What is a sensitive stomach?

A sensitive stomach is a term commonly used to describe a range of upper gastrointestinal symptoms, particularly in response to certain foods or situations. It is a non-specific term for any cause that may trigger the the onset or worsen  symptoms like nausea, vomiting, indigestion, bloating, heartburn or excessive belching.

What are sensitive bowels?

As sensitive bowel is another common term used to describe gastrointestinal upset usually when the symptoms involve the lower parts of the gut. Here as well it is a non-specific term that generally describes lower gastrointestinal symptoms like flatulence, intestinal cramps, bloating, abdominal distension, loud bowel noises, loose stool or even diarrhea, difficult passing stool or constipation.

Meaning of sensitive stomach and bowel

In order to understand what these common terns may be referring to, it is important to have a knowledge of the workings of the gastrointestinal tract (gut). The human alimentary tract starts from the mouth. Here food and a drink enter the gut and travel the following course :

  • Throat
  • Esophagus
  • Stomach
  • Small intestine
  • Large intestine

Digestion starts within the mouth by the action of the enzymes in saliva. It then takes full effect within the stomach and some nutrients are also absorbed into the bloodstream here. Partially digested food known as chyme then undergoes further digestion mainly in the first part of the small intestine known as the duodenum. The small intestine, or small bowel, is the longest part of the gut and gradually the food is completely digested and almost all the nutrients are absorbed into the bloodstream.

By the time this material reaches the end of the small intestine, it is largely just waste material and water. It is then passed into the colon of the large intestine which further processes any residual of nutrients and absorbs most of the water back into the body. Finally this material becomes solid matter known as feces or stool. When the colon is full, stool is passed out by the process of defecation.

This entire process does not just happen immediately after eating but is an ongoing chain of events throughout the day and  even when a person is asleep. There are several conditions involving parts of the gastrointestinal tract or the entire gut as a whole which may be termed as a sensitive stomach or sensitive bowel. The symptoms arise mainly due to :

  • Irritation of the gut lining
  • Problems with digestion
  • Problems with absorption
  • Rapid or slow movement through the gut
  • Disruption of the bowel bacteria (normal intestinal flora)
  • Structural disturbance in the wall of the gut

These disruptions may be associated with any number of diseases and is then known as pathological. Sometimes there is no disturbance anywhere in the gut yet a person experiences symptoms. In these cases the disorder may be known as functional meaning that it is not normal yet there is no underlying disease.

Causes

The upper gut (gastrointestinal tract) is the area from the mouth to end of the first part of the small intestine (duodenum). The lower gut runs from the second part of the small intestine (jejunum) to the rectum but may also include the anus. It is not always possible to strictly demarcate the transition from the upper to lower gut. The causes of sensitivity of the upper and lower gut is therefore discussed separately under a sensitive stomach and sensitive bowel respectively. The word ‘stomach’ refers specifically to the hollow sac lying between the esophagus (food pipe) and small intestine but is often used to describe the upper gut as a whole in lay terms.

Sensitive Stomach Causes

  • Acid reflux is the backward flow of stomach acid from the stomach into the esophagus (food pipe). It is also known as gastroesophageal reflux disease (GERD). It commonly presents with heartburn (burning chest pain), nausea and regurgitation. The symptoms worsen at night, after eating particularly certain foods and drinks and when lying down flat.
  • Gastritis is the inflammation of the stomach wall which in most cases is due to an infection with a specific type of stomach bacteria known as Helicobacter pylori (H.pylori) or with excessive use of certain medication like NSAIDs (non-steroidal anti-inflammatory drugs). The symptoms include a gnawing stomach pain (just under the lower left ribcage), indigestion, bloating (sensation of fullness), nausea and belching. Typically the symptoms worsen with hunger and somewhat eases after eating.
  • Peptic ulcer is an open sore in the wall of the stomach (stomach ulcer) or duodenum (duodenal ulcer). It may sometimes include open sores in the lower part of the esophagus (esophageal ulcer). Ulcers tend to form after prolonged or severe gastritis. Symptoms include upper abdominal pain that worsens at night and when hungry, nausea, sometimes vomiting of dark blood, blood in the stool, unintentional weight loss and change in appetite.
  • Gallstones are hard sediments of bile that form in the gallbladder. Although the gallbladder is not actually part of the gut, bile and gallstones usually pass out into the duodenum of the small intestine. Symptoms are usually present when a gallstone blocks the bile duct.This includes sudden upper abdominal pain which occurs as attacks that persists for hours. The pain also radiates to the back or right shoulder.

Sensitive Bowel Causes

  • Irritable bowel syndrome (IBS) is a condition marked by abnormal bowel habit (episodes of diarrhea or constipation) with abdominal bloating and pain. It is a functional disorder meaning that it is not due to any disease but appears to be a result of abnormal gut motility although the exact cause is unknown. IBS is often diagnosed when no other disease of the bowel can be identified. Certain foods tend to worsen the symptoms or trigger attacks but these are not the causes of IBS.
  • Inflammatory bowel disease (IBD) is a chronic condition of the bowel marked by persistent or recurrent inflammation of the lower gut, particularly the colon and rectum. There are two types of IBD – Crohn’s disease and ulcerative colitis. While ulcerative colitis is isolated mainly to the colon and rectum, Crohn’s disease can affect any part of the gut, even the stomach and mouth. Symptoms include episodes of diarrhea or constipation, abdominal pain, intestinal cramping, bloating and mucus in the stool.
  • Food intolerance is a broad term to describe any problems with digestion or absorption of certain nutrients. There are several different types of food intolerance.
  • Lactose intolerance – lactose (milk sugar) found in large quantities in dairy products.
  • Gluten intolerance – gluten is a protein found in wheat and other grains.
  • Fructose malabsorption – fructose (fruit sugar) found in fruits, fruit drinks and some other beverages.
  • Sorbitol intolerance – sorbitol is a type of sugar found in diet foods and drinks and sugar free products like chewing gum.
  • Diverticular disease is term used to refer diverticulosis and diverticulitis. Diverticulosis is a condition where outpouchings form in the wall of the colon. These pouches are known as diverticula (singular ~ diverticulum). When these pouches become inflamed then it is known as diverticulitis. The exact cause of diverticular disease is unclear but is believed to be associated with a low fiber diet and more likely to be seen after the age of 40 years. Diverticulosis may present with bloating, lower abdominal discomfort and constipation. Diverticulitis symptoms include abdominal pain, altered bowel habit, nausea, vomiting and fever.

Symptoms

The specific symptoms of each type of disorder has been discussed above. These symptoms are similar in many respects although the disease mechanism can differ significantly. Most of these conditions are chronic meaning that it is persistent or is recurrent over a long period of time. The term sensitive stomach usually means that the symptoms are easily triggered or aggravated by certain foods or situations.

Common foods and drinks that tend to worsen symptoms includes :

  • Caffeine
  • Alcohol
  • Spicy foods
  • Processed foods
  • Preservative like MSG (monosodium glutamate)
  • Fatty or oily foods

More specific foods that may aggravate symptoms are largely associated with food intolerance.

Other factors associated with symptoms includes :

  • Strong emotion like fear or anger
  • Psychological stress
  • Sleep
  • Certain medication

Treatment

A sensitive stomach or sensitive bowel is not a specific condition. Therefore there is no specific treatment for it. The treatment for individual conditions varies but some general measures may be helpful for most of these conditions.

  • Stress management.
  • Moderate alcohol intake or avoid alcohol altogether.
  • Reduce caffeine intake.
  • Maintain a bland diet without excessive use of spices.
  • Avoid preserved and processed foods.
  • Identify specific triggers and remove it from the diet.


Article reviewed by Dr. Greg. Last updated on March 25, 2012