General information
If stomach pains occur after eating, this can have numerous causes. These range from relatively harmless food intolerances to congenital food intolerances and rare, malignant tumours. In order to find the right diagnosis, an exact anamnesis and many different diagnostic examination techniques are necessary.
Causes
The causes of abdominal pain after eating are very varied. For this reason, numerous laboratory chemical, image-diagnostic and other medical-technical examinations are often necessary to make a diagnosis. In the following, the most important causes of abdominal pain, which typically occur immediately after eating, will be named and briefly described.
Many patients complain of abdominal pain or stomach complaints after eating. In the case of abdominal pain after eating, a stomach ulcer may be behind it. The decisive factor here is when the complaints occur.
Pain directly after eating could be a sign of an ulcer on the stomach wall, while stomach pain that disappears after eating is more likely to be a duodenal ulcer. If the abdominal pain is closely related to food intake, a gallstone in the gall bladder could also be the cause. These abdominal pains after eating then occur for a few minutes to a few hours, especially after the intake of fatty foods.
The pain is usually located on the right side diagonally above the navel. The cause is the contraction of the gall bladder after eating fatty food. As a result of these contractions, stones stored in it are pressed against the gallbladder wall and cause pain.
Patients with inflammation of the pancreas (pancreatitis) can also experience an increase in pain after eating, but the pain tends to be girdled around the abdomen. In general, the pain can occur in any position and region of the abdomen. For example, some patients complain of abdominal pain while sitting or abdominal pain in the middle.
The most common abdominal pain is caused by flatulent food. After eating pulses, for example, there is often very severe abdominal pain after some time, but it subsides after going to the toilet or after breathing (flatulence) but usually increases in intensity again immediately. In the case of food intolerance, such as lactose intolerance, the consumption of milk or dairy products often leads to cramp-like abdominal pains in addition to nausea.
The pain is usually localised above the intestinal area, is of a pressing and stabbing character and usually improves only after going to the toilet. Too much, too fatty or too fast food can cause abdominal pain in some people immediately after eating. Chronic constipation can also lead to an unpleasant feeling of fullness and stomach ache after eating.
The symptoms and the probability of occurrence vary greatly from person to person. The chronic constipation can usually be treated well by taking light laxative medication and a change in diet. A sufficient amount of drinking also regulates the bowel movement and is therefore essential for symptoms of this type.
Whether the food was eaten too much, too quickly or too greasy and was not tolerated varies from person to person and depends on the situation. Accordingly, not every abdominal pain can be adequately explained or diagnosed. In this case only a slower and lower food intake helps, depending on your own well-being.
Food intolerance is understood to be all symptoms that follow directly after food intake. These can vary greatly and can cause itching, skin rash, abdominal pain, nausea, diarrhoea, headaches and also breathing difficulties. In order to make the correct diagnosis, numerous examinations are often necessary.
The exact anamnesis is particularly important. Patients often keep a symptom diary for several weeks to filter out the specific food. Although it seems as if many people suffer from food intolerance, the real intolerances, which go hand in hand with a reduction in quality of life, are relatively rare.
Lactose intolerance is particularly common. In this case, the intestine does not produce sufficient amounts of the enzyme lactase, which is used to break down milk sugar in the intestine. In this case, the intestine cannot digest the milk sugar sufficiently.
As a result, the lactose reaches the large intestine undigested and begins to ferment there. This leads to malaise, stomach ache or other symptoms. About 15 out of 100 people in Germany suffer from a more or less pronounced lactose intolerance.
A breath test for diagnosis can help to make the right diagnosis. However, this only makes sense if lactose intolerance is actually suspected. In many cases the test is false positive.
Since there is no curative therapy, the only way to reduce symptoms is to avoid lactose. The symptoms of fructose intolerance are similar to those of lactose intolerance. This is an intolerance of fructose, which reaches the intestines undigested and can also lead to flatulence, diarrhoea and abdominal pain after eating.
However, fructose intolerance should not be confused with intestinal fructose intolerance. This is accompanied by a congenital transporter defect in the intestine and leads to massive and dangerous symptoms early on. A breath test can also be used in case of fructose intolerance.
However, even in this case there is no curative therapy. Only the avoidance of appropriate food can alleviate the symptoms. Gastritis is a disease that can be triggered by an unhealthy lifestyle, chronic alcohol or nicotine consumption, some medications (acetylsalicylic acid, ibuprofen, …) or the bacterium Helicobacter pylori.
If it is chronic (chronic gastritis), it can lead to serious complications such as gastric bleeding, a perforation of the stomach or a stomach ulcer. Usually, no symptoms appear for a long time in this case. Acute gastritis is accompanied by a feeling of pressure, especially in the upper abdomen, loss of appetite, nausea and belching.
The symptoms typically worsen after eating. A stomach ulcer is a complication of chronic gastritis. This can be triggered by certain drugs, the bacterium Helicobacter pylori, a disturbed stomach movement or an increased production of gastric acid.
But nicotine or alcohol abuse can also damage the stomach lining and promote the formation of a stomach ulcer. The symptoms of a stomach ulcer are nausea and pain in the middle of the upper abdomen, as well as vomiting, heartburn and weight loss. Typically, these symptoms increase immediately after eating or when the stomach is empty.
The diagnosis of a peptic ulcer or inflammation of the mucous membrane of the stomach (gastritis) is usually made by gastroscopy, which enables the examiner to examine the mucous membrane of the stomach closely. The therapy is usually based on inhibiting the high acid production of the stomach by proton pump inhibitors. If complications such as gastric bleeding or perforation of the stomach ulcer occur, surgery is necessary.
Gallstones develop when endogenous substances such as cholesterol or protein solidify in the gall bladder. Risk factors for gallstone disease include advanced age, female sex, overweight and nicotine use. The symptoms of gallstone disease consist of right-sided colicky pain in the upper abdomen.
The gallbladder produces a lot of bile, especially after very high-fat meals. However, this cannot leave the gallbladder because of the stones. This leads to strong contractions of the gallbladder, which causes the colicky pain in the upper abdomen.
For this reason, the pain is particularly frequent after very high-fat meals. In some cases, however, there are no symptoms at all for a long time. As a rule, no therapy is then necessary.
However, if the gallbladder causes severe pain, it is usually removed (cholecystectomy). Although gallstones can also be dissolved by medication, the disease usually recurs. For this reason, the removal of the gallbladder is the therapy of choice.
Psychological stress or psychosomatic complaints can also lead to abdominal pain after eating. The constellation of symptoms is very varied and individual. In case of constant abdominal pain after eating, many other causes should be considered first.
However, if the results are not satisfactory, a psychosomatic diagnosis is always useful and important. A lot of stress and psychological strain of any kind can cause real physical symptoms. However, in order to find the real cause of the physical symptoms, the patient must engage in the examination and the diagnostics.
This usually consists of many conversations, relaxation exercises and rest. In contrast to the usual diagnostic means. However, since in this case the abdominal pain cannot be cured by medication or other therapies, psychosomatic therapy is often helpful and healing.
