Irritable stomach – what really helps?

Irritable stomach - what really helps

More and more people suffer from an illness for which doctors cannot find a cause: an irritable stomach. This disease is accompanied by non-specific symptoms such as stomach painflatulence or nausea, which makes diagnosis difficult. But even if an irritable stomach is not easy to diagnose, numerous tips can alleviate the symptoms or even disappear. Read here how to recognize an irritable stomach and what helps against it.

What is an irritable stomach?

The irritable stomach, or “non-ulcer dyspepsia” or “functional dyspepsia”, is a collective term for upper abdominal complaints for which a cause cannot be found either in imaging methods or in laboratory tests.

The main symptom of an irritable stomach is vague complaints in the upper middle abdomen. This is where the stomach is located. The disease is diagnosed when all tests for possible other diseases are negative, i.e., do not indicate another disease.

The cause of the clinical picture is often psychological stress and stressful situations, which is why one also speaks of a “stress stomach”. Mental illnesses, such as depression and anxiety disorders, can also be a possible cause. 

The “sensitive stomach” often occurs in connection with irritable bowel syndrome. This clinical picture is characterized by abdominal pain and stool irregularities, for which no organic cause can be found either.


The multiple causes of irritable stomach syndrome

Irritable stomach syndrome is also referred to as a “sensitive” or “nervous” stomach because the affected person’s nervous system in the upper gastrointestinal tract reacts more sensitively to external and internal stimuli than a healthy person’s nervous system.

The stomach can react particularly sensitively to gastric acid. For example, their formation is stimulated by caffeine, which is why coffee consumption can hurt the health of the gastric mucosa. Aspirin® can also damage the gastric mucosa by reducing the production of hormones that protect the mucous membrane.

Another possible cause is a disturbance in the movement of the stomach. If the stomach is not moving enough, the food stays in the stomach longer, and the typical symptoms of an irritable stomach can occur.

A connection with the bacterium Helicobacter pylori infection is also being discussed. This is a bacterium that can colonize the stomach and cause inflammation in it.

What are the symptoms of an irritable stomach?

Possible symptoms of an irritable stomach include:

  • Upper abdominal pain, or stomach pain or pressure in the stomach area
  • nausea
  • bloating
  • increased belching
  • Vomiting, the food does not stay in the stomach
  • Stomach cramps
  • gas
  • heartburn
  • rapid saturation with food intake
  • piercing feeling of hunger, at the same time reduced appetite
  • fatty food is no longer tolerated

The abdominal pain often cannot be precisely localized and can even radiate so far into the back that those affected complain of back pain.


This speaks against the classic irritable stomach syndrome

While an irritable stomach can only be diagnosed by excluding other diseases, there are also symptoms that usually speak against the diagnosis of an irritable stomach. These include:

  • Fever
  • Weight loss despite constant food intake
  • Night sweats
  • nocturnal diarrhea
  • black stool (“tar chair”, melena)

These symptoms usually indicate other illnesses. Black stools can occur, for example, due to bleeding in the upper gastrointestinal tract, especially in the stomach, small intestine or esophagus. But even when taking iron tablets, the stool turns black.

Fever, weight loss and night sweats can be summarized in medicine as “B symptoms” and can be related to infections and cancer.

Nocturnal  diarrhea  can indicate chronic intestinal inflammation, such as microscopic colitis. This can be diagnosed by microscopy of samples   taken during a colonoscopy .

The symptoms of irritable stomach syndrome are diverse and require an individual diagnosis.

Diagnosis of irritable stomach – no classic test available

Irritable stomach is a diagnosis of exclusion. This means that there is no classic test for diagnosing the disease and that it can only be referred to as irritable stomach syndrome if an organic cause of the symptoms has been ruled out.

For this purpose, the treating doctor arranges examinations such as an ultrasound examination of the abdomen, a  gastroscopy , stool examinations and/or laboratory tests of the blood.

 The diagnosis of irritable stomach syndrome can only be made if the symptoms persist for  at least three months and the examinations carried out by the doctor do not produce any results.

Diseases with similar symptoms

Other possible diseases with similar symptoms, which can usually be diagnosed through examinations, include:

  • Stomach ulcer  ( ulcer )
  • chronic stomach inflammation or inflammation of the stomach lining (gastritis)
  • Reflux
  • Food intolerances (e.g. celiac disease,  lactose intolerance  or food allergies)
  • Gastrointestinal infection
  • Cancers of the upper gastrointestinal tract (stomach cancer)


The right diet: fat-free and fresh

The treatment of an irritable stomach includes, among other things, dietary measures. Foods that worsen the symptoms (e.g. fatty foods) should be omitted. Smaller and more frequent meals often have   a positive effect on recovery.

Changing your eating habits can often help alleviate the symptoms. You should make sure  to eat freshly cooked meals as much as possible  and avoid ready-made meals as much as possible.

Cooked vegetables and lean meat (e.g. turkey and chicken), cooked  rice  and pasta as well as low-fat sausage, cheese and fish can usually be tolerated well and therefore eaten.

What to eat if you have an irritable stomach? The low FODMAP diet

A special form of diet that many sufferers have had good experiences with is the so-called low-FODMAP diet. The main aim here is to avoid various, difficult-to-digest multiple sugars. The low-FODMAP diet already has high success rates in treating irritable bowel syndrome and can also help with irritable stomach problems.

Some products that you have to avoid during this diet include:

  • Lactose (in dairy products)
  • Fructose  (found in fruits and many soft drinks)
  • some types of grain
  • legumes

Foods that are difficult to digest must be completely avoided for six to eight weeks, then they can be reintroduced into the diet little by little.

What should you avoid if you have irritable stomach syndrome?

The following are considered poorly tolerated by an irritable stomach:

  • generally high-fat dishes
  • Foods that can cause bloating, such as  garlic , legumes, onions and cabbage
  • spicy food
  • Caffeine and Aspirin®


What really helps varies from person to person

Different foods can be tolerated better or worse from person to person.

In order to find out what can be best tolerated personally, it is recommended to keep a so-called “symptom diary”. Meals and the following symptoms should be documented daily in order to uncover a connection between certain foods and the subsequent symptoms.

By subsequently avoiding the corresponding foods, the “weak stomach” can be strengthened and the symptoms can improve. In order to get rid of irritable stomach syndrome, a consistent change in lifestyle and eating habits is required.

What to do if you have an irritable stomach? This also helps!

In addition to adjusting your diet, you should also avoid consuming  nicotine and alcohol if you have an irritable stomach .

Being overweight can also promote the condition of a “weak stomach”. It is therefore advisable  to do sport  and get enough exercise in order to counteract possible obesity as well as possible psychological stress.

Getting enough sleep and relaxation techniques  such as yoga can also  help against stress. If you have a possible mental illness, psychotherapy is recommended  .

Which home remedies can help?

Tea is one of the home remedies that can help. But which  tea  is best for irritable stomach syndrome? Chamomile tea, peppermint tea, fennel tea or sage tea in particular can help soothe the stomach and relieve cramps.

A hot water bottle  or a  light abdominal massage can also   help with acute symptoms.


Which medications for an irritable stomach?

The use of medication depends on the individual symptoms. The following medications can help with an irritable stomach:

  • If you have cramp-like symptoms, antispasmodic medications such as Buscopan® can be used.
  • If symptoms occur during and after eating, medications that promote stomach movement (prokinetics such as metoclopramide) are recommended.
  • If you have heartburn, acid suppressants can be helpful (proton pump inhibitors such as  pantoprazole  or  omeprazole ).
  • A drug that combats several irritable stomach problems at the same time is Iberogast®. It has both a stimulating effect on stomach movement and an antispasmodic effect, while at the same time improving the protection of the gastric mucosa.

How long does irritable stomach syndrome last?

The symptoms of irritable stomach syndrome disappear or improve after one to two months in more than half of the patients if a diet and any prescribed medication are taken.

However, the symptoms may return after stopping the medication. In most cases, the symptoms do not disappear entirely with treatment but improve significantly.

In general, the prognosis of the disease is favourable, as there are usually no secondary severe diseases or complications. 

Suppose the change in diet is followed consistently, and a stress-free lifestyle can be achieved. In that case, an irritable stomach can improve significantly within a few months without further consequences. 

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