Stomach irritation is a common term used by many patients to report some discomfort or abnormality believed to be originating from the stomach. It is extremely subjective and variable in meaning because unlike other symptoms it does not denote the actual sensation or disturbance that one is experiencing. However, there are several causes to describe a whole host of primarily gastrointestinal symptoms which a person may report as stomach irritation. Without the presence or reporting of other symptoms though it is difficult to identify possible causes and may warrant the need for further diagnostic investigation. Stomach problems may not always be due to any disease or disorder of the stomach itself. Even pain or discomfort that corresponds with the anatomical position of the stomach may not be gastric in origin but associated with neighboring organs like the esophagus or duodenum or even structures in the surrounding abdominal quadrants.
The stomach is a hollow muscular sac that lies between the esophagus and small intestine. The mucosal lining produces digestive enzymes and hydrochloric acid that are an important part of chemical digestion. Mucus secreted in abundance from the mucosal lining serves as a barrier to prevent the acid and enzymes from damaging the stomach lining. The stomach is capable of powerful muscular contractions that can churn food thereby breaking it down into small pieces. The partially digested food is then passed out at intervals through the pylorus and into the duodenum (first part of the small intestine) where it undergoes further digestion and subsequent absorption. The entrance and exit of food and fluid through the stomach is controlled by the lower esophageal sphincter (LES) between the esophagus and stomach and the pyloric sphincter between the stomach and duodenum.
Signs and Symptoms
Normally the stomach does not experience any pain although there can be some discomfort with overeating or when hungry. Bloating is a sensation of fullness that may also arise with overeating and the intake of carbonated beverages. Belching is another normal occurrence and tends to arise more frequently and excessively with consuming carbonated beverages and as a result of air swallowing (aerophagia). The term ‘stomach irritation’ may be used to describe a number of symptoms that may not be isolated to the stomach. This includes :
- Stomach pain
- Burning chest pain (heartburn)
- Excessive belching
Causes of Stomach Irritation
There are a several disorders that affect the stomach that may cause the symptoms mentioned above. At times pathology within the esophagus and small intestine may also be responsible even if the stomach is not involved at all. Some of the possible causes are discussed below.
Gastritis is inflammation of the stomach wall most commonly limited to the inner mucosal lining but can extend deeper into the underlying layers. Most cases are due to H.pylori infection or with the use of NSAIDs (non-steroidal anti-inflammatory drugs). Common symptoms include gnawing stomach pain, nausea, vomiting (sometimes blood), and bloating. The pain is typically worse at night.
Gastroenteritis is the inflammation of the stomach and intestines causing acute nausea, vomiting and diarrhea. It is mainly due to a viral or bacterial infection but can also arise with exposure to bacterial toxins even without an infection. Viral gastroenteritis is also commonly known as the stomach flu while gastroenteritis from bacterial toxins is known as food poisoning. The infection or toxin is usually spread through the ingestion of contaminated food and water. With viral infections, the spread can be through sharing utensils and making personal contact with an infected person.
Peptic Ulcer Disease
Stomach ulcers are open sores that form on the stomach wall. It is a complication of gastritis. Ulceration more commonly occurs in the duodenum of the small intestine and the condition is collectively referred to as peptic ulcer disease. Sometimes ulcers may arise in the esophagus as well especially if there is acid reflux. There may a slight variation in symptoms between stomach and duodenal ulcers but it largely resembles gastritis. The pain in peptic ulcer disease is typically more intense, worse at night and when the stomach is empty.
Acid reflux is a the backward flow of stomach acid up into the esophagus. It does not involve any disease in the stomach but is often grouped under the broad term of ‘stomach irritation’. Acute reflux may arise for a number of reasons like overeating, exercising after a heavy meal, excessive alcohol consumption and hanging upside down after a meal. However, chronic reflux (gastroesophageal reflux disease ~ GERD) is associated with a dysfunction of the lower esophageal sphincter. The most defining feature is burning chest pain commonly referred to as heartburn. Reflux may also cause difficulty swallowing, sore throat, hoarseness of the voice and sour eructations.
A hiatal hernia is an abnormal protrusion of a portion of the stomach into the thoracic cavity through the diaphragmatic opening. It may arise due to being born with an abnormally large diaphragmatic opening, injury to the area, recurrent increased intra-abdominal pressure or weakness of the diaphragmatic muscles. The symptoms are largely similar to other more common disorders as mentioned above and includes belching, nausea and heartburn.