Lloydspharmacy.com Health

Reviewed by Dr Dan Rutherford, GP

What are the symptoms?

The symptoms of an upset stomach include occasional heartburn, a taste of bile in the mouth and pains in the stomach, which can be made worse by coffee, citrus fruits, fatty foods, onions, alcohol and chocolate.

In some cases, milk can ease the pains. Other symptoms include irregular bowel movements, constipation and pain when going to the toilet.

What are the possible causes?

Reflux oesophagitis

Usually the problem is caused by reflux oesophagitis, which is brought on by stomach acid that has moved up to the gullet. This usually feels like heartburn or leaves a taste of bile in the mouth.

Reflux oesophagitis can be caused by the opening of the muscle around the top of the stomach, or because the stomach is being pushed due to pregnancy or obesity.

Drinking coffee and eating citrus fruits, fatty foods, onions, alcohol and chocolate often makes the condition worse as these encourage the muscle at the top of the stomach to relax.

Ulcers

Ulcers have similar symptoms and are, therefore, sometimes mistaken for reflux oesophagitis. If symptoms include weight loss and black stools it is important to contact a doctor, who can determine whether or not the condition is caused by an ulcer.

In 9 out of 10 cases an ulcer is caused by a bacteria called Helicobacter pylori. This bacteria can be treated with an antiulcer medicine and antibiotics, which also reduces the risk of contracting new ulcers.

Irritable bowel syndrome

Another cause could be irritable bowel syndrome, which often appears as a pain that gets worse when eating, and is helped by going to the toilet. An irritated large intestine occurs when there is a change of movement in the intestines. It usually helps to drink a lot of water and go to the toilet regularly.

Other, rarer diseases

Other, rarer diseases that require a visit to a specialist include ulcerative colitis and Crohn's disease.

What can be done to help?

Ask a pharmacist for advice about treatments that can be bought over the counter without a prescription.
If these do not help visit a doctor to establish the cause of the symptoms.
After being diagnosed, complete the prescribed treatment.
If initial treatment does not work, return to the doctor. Most cases of reflux oesophagitis and ulcers can be treated successfully with medicine for excess stomach acid and sometimes antibiotics.
If the cause is irritable bowel syndrome, do not buy stomach acid neutralisers (antacids). They won't have any effect.

What are the danger signs?

Bloody, black or tar-like stools - all of which suggest bleeding from within the digestive system.
Nausea, or vomit containing blood, or with an appearance similar to ground coffee.
Unintentional weight loss.
Paleness and fatigue due to an unexplained lack of iron.
Sudden, sharp pains.

All these symptoms require a doctor's diagnosis, as the condition can become very dangerous.

Based on a text by Dr Carl J Brandt

Last updated 02.03.2005