We’ve all eaten or imbibed something that didn’t agree with us, or caught a stomach bug that was settled with rest, over-the-counter aids and some chicken broth. While many times we can go it alone and solve a stomach ache ourselves, there are certainly times when it’s necessary to see a doctor. Dr. Gina Sam is a Gastroenterologist with Mount Sinai Hospital in New York City and an Associate Professor. She provides insights on symptoms indicative of common abdominal conditions and advises when it’s time to see the doctor.
Common symptoms of indigestion include feeling full fast during a meal, a slicing pain, burning or tightness between your breastbone and navel or bloating. The tricky thing with indigestion is that it can be triggered by something else that is worse. Persistent indigestion may be a side effect of a medication, caused by smoking, thyroid disease, ulcers, infection, or gastroesophageal reflux disease (GERD). “If you rarely have indigestion and feel funny or discomfort after a spicy meal that may go away on its own. However, if indigestion is a daily occurrence for more than 2 weeks and is coupled with trouble swallowing, fatigue or weakness, then absolutely see your doctor to be sure it isn’t due to something more serious,” advises Dr. Sam.
When the small intestine fails to produce enough lactase, an enzyme that digests milk sugar (lactose) food reaches the colon before it has been processed and absorbed. Undigested lactose interacts with normal bacteria in the colon leading to diarrhea, nausea, bloating, cramping, gas and sometimes even vomiting. These symptoms of lactose intolerance usually begin 30 minutes to two hours after consuming foods or drinks with lactose. Dr. Sam explains that the challenge with lactose intolerance is that it often leads to calcium deficiency so it’s always a good idea to see your doctor to create a plan that explores which foods trigger discomfort and which are still okay.
According to Dr. Sam, “kidney stones don’t cause symptoms until they pass on from the kidney toward your bladder. That’s when there may be cloudy or foul-smelling urine that can appear brown or pink. There may also be a frequent need to urinate but the ability to urinate small amounts. Nausea and vomiting along with fever and chills are also symptoms. Usually when lower back pain is so severe sleeping and even sitting is difficult the patient seeks medical attention.“ She adds, “When you have kidney stones you just know something isn’t right, yet sometimes it takes people longer to see several symptoms before they seek medical attention.“
While appendicitis is more common among people ages 10-20, it can strike at any age. Typical symptoms are pain specifically in the lower right quadrant of the abdomen, however, half of those with appendicitis have pain elsewhere. Also, not everyone has his or her appendix in the same place making the pain site vary. “This is why it is important to monitor symptoms closely. Many of the symptoms are similar to ones associated with other conditions such as kidney stone, Crohn’s disease; even ectopic pregnancy,” offers Dr. Sam. She further explains that the patient can expect several tests (blood, urine, MRI, CT or ultrasound) to confirm diagnoses. Some doctors don’t want to risk waiting for test results and based on how the patient describes his or her own symptoms may opt to surgically remove the appendix.
Gallstones are stones that form in the gallbladder, a tiny sac that hangs out under the liver, disgorging bile as needed to digest fats. These stones cause swelling and can block the duct into the intestine, resulting in pain. Gallstone pain tends to strike the right side of the upper abdomen, particularly after fatty meals. Such meals trigger the gallbladder to contract. “If the gallbladder is inflamed, any contraction of that nature will be amplified and typically will cause pain to the patient,” says Dr. Sam
Medication side effects
“No drug is without side effects and sometimes that includes abdominal pain.”
Oral bisphosphonates, a popular class of drugs that helps preserve bone density and prevent osteoporosis, can cause swelling and therefore pain in the lower esophagus says Dr. Sam.
Pain medications known as NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and aspirin can also cause swelling in the stomach lining and may even lead to ulcers.
Rule of thumb is to trust the gut. When something feels more serious, it usually is. Some stomach issues can either be symptoms of other more serious issues or if left unaddressed, can escalate into something worse. “Whenever you’re feeling prolonged discomfort and sharp pain it’s worth seeing your doctor,” advises Dr. Sam.
About the doctor:
Dr. Gina Sam, MD/MPH is an Assistant Professor in the Division of Gastroenterology, Department of Medicine at Mount Sinai School of Medicine, New York. She is the Director of the Mount Sinai Gastrointestinal Motility Center specializing in achalasia, gastroesophageal reflux, functional disorders, irritable bowel syndrome, gastroparesis, and anorectal disorders including pelvic floor dyssynergia and fecal incontinence.