WHY DOES MY STOMACH HURT WHEN I EAT TOO MUCH? WHAT DOES IT MEAN?
“To eat is human, to digest is divine.” -Charles T. Copeland.
Excess gas, bloating and gas pains are some of the most frequently complaints encountered by the doctors. As a physician, when we see a patient with these complaints, we are concerned whether or not these are just unsubstantiated subjective complaints or if they are due to more serious medical problems, like bowel obstruction or paralysis of the bowels. We carefully examine these patients, do X-rays if necessary to differentiate these conditions.
Generally, these complaints are harmless, most often ambiguous, subjective sensations that the abdomen is swollen with excess gas and painful. Gas pains are poorly defined, nonspecific and transient. In fact, clinical studies have shown that there is no excessive gas accumulation in the abdomen. There is no increase in the abdominal girth. It is just a feeling that the abdomen is distended with gas.
It is normal and physiologic to have some gas in the gastrointestinal tract, to keep the bowel lumen open, to prevent it from sticking together. Scientific studies and measurements have shown that the gastrointestinal tract normally contains about 200 mL of gas. Because gas is light, it tends to accumulate in the upper abdomen under the ribcage.
After eating, the volume of gas increases by 65 %, mostly due to swallowed air while eating; especially for those people who eat fast and talk too much while eating and, drinking too many carbonated drinks.
Hence, it is normal to feel bloated after eating. But this bloating resolves gradually by burping and passing gas through the anal passage. Studies have shown that a person, on average, could pass gas 15 to 20 times a day, even while sleeping without even being aware of it.
The other sources of gas formation in the bowels are due chemical process of digestion and bacterial fermentation of undigested food substances. There is also diffusion of certain gas molecules from the blood into the bowel lumen.
There are 5 types of gases in our gastrointestinal tract: Nitrogen ( N 2 ), oxygen ( O2 ), Carbon dioxide (CO2 ), Hydrogen (H2 ) and Methane ( CH4 ). H2 is prominent gas; O2 is present in low concentration. The amount of H 2, CH 4, and CO2 are variable.
Noxious odor of flatus comes from the increase amount of Hydrogen Sulfide (H2S) in the passed gas. This gas is released during the bacterial metabolism of sulfate, cystine and mucin containing food substances.
Some patients, especially IBS (irritable bowel syndrome) patients, frequently complaint of excessive gas formation, bloating, abdominal pains, diarrhea or constipation. Well-designed clinical studies have shown that there is no excess gas formation in IBS patients compared to normal volunteers. They are more sensitive to gas volume. In addition they tend to have bowel spasms and they trap gas.
Common sense approach to prevent excess gas formation should be as follows:
1. Eliminate or reduce gas forming foods and lactose containing milk and milk by products, artificial sweeteners containing drinks, carbonated drinks, beers, fructose containing corn syrup from your diet. Follow a low FODMAP (low in fermentable oligo-di -mono saccharides and polyol) diet.
2. Don’t eat fast, don’t talk too much while eating.
3. Drink peppermint tea or chamomile tea.
4. Avoid constipation.
5. Try OTC medications containing simethicone or activated charcoal.
6. Drink plenty of water and, exercise.
If all these measures do not work, it’s time to see your favorite Gastroenterologist.
