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Irritable Stomach 

Woman with curly dark hair is lying on the sofa while suffering from irritable stomach.

Irritable stomach - What helps against a nervous stomach? 

An irritable stomach, also known as nervous stomach or functional dyspepsia (FD), is a disorder of the upper abdomen from which many people in industrialised countries suffer.  

Unlike irritable bowel syndrome (IBS), it mainly affects the upper part of the gastrointestinal part. In 30% of patients, the symptoms overlap. Irritable stomach and irritable bowel syndrome are referred to as "functional gastrointestinal disorders". Physicians choose the term "functional" when they cannot exclude any organic cause for the symptoms, such as stomach ulcers.  

The underlying causes are varied and some proposed causes are yet to be studied comprehensively. In addition to a pre-disposition, external factors such as nutrition or stress can also trigger the complaints. The aim of the treatment is first and foremost to alleviate symptoms such as abdominal cramps, stomach pain or bloating. Additionally, efforts are made to identify the triggering factors and, if possible, to challenge them. As such, in addition to a drug therapy, sufferers themselves can do a lot to alleviate their complaints. 

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What signs and symptoms are characteristic of a irritable stomach? 

Many sufferers cannot pinpoint the unease in their stomach. Some complain of vague discomfort in the upper abdomen, others describe the pain as "belt-like" because it is not limited to the abdomen, but might also radiate into the back.  

These are the most common symptoms of irritable stomach: 

  • Early satiety
    Feeling that the stomach is overfilled soon after starting to eat, unproportional to the quantity of food taken, so that the meal cannot be finished  
  • Epigastric or upper abdominal pain
    Pain localized below the sternum, pain localized in the upper abdomen  
  • Fullness
    Feeling of congestion of food without relation to prior food intake which could explain this feeling 

Other symptoms of irritable stomach include: 

  • Nausea
    Urgent feeling of need to vomit, but vomiting does not actually occur 
  • Vomiting
    Ejection of mucus and gastric contents, or strong unproductive retching 
  • Heartburn / Acid eructation
    Belching with acid taste, burning sensation in the oesophagus 
  • Abdominal cramps
    Spasmodic or colic-like stomach pain without specified localization 
  • Sickness
  • Loss of appetite
    Listlessness for food intake 
  • Retrosternal discomfort
    Unpleasant feeling behind the sternum, painful or drawing 

If you experience symptoms such as bloody bowel movements, significant weight loss or difficulty swallowing, you should reach out to your physician. These symptoms may indicate an organic disorder of the digestive tract that urgently requires therapy by an internist or a gastroenterologist. 

Causes of an irritable stomach

The exact causes of irritable stomach are unknown. The previously assumed cause of an infection with the bacterium Helicobacter pylori and irritable stomach is now treated as a separate entity.

Instead, it is likely that there are several interacting physical, psychological and social factors behind irritable stomach disorder (so-called multifactorial development). One possible cause of irritable stomach is a hypersensitivity of the nervous system of the gastrointestinal area. This complex network of nerves (enteric nervous system) runs through the entire gastrointestinal tract and controls the digestive processes in the body. For example, if the nerves are overly sensitive to normal and healthy pressure e.g. due to food intake, the feeling of pain could be the result. 

Furthermore, disturbance of gastric motility can be one of the causes for discomfort: 

The muscles in the stomach mix food by rhythmic contraction and relaxation and push it further along the gastrointestinal tract. Sometimes this movement gets out of step. In the upper storage area muscles are too tight to adjust in volume to provide space for the supplied food. In the lower part of the stomach, which leads to the small intestine, the muscles are too relaxed to transport the food towards the intestine. This may lead to unpleasant pressure and feeling of fullness and even early satiety just after starting a meal.

Some triggers for symptoms of irritable stomach are known, others are just suspected. Possible triggers of symptoms may be your eating habits. For many sufferers, the consumption of coffee, hot spices, alcohol and/or fatty foods may lead to upper abdominal pain. Incompatibilities with dairy products, eggs and certain types of fruit can also trigger symptoms of irritable stomach. 

In addition, psychological reasons or a wrong diet can play a role in triggering symptoms of irritable stomach: like permanent stress or an unbalanced diet. For example, severe conflict situations and psychological stressors, such as anxiety or depression are shown to be connected to irritable stomach. It can unfold into a vicious circle where mental stress irritates the stomach and the symptoms of the irritable stomach in turn increase the mental stress.  

Once sufferers are sensitized to their own disorder, they often deal with it more consciously. This has the advantage that they can make a positive influence, for example by eating healthy food, which would not trigger any future symptoms. But it also has the disadvantage that one pays more attention to physical processes and perceive complaints with greater intensity. 

A man dressed in white t-shirt, seen only from hip to shoulder, suffering from irritable stomach.

Irritable stomach: Reaching a diagnosis is difficult

Often it is not easy to diagnose irritable stomach or irritable bowel syndrome: A diagnosis of "irritable stomach" can be made if the gastric symptoms persist for at least twelve weeks during a six-month period without clear organic causes.

Interesting: Scientists calculated that between 10 and 20 percent of the population in the industrialized nations suffer from irritable stomach.

Difference between IBS and irritable stomach 

Irritable stomach and irritable bowel syndrome show many similar symptoms. Up to 30 % of patients may experience symptoms of irritable stomach overlapping with symptoms of irritable bowel syndrome. Both disorders show similar risk factors and triggers. So what are the differences?  

The main symptoms of irritable stomach are:  

  • Early satiety 
  • Upper abdominal pain 
  • Feeling of fullness 

The main symptoms of irritable bowel syndrome are: 

  • Pain connected with  
  • Changes in stool frequency or 
  • Changes in stool texture 

However, a slight differentiation aid can be attempted by locating the complaints: While the symptoms of irritable stomach occur mainly in the upper part of the gastrointestinal tract, people with irritable bowel syndrome tend to complain about changes in stool frequency and texture such as diarrhoea and/or constipation. 

The exact cause of IBS is not yet known. As already mentioned, people with a medically diagnosed IBS may have hypersensitive nerves in the digestive tract. But that's just one of the possible causes. Doctors and researchers also believe that psychological factors may play a role. 

Irritable stomach and functional indigestion – one and the same?  

Functional disorder is the generic term for clinical pictures such as irritable bowel syndrome or irritable stomach syndrome. According to a scientific definition, a functional disorder is "the increased and intensified occurrence of complaints that are triggered in the upper and lower gastrointestinal tract, persisting for more than twelve weeks or repeating themselves without an organic disease of one of the organs involved in digestion being found in routine diagnostics 

Stethoscope with blues rubber parts, lying on a sheet of data regarding irritable stomach.
Man wearing blue t-shirt is holding his stomach.

Possible treatments for irritable stomach

Since an irritable stomach can be characterized by numerous symptoms, it makes sense to be able to treat the complex disorder and its various symptoms as comprehensively as possible.

This is where the so-called multi-target principle of Iberogast® comes in, which is fast-acting and may comprehensively relieve numerous symptoms. Iberogast normalizes gastric motility. Studies have shown that Iberogast® is further able to calm the intestinal nerves and normalizes acidification and also protects the stomach lining.

More tips for stomach problems 

There are many ways to relieve the symptoms of irritable stomach. Many of the following will generally help you to feel healthier. What works in the end differs from person to person - just try it out: 

  • For complaints that persist for several days or are recurrent, consult a specialist so that they can exclude organic disorders early. 
  • Relax: Avoid too much stress and find a balance to your professional life. Try some suitable “soft” sports such as yoga or walking.  
  • Pay attention to regular meals. Most people can better tolerate five smaller dishes over the course of the day than, for example, two very large ones - try what suits you and stick with it. 
  • Take time for each and every meal and do not gobble up but enjoy your meal. 
  • Also, avoid foods that did not work out well for you, which might be such as coffee, alcohol, or spicy foods. 

If your irritable stomach is due to psychological distress, psychotherapy may be considered as a supplement treatment. Talk to your general practitioner about it, they will be able to refer you to a specialist. 

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