Gastric Pain

Gastric Pain
Picture of a lady suffering from gastric pain

What is gastric pain?

Gastric pain is sometimes simply referred to as “gastric” by Singaporeans. “Gastric” refers to the stomach. Gastric pain is used to describe pain in the upper abdomen at the stomach after the oesophagus. 

Although pain from the upper abdomen is usually caused by problems in the stomach, it may sometimes originate from other organs like the gallbladder, bile duct, pancreas, small intestine or even our liver. 

Medical professionals refer to gastric pain more specifically as “epigastric pain” for pain in the middle of the upper abdomen. 

Experiencing pain from the upper abdomen?

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What causes gastric pain?

Stomach or duodenal (small intestine) ulcers usually last weeks. The pain is intermittent and gets worse with hunger. Food may help to relieve some of the pain. The pain is mild to moderate in severity and occurs irregularly with no clear onset. Pain similar to stomach ulcers can sometimes be caused by medication or drinking too much alcohol. Occasionally, the pain may be felt in the back as well.

Another cause of gastric pain may be gallstones, which feels quite different from those of ulcers. The pain may originate from the right side of the upper abdomen and has a clear onset time, which means you should be able to tell when the pain started. The pain may last 1 – 6 hours, after which it subsides. The pain is normally more severe than those of ulcers, and can occur in the middle of the night which may wake you up. 

The pain may be accompanied by vomiting and excessive sweating. This pain is known as “biliary colic” and is caused by a gallstone that is temporarily lodged in the neck of the gallbladder.

Pancreatitis is inflammation of the pancreas. The pain for pancreatitis is usually very severe, causing you to bend over and stay in one position. The pain may radiate to the back.

The main characteristic of this pain, usually not severe, is its persistence over weeks. The pain normally worsens at night and may be accompanied by other symptoms such as: 

  • Weight loss 
  • Difficulty swallowing 
  • Change in bowel habits 
  • Blood in stool or Black stools 

Epigastric pain may not always have an obvious cause, and sometimes the pain may be caused by stress or abnormal motility and function of the stomach, or perhaps other rare diseases.

What are the symptoms that accompany gastric pain?

Other symptoms that come along with gastric pain may include: 

  • Excessive wind, which can make you feel bloated 
  • Indigestion 
  • Feeling hungry but not being able to eat much before being full again 
  • Nausea or vomiting 

When should I seek treatment for gastric pain?

If you have the following alarm symptoms, you should seek help from your doctor immediately: 

  • Recurrent vomiting 
  • Unexplained weight loss 
  • Loss of appetite 
  • Black stools 
  • Difficulty swallowing 
  • Changes in bowel habits 

This is especially true for those aged 35 and above. Also, those with a family history of stomach cancer or pancreatic cancer should also seek help early as you are at higher risk of developing cancer. 

Experiencing any of the above symptoms?

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How is gastric pain diagnosed?

The doctor will ask if your stool is black. When the stool is black, it suggests bleeding in the stomach. The blood is digested and passed out as a black, sticky stool that is tar-like with a fishy smell. 

A common investigation your doctor will carry out would be a gastroscopy or upper gastrointestinal tract endoscopy, where a camera on a tube is inserted into the stomach through the oesophagus to have a view of the inside of the stomach. 

Ultrasounds would be usually for biliary pain. CT scans or MRIs may help detect cancers. 

What are the treatments for gastric pain?

Stress can cause non-ulcer dyspepsia, so low doses of antidepressants and anxiety-relieving drugs may be prescribed by your doctor to alleviate your symptoms. 

Medication for reducing stomach acid may also be provided, such as: 

  • H2 blockers or Histamine-2 blockers – cimetidine, ranitidine, nizatidine, famotidine 
  • Proton pump inhibitors – omeprazole, lanosprazole, pantoprazole, rabeprazole, esomeprazole

If your gastric pain is because of a peptic ulcer, drugs to reduce stomach acid will likely be prescribed. 

If the ulcer is because of an H. pylori infection, you may receive short-term triple therapy where you will be given 1 acid-reducing agent and 2 antibiotics. Triple therapy is effective in clearing the infection in up to 90% of the cases.

How can I prevent gastric pain?

Eat small, frequent meals.

5 or 6 smaller meals a day may help with indigestion rather than 3 heavy meals. 

Eat on time and avoid skipping meals. 

This helps your stomach to only release gastric juices during mealtimes and not randomly throughout the day. 

Avoid foods that irritate your stomach.

Cut down on spicy, acidic, fried or fat-rich foods to help to reduce gastric pain and allow the stomach to heal. 

Drink alcohol in moderation. 

Overconsumption of alcohol can weaken the lining of the stomach, making you more vulnerable to ulcers. 

Quit smoking.

Smoking can increase the production of stomach acid, thereby slowing down healing and increasing the risk of stomach cancer. 

Manage your stress.

High stress may result in the overproduction of stomach acid. Exercise regularly and practise relaxation techniques such as yoga to keep your stress levels down. 

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