Gut Check

Stomach Aches Can Be More Than an Annoying Pain

By Pete Alfano


Our stomach has one essential job — to digest the food we eat and send it to the small intestine. But what we put into our stomach can make that job more complicated and exacerbate problems ranging from an old-fashioned tummy ache to acid reflux disease, peptic ulcers, and in some rare cases, cancer. 

Food isn’t the only culprit for the gut-wrenching discomfort we can experience in our stomachs. That old health nemesis stress, as well as lack of sleep, anxiety, and depression, can get your stomach churning. So does the overuse of anti-inflammatory drugs (NSAIDs) such as ibuprofen.

While the stomach’s job seems simple, in practice, it is a complex organ that is home to what medical science has found to be between 300 and 500 types of bacteria. Some are bad bacteria, but most are the good kind and necessary for proper digestion and a healthy immune system. 

So, what can make the job of these so-called “gut bacteria” harder? Eating too much processed food. A diet high in sugar. Spicy food, over-eating, eating too quickly, yo-yo weight gain and loss, and undiagnosed food allergies can all contribute to the discomfort you may feel after eating. And while none of those things will cause a peptic ulcer, they worsen symptoms. A peptic ulcer is usually caused by an infection of the Helicobacter bacteria – one of the good kinds. Burning pain in the pit of your stomach, heartburn, bloating, and nausea can be signs of a peptic ulcer. But be aware that symptoms of acid reflux are like those of heart disease.

A more common disorder is gastroesophageal reflux disease (GERD). This occurs when stomach acid backs up into your esophagus, which is the tube that connects the mouth to the stomach. Frequent bouts of acid reflux disease can irritate the esophagus lining and make swallowing difficult. Untreated, chronic GERD may even lead to esophageal cancer. Other GERD symptoms include chest pain, a burning sensation in your chest, and the feeling that you have a lump in your throat. Unfortunately, coffee, caffeine, alcohol, and acidic and fried foods all tend to aggravate acid reflux disease, so consume them at your own risk. 

The key to a healthy stomach is eating a balanced diet with more fiber and less high-fat foods. Studies show that Americans consume only 40 to 50% of their daily allotment of fiber. Avoid foods your stomach has difficulty digesting, limit alcohol and caffeine, and try to reduce stress, manage your weight, and get enough sleep.

If problems persist, then it is time to visit a gastroenterologist. Numerous tests are available to determine the cause of your gut pain. They include a barium swallow to look at the stomach and esophagus, a lower barium enema for the rectum and intestines, an endoscopy, which is a tube inserted in the throat under anesthesia that enables a doctor to view the esophagus and stomach, a colonoscopy, and various imaging tests. The goal is to make your stomach’s job as easy as possible. 

Can You Stomach These Medications?

What is your remedy of choice when your stomach is misbehaving? Do you prefer proton pump inhibitors (PPIs) or a histamine-2 receptor blocker H2-Blocker? Maybe, your preference is calcium carbonate. 

You probably do not know these over-the-counter medicines by their chemical classifications. You might recognize PPIs by brands such as Nexium (esomeprazole) and Prilosec (omeprazole). A popular H2-Blocker is Pepcid and Tums is calcium carbonate. Does it matter which one you take?

PPIs such as Nexium and Prilosec work by reducing stomach acid and treating acid reflux. These medications are taken daily and take longer to work because they are intended for frequent, chronic heartburn. An H2-Blocker like Pepcid also reduces stomach acid and helps prevent peptic ulcers. It is also effective in reducing a bout of acid reflux. It is intended for occasional heartburn but not a chronic problem.

Finally, calcium carbonate is what you pop into your mouth when acid indigestion is mild and occurs infrequently. You chew a couple of Tums and usually get relief quickly. Calcium carbonate can be taken several times a day, while medical experts recommend that an H2-Blocker be taken no more than twice a day. PPIs are generally taken once daily, typically in the morning before eating. Doctors say that none of these medications should be used for longer than two weeks at a time, and please, no mixing or matching. You can reduce their effectiveness if you take multiple medications. Finally, consult your physician about possible interactions with other medicines you take.