Stomach and Intestinal Upset: What It Is and What Causes It

"I have a stomach upset" — that's how we usually describe heaviness under the breastbone, nausea, and vague trouble with bowel movements. Let's figure out what lies behind this everyday word, how stomach complaints differ from intestinal complaints, and at what point it's time to see a gastroenterologist.

What is called stomach and intestinal upset

Let's clarify right away that this is not a diagnosis. Doctors speak of dyspepsia — a feeling of pain or discomfort (heaviness, fullness, early satiety) in the epigastric region closer to the midline. English-language reference books call the same thing upset stomach: discomfort or burning in the upper abdomen, belching, bloating, nausea.

Intestinal upset is a separate matter, when complaints are related to the frequency and character of stool. These are different scenarios, and they should not be mixed up.

Main causes: food, medications, stress, and infection

Dyspepsia is often based on stomach acid irritating the stomach lining or the esophagus — this is acid reflux. Sensations can be intensified by coffee, tomatoes, alcohol, chocolate, fatty and spicy food, excess weight, smoking, pregnancy (after the 27th week it is very common), stress and anxiety, and some medications, including anti-inflammatory painkillers such as ibuprofen.

Sometimes the cause is a hiatal hernia, stomach ulcer, Helicobacter pylori infection of the lining, or impaired motility of the stomach and duodenum. Sometimes a person simply eats too much, too fast, or when nervous.

How upset manifests: symptoms

Complaints usually come after eating or drinking:

• heartburn — a burning pain in the chest;
• a feeling of fullness and bloating;
• nausea;
• belching and increased gas formation;
• food or bitter fluid coming back into the mouth.

In dyspepsia, pain and discomfort in the epigastric region and early satiety are added — the stomach seems to fill up right after eating begins, regardless of the amount.

How stomach upset differs from intestinal upset

The easiest way is by its connection to stool. In dyspepsia, symptoms do not disappear after a bowel movement and are not related to changes in the frequency and character of stool. If the abdomen hurts but feels better after going to the toilet, or the stool has noticeably changed, it is more likely about the intestines — and doctors discuss irritable bowel syndrome separately.

There is also an everyday clue: pain in the abdomen or back usually does not relate to symptoms of dyspepsia — with such complaints, the cause is often constipation.

What diseases may hide behind these symptoms

Similar sensations are caused by peptic ulcer disease, GERD, gallstone disease, chronic pancreatitis, and in some people stomach cancer, although this is a rare variant: about one case in fifty.

And let's immediately debunk a favorite myth: "you have gastritis, treat the lining and everything will pass." In Western practice, the diagnosis of "chronic gastritis" as an explanation for such complaints has almost fallen out of use: persistent changes in the lining often produce no symptoms at all, so doctors focus on symptoms. Functional dyspepsia is diagnosed when complaints last more than 12 weeks within a year, endoscopy finds no organic cause, and there is no connection to stool.

Warning signs and when to see a doctor

People go to the doctor if the upset lasts longer than two weeks or keeps coming back again and again. Reasons for a conversation include severe pain, unintentional weight loss, difficulty swallowing, persistent vomiting, iron-deficiency anemia, a feeling of a lump in the stomach, and blood in vomit or stool.

The doctor assesses the complaints and, if necessary, refers for examinations: blood and stool tests, ultrasound, X-ray, esophagogastroduodenoscopy, 24-hour pH monitoring, Helicobacter pylori testing, manometry.

Stomach upset by itself is not a reason to call an ambulance; 103 or 112 — if the condition is life-threatening, for example with signs of a stroke or heart attack.

This material is for reference: it does not replace a doctor's consultation — unfortunately, it is impossible to make a diagnosis from an article; this requires an examination and, most likely, tests.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer