Gastric pain: When to see a doctor in Singapore and how to relieve the pain

Do you often experience abdominal pain? Specifically, pain that arises in the centre of your upper abdomen? You may be experiencing gastric pain, a sort of pain that can range from a dull ache to a throbbing pain. While gastric pain is quite common in Singapore due to our stressful lives and tendency to have irregular meals, this stomach condition may be a sign of more serious health issues like stomach cancer and gallstone disease. 

When should you see a doctor and how can you manage the pain for relief? Below, all you need to know about gastric pain.

Symptoms of gastric pain

The signs and symptoms of gastric pain include:

• Gnawing or burning pain in your upper abdomen that may become better or worse with eating 
• Nausea 
• Vomiting 
• Diarrhoea 
• The feeling of fullness in your upper abdomen

What are the causes?

Gastric pain is usually caused by excessive acid in the stomach that arise from issues such as:

Flatulence
Gas or flatulence occurs naturally in our digestive tract due to digestive processes. Sometimes, gas can buildup, causing pressure, fullness, a feeling of belatedness and mild pain. This pain usually comes in waves and your abdomen may swell. Flatulence after eating is normal, which is why we sometimes tend to burp more after eating certain food. Food like beans, cauliflower and garlic are known to cause flatulence. 

This pain is often fleeting and non-serious; if it is serious, some medication may help. However, if it occurs with persistent vomiting, diarrhoea or a fever, a visit to the doctor is advised.

Indigestion
Indigestion, or dyspepsia, is the full and comfortable burning sensation we experience in our upper abdomen after eating. This pain and full feeling can sometimes also be felt in the throat, mouth or chest. Indigestion is usually the result of an acid buildup in the stomach and is caused by eating too quickly or consuming certain food. 

In some instances, recurring indigestion may be due to acid reflux or a stomach ulcer. If your indigestion is accompanied by weight loss or severe pain, please see a doctor.

Gallstones
Bilirubin or cholesterol sometimes form solid particles in the gallbladder — these particles are known as gallstones. While gallstones that are small in size and may not cause problems, having large or numerous ones can result in pain, vomiting and fatigue. In severe cases, gallstones can lead to impaired functions in the pancreas and liver. 

To remove gallstones, your doctor might either prescribe medication or recommend surgery to remove your gallbladder.

Stomach virus
Stomach virus, or stomach flu, typically manifests as diarrhoea, nausea, vomiting and gastric pain. Some people may experience headaches, fatigue or muscle aches as well. Patients with stomach virus must remember to stay hydrated and sip on water or electrolytes regularly. Most cases of stomach virus cure by themselves.

Liver or pancreas issues
Hepatitis (inflammation of the liver) or pancreatitis (inflammation of the pancreas) often results in upper abdominal pain or gastric pain. Look out for other accompanying symptoms like jaundice, unusually dark urine, nausea, vomiting, and pale or oily stools.

Bowel obstruction
Bowel obstruction happens when tissue blocks the intestinal pathway, getting in the way of digestive waste. It is usually caused by fibrous scar tissues, tumour growth or an inflamed intestinal wall. On top of constipation and pain, patients might also experience the vomiting of bile, rapid weight loss and abdominal swelling.

When should you see a doctor?

While most cases of gastric pain usually resolve itself, more serious cases would require medical intervention. It is recommend that you see a doctor if you experience gastric pain accompanied with these symptoms:

• Changes to bowel movement e.g. bloody or black stools 
• Persistent vomiting or diarrhoea for more than 12 hours 
• Fever 
• Unexplained weight loss
• Intense and debilitating pain

Additionally, you should see a doctor if your symptoms have appeared recently, as they might be indications of a more serious health problem. For symptoms that are long-standing, going back for say a few decades, they are less likely to mean anything more severe.

Health issues from gastric pain 

At the doctor’s, you may be required to do a colonoscopy or CT scans to rule out organic causes of gastric such as inflammation, ulcers and cancer. Organic causes include:

Peptic ulcer disease
Peptic ulcer disease occurs due to a defect in the duodenum wall or innermost layer of the stomach. Most peptic ulcers are due to the overuse of non-steroidal anti-inflammatory drugs and other painkillers, as well as Helicobacter pylori infection. 

Tests taken: blood test, stool test, urea breath test or endoscopy

Gallstone disease
While gallstones do not usually cause any symptoms, a gallbladder inflammation may lead to severe abdominal pain. Occasionally, gallstones may cause pain without any significant inflammation. 

Tests taken: ultrasound scans and CT scans

Gastro-oesophageal reflux disease
Gastro-oesophageal reflux disease is a chronic condition where bile or stomach acid goes back into your food pipe, irritating its lining. 

Tests taken: endoscopy

Cancer
Stomach, pancreatic or liver cancer can cause abdominal pain. 

Tests taken: endoscopy 

If tests come back normal with no organic cause found, the gastric pain is ruled as non-ulcer dyspepsia or functional dyspepsia, which forms the majority of gastric pain cases.

How to relieve gastric pain

Gastric pain can get uncomfortable — here are some ways to relieve the pain at home. 

• Eat easily digestible food like high-fibre grains and lean meats
• Sip water or other clear fluids 
• Avoid dairy products 
• Avoid high-fat, greasy or fried food, citrus fruits and food, alcohol, caffeine and carbonated beverages 
• If possible, take over-the-counter gastric medication

Tips on reducing and avoiding gastric pain

Eat on time and avoid skipping meals
Eating on time will accustom your stomach to release gastric juices only during mealtime. When you skip meals, the gastric juices will cause upset to your stomach.

Avoid eating large meals
Overeating can lead to indigestion or other digestive problems due to pressure on the abdominal wall.

Chew your food properly
When you chew your food properly with sips of water in between, your body is able to better gauge hunger levels and digest food properly.

Moderate your alcohol consumption
Too much alcohol over a period of time can weaken and inflame your stomach’s protective lining, causing frequent gastric pain and ulcers.

Avoid food that causes gas and irritation
This includes spicy food, high-fat dairy products, tomato products, garlic, citrus food and fried food.

References

1. Schellack, N., Schellack, G., Van Der Sandt, N., & Masuku, B. (2017). Gastric pain. SA Pharmaceutical Journal, 84(2), 28–35. https://doi.org/10.1097/00005053-192905000-00032
2. When Should You See A Doctor For Your Gastric Pain? (n.d.). https://www.gutcare.com.sg/when-should-you-see-a-doctor-for-your-gastric-pain/