help with acute discomfort.
What medications for irritable stomach?
The use of medication depends on the individual complaints. The following medications can help with irritable stomach:
- Antispasmodic medications, such as Buscopan, can be used for cramping symptoms.
- For discomfort that occurs during and after eating, medications that promote gastric motility (prokinetics such as metoclopramide) are recommended.
- For heartburn, acid inhibitors can be helpful (proton pump inhibitors such as pantoprazole or omeprazole).
- A drug that combats several irritable stomach problems at once is Iberogast. It has both a stimulating effect on the movement of the stomach and an antispasmodic effect, while improving the protection of the gastric mucosa.
How long does irritable stomach syndrome last?
The symptoms of irritable stomach syndrome disappear or improve after one to two months in more than half of patients if a diet is followed and any prescribed medication is taken. However, after discontinuation of medication, the symptoms may recur. In most cases, the symptoms do not disappear completely with treatment, but they improve significantly. In general, the prognosis of the disease is favorable, as there are usually no serious sequelae or complications. Thus, if dietary changes are consistently adhered to and a stress-free lifestyle can be achieved, irritable stomach can improve greatly within a few months without further consequences.
Sources and further information
- Herold, G. and associates (2018): internal medicine. Gerd Herold self-published.
- Baenkler, H.-W., Goldschmidt, H., Hinterseer, M. (2010): Kurzlehrbuch Innere Medizin. Thieme Verlag, 2nd edition.
- Labenz, C., Labenz, J. (2017): Irritable stomach and irritable bowel. Distressing symptoms. In: Pharmazeutische Zeitung, Vol. 14.
- Sheperd, S., Gibson, P. (2015): The low-FODMAP diet: debunking food intolerances and enjoying them symptom-free. TRIAS, 1st ed.
