Nervous Stomach

What is a nervous stomach?

Actually, there is no such diagnosis as a nervous stomach. Yet we all know we have felt it in one way or the other. It is actually a misnomer, as many of the symptoms people get have little to do with the actual stomach organ. Some people describe “butterflies” in their stomach when they are anxious or anticipating something will happen- these are issues seated in the diagnosis of anxiety. Others describe it as a gassy, bloating feeling, with alternating bowel habits. These symptoms describe what we now know is irritable bowel syndrome. People who have a burning feeling with indigestion may be having symptoms of gastroesophageal reflux or ulcer disease. Regardless of the symptoms, we seem to tie these symptoms to our emotions at the time, hence “nervous.” We shall discuss possible causes and attempt to help you distinguish what problem is explaining your symptoms, and how to make them improve.

The Wiring of the Gut

The gut, like other part of the body, produces chemical hormones called neurotransmitters- these are like the Morse code of bowel control. They cause impulses to the brain to make us sense certain symptoms. We may feel pain, bloating, fullness, gas, heartburn etc. Another impulse that happens is called the gastro-colic reflex, which simply means that when something is placed in the stomach, the colon has an urge to empty. Hence, many people need to use the restroom directly after eating. This is a classic symptoms of Irritable Bowel Syndrome, or IBS. However, the ebb and flux of neurotransmitters creates most of the symptoms we perceive as a nervous stomach. Most of these symptoms are heightened in times of stress and anxiety, and for some are difficult to control, even with prescription medication, which is infrequently needed.

Nervous stomach has a wide range of Symptoms

One person complaining of nervous stomach maybe referring to those “butterflies,” like how we feel before our first kiss. Others refer to symptoms of bloating, gaseousness, flatulence, and stomach bloating. Still others yet may refer to a burning and sense of indigestion. Many will feel outright abdominal pain, decreased appetite, nausea, and vomiting. Frequently, people who relate to this condition may have sudden urges to have a bowel movement after a bout of cramping. Each of these constellations of symptoms point toward different problems, and each can be treated specifically to improve the patient’s symptomatology. Let’s discuss each entity.

Irritable Bowel Syndrome

IBS is a group of symptoms that happen recurrently, and seem to establish some type of pattern. Anxiety and stress make the symptoms worse, but do not cause the problem. The symptoms are commonly abdominal cramping and diarrhea, frequently after eating. However, there is a form of the illness that presents with constipation, and yet another where the affected person has an alternating pattern of diarrhea and constipation. A typical presentation is when you go out to dinner, and have to move your bowels before leaving the restaurant. Another typical example is when a person is very anxious about a big event, has a stomach ache, and then has loose stool which relieves the stomach ache for a time. The symptoms for many people come on, simply when they are nervous, and resolve after their anxiety is gone. The treatment of IBS starts with increasing fiber in the diet which makes the stool more formed and regular. There are new medications now available for people who experience predominantly constipation symptoms, and others for when the symptoms are variable.

Gastroesophageal Reflux Disease (GERD)

GERD is otherwise known as Acid Reflux. This is the issue when acid from the stomach rushes up into the esophagus. For many people, the symptoms are burning in the chest, indigestion, belching, acidic taste in the mouth, and more prominent symptoms while lying down. It can present as chest pain, scaring the patient into thinking they are having a cardiac event, and it is the most common cause of chest pain evaluations in the ER. However, many people feel the gurgling of the acid, and often think they are feeling “flutter” or “butterflies” as well. The treatment is antacid medication such as Tums, ranitidine, or omeprazole.

Food intake you don’t agree tith

Often without having anything medically wrong with us, certain foods can make us feel queasy, and give symptoms of increased movement of the intestines. Many different foods can do this, such as spicy food, foods with high fat, foods with sugar alcohols (sugar free candy), foods that one has allergy or a poor tolerance to. Eating habits can cause similar symptoms to what many people interpret as a nervous stomach. Overeating, binging and purging, and eating late at night before bed can all cause these similar symptoms. Food allergies can also cause this issue. Eliminating the food or activity related to the symptoms resolves most in due time. Medications can also cause these symptoms, and stopping the agent may be in order- consult your physician.

Ulcer disease

Most lay people believe that stress and anxiety, although they can make a person feel like they have a nervous stomach, do not cause ulcer disease as commonly as was thought to be true. A bacteria called Helicobacter Pylori has been found in the stomach in patients with ulcer disease. People with significant stomach symptoms often need to undergo endoscopy and a biopsy to rule out this infection. It can also be documented by a breath test, or blood-work. Once treated, symptoms usually resolve after the 2 week course of antibiotics and antacids.

Gaseous symptoms

As we all know, certain foods are more prone to give gas, flatulence and belching symptoms. Gas in the abdomen moves freely, and with positional change will shift in the stomach and intestines, causing a flutter like sensation, and often pain. Gas can also build up behind constipated stool and create the same symptoms. Promoting stool production with increased water intake, a stool softener, or if need be, a laxative will allow the stool and pent up gas to pass. Simethicone orally will often relieve these gaseous symptoms.

General steps to take for relief of all Causes of nervous stomach

  • Stay hydrated with 64 oz of water daily
  • Avoid spicy, high acidic foods
  • Avoid alcohol
  • Avoid high fat foods, fast foods
  • Do not eat or drink within 2 hours of bedtime
  • Avoid Carbonated, Caffeinated products
  • Avoid excessive use of ibuprofen or NSAIDs
  • Avoid foods that produce gas (beans, broccoli, cabbage, etc.)
  • Avoid excessive consumption of foods with sugar alcohols
  • Try to limit stressful situations
  • Employ meditation and relaxation training
  • Get regular aerobic exercise to promote endorphin release & digestive functions
  • Herbal remedies with ginger, peppermint and honey are helpful
  • Taking a regular probiotic will promote gut health


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