Strengthen the center — the stomach and its key position for health
Cassandra Mougiakou, MD, Specialist in Internal Medicine
Dear colleagues,
Today, I face the challenge to address the quite common subject of stomach problems and I will hopefully give you some new and useful information.
My goal is to relate to the stomach, not only as a very important organ, but also to the metaphorical stomach, the solar plexus area.
We say that one needs to “have a strong stomach” in order to undertake a difficult task or cope with a difficult situation, meaning that the stomach needs to be able to cope with stress situations quite well. Also, on the psychological level, one needs to have a fair amount of self-esteem and self-confidence to be able to cope with the challenges brought upon them by the outer world.
On the other hand when something “sits on the stomach” that means that it cannot be accepted well and this can lead to real indigestion symptoms.
The Stomach is the fuel factory for the body. Any disturbance or malfunctioning may severely affect its overall functioning.
The stomach
The stomach is placed to the left in the upper abdominal region of the body just below the diaphragm. It is the widest and most distensible part of the digestive system. This organ does a lot more than just digest food. It also stores food, churns it, breaks it down both mechanically and chemically, kills microbes, secretes hormones and mucus, and also absorbs nutrients.
After receiving food from the esophagus, the stomach churns and partly digests it. It is a short-term food storage facility in the abdomen. After staying there for three to five hours, the food leaves the stomach to enter the duodenum, the first part of the small intestine.
An average individual’s stomach measures about 30 cm in length. On the other hand, the width is around 15 cm. The J-shaped hollow structure can easily hold up to 1.5 liters of food on average. However, the overall capacity may vary from one individual to another. Its amazing extendibility allows it to store an even greater amount of solids and liquids. Its elasticity enables it to change its size according to an organism’s requirements.
The stomach carries out the physical and chemical digestion of food. When the muscles contract and relax periodically, it results in the physical digestion of the food. The other function of the stomach is the chemical breakdown of a meal. The enzymes secreted by glands in the walls of the stomach help in the chemical breakdown of dietary substances.
The coordinated motion of horizontal and longitudinal muscles helps in the physical mixing of the food with the enzymes. The waves of muscular contraction are called peristalsis.
Functions of the stomach
The stomach however is unable to digest all the food categories. At this point, it is the protein component of our diet, which breaks down into smaller constituent parts. The chief cells in the stomach secrete pepsinogen, which is then converted with the help of the gastric acid into its active form, pepsin.
Another important gastric enzyme that helps in the chemical breakdown of the food is gastric lipase. It helps in the breakdown of fats. Thus, the stomach absorbs mainly the lipid-soluble compounds, such as aspirin and ethanol that the stomach takes up.
The chief cells in the stomach also secrete an enzyme, called chymosin or rennin, for the coagulation of milk.
Since the pepsin enzyme requires an acidic medium for its optimum activity, stomach acid or HCL is produced in order to maintain a highly acidic environment.
The release of HCL also serves another additional but very important function in the stomach: killing pathogens, which helps avoid different kinds of diseases.
The stomach secretes the gastric intrinsic factor or GIF into the lumen. The GIF is a glycoprotein in nature produced by the parietal cells in the wall of the stomach. The primary job of the GIF is to facilitate the absorption of vitamin B12. This absorption, however, takes place in the small intestine.
The stomach also secretes hormones, which are called gastric hormones. Gastrin is the principal hormone that the gastric epithelium of the stomach secretes. Its job is to stimulate the secretion of gastric acid into the stomach lumen. At the same time, it also plays a role in the proliferation of gastric epithelium.
Another job of the stomach is to secrete sticky mucous. This mucous creates a mucous layer along the internal lining of the lumen. The purpose of this mucous membrane is to protect the stomach against self-digestion.
Two muscular valves control the passage of food into and out of the stomach. Food enters the stomach from the esophagus (pH value 7.0) through the lower esophageal or cardiac sphincter. On the other hand, the passage of food from the stomach into the intestine takes place through the pyloric sphincter.
After undergoing partial digestion, the chyme (chymos — greek word for juice) with a pH of about 2-4 leaves the stomach to enter the small intestine. Thus, the valve at the bottom of the stomach (pyloric sphincter) starts to slowly release the stomach contents into the duodenum (pH 6). Here most of the absorption of carbohydrates, proteins, fats, water, vitamins and minerals takes place. Afterwards, the undigested matter enters the large intestine for further absorption of the useful substances. The pH rises up and down as it travels through the intestines (6 in the duodenum, 7.4 in the terminal ileum) and out the other end (5.7 in the caecum, 6.7 in the rectum).
If the pH is wrong from the beginning, everything downstream from the small intestine to the large intestine will likely be compromised.
Low stomach acid can cause diarrhea just as fast as it can cause constipation so if one has any digestive problems the HCL level needs to be determined.
HCL
The pH of the stomach varies, from 1-2 up to 4-5. When we eat, the stomach releases enzymes called proteases and hydrochloric acid to aid in digestion. By itself, the acid doesn’t really do much for digestion, but the proteases that cleave proteins work best in an acidic environment or low pH, so after a high-protein meal, the stomach pH may drop to as low as 1 or 2.
However, buffers quickly raise the pH back to 3 or 4. After the meal has been digested, the stomach pH returns to a resting level of about 4 or 5.
Many of the stomach related complaints are associated with an imbalance in the secretion of HCL. Nowadays, medications that aim at decreasing or neutralizing the excretion of HCL are used very widely (PPIs — proton pump inhibitors, H2 receptor antagonists, antacids). They are prescribed even to patients with healthy stomach as a preventive measure against stomach damage when they are on other medications.
So, the current assumption is that there is too much HCL being produced by the stomach. But how can we really be sure that this is the case?
The stomach needs a pH of 2 and lower to break down proteins and make vitamin B12 available. If the proteins go to the small intestine not digested well (as protein fragments instead of amino acids) they may be the cause of the so-called “leaky gut”. Gluten or other lectin particles can make holes in the small intestine allowing undigested food particles to go into the bloodstream. If you don’t absorb vitamin B12 you may become fatigued very easily.
Before the discovery of H. pylori, it was widely believed that peptic ulcer disease was caused by excess acid secretion, but following the recognition of this organism’s role in the pathogenesis of peptic ulcer disease and its effect on acid secretion, interest in measuring gastric acid output declined.
However, there still exists a need to measure gastric acid secretion. Gastric acid is believed to be important as a protective mechanism against ingested pathogens. Low acid output states may predispose to enteric infections e.g. E. coli and V. choleroe, whereas the use of acid-suppressant drugs such as proton pump inhibitors have been associated with a higher incidence of gastroenteritis, pneumonia and Clostridium diffichle infections.
Levels of gastric acid secretion differ in various disease states and their measurement may help in the diagnosis and treatment of these diseases. High levels of acidity are seen in duodenal ulcers and patients with Zollinger—Ellison syndrome, whereas low (hypochlorhydria) or absent (achlorhydia) acid secretion is found in pernicious anemia, atrophic gastritis and gastric carcinoma.
Conventional methods of measuring gastric acid secretion involve aspiration of gastric contents through a tube placed in the stomach during stimulation of acid secretion by histamine, pentagastrin or tetragastrin. However, these tests are uncomfortable, time consuming and can cause side effects, whereas most of the non-invasive methods are at best semi-quantitative and useful in detecting low or absent acid secretion.
Simple natural home methods of measuring stomach acid
Beet root test
After consuming beet the color of the urine is checked; if the color is pink (beeturia) that means that the stomach acid is too weak (it is not enough), but if it is clear then there is sufficient stomach acid. Beeturia is caused by the betalain pigments in the beets, breaking down and being excreted.
Lemon juice test
In case of stomach pain, take a tablespoon of lemon juice. If this makes the pain go away, you may have too little stomach acid. If it makes your symptoms worse, then you may have too much stomach acid.
Baking soda test
Mix 1/2 teaspoon of baking soda into 1/2 glass of water and drink it 10′-15′ before eating. This mixture should trigger the secretion of acid. The by-product of this will be CO2, even in the first 90′ and up to 3′. If this doesn’t happen, it means that the stomach is not acidifie enough. Early and repeated belching may be due to excessive stomach acid (but don’t confuse these burps with small little burps from swallowing air when drinking the solution). Any belching after 3 minutes indicates a low acid level.
The test should be performed 3 consecutive mornings to find an average. Also, to increase accuracy of the test, you must do it as soon as you wake up in the morning before putting anything in your mouth.
Because the time frames can vary person-to-person, as well as how they drink the solution, this test is only a good indicator that you might want to do more testing to determine your stomach acid.
This test is not accurate enough to rule out low stomach acid. To rule out low stomach acid, you will need to try the Heidelberg test or Betaine HCL challenge test.
HCL supplementation test
A progressively increasing amount of capsules with hydrochloric acid (also together with pepsin, if the meal contains protein) is recommended with each meal. Start with one capsule and increase gradually until the feeling of warmness in the stomach ocurs. There are people who take 10 pills before they get this feeling.
INSTRUCTIONS FOR BETAINE HCL SUPPLEMENTATION
1. At the very start of the meal, take one capsule of Betaine HCL. Monitor how your stomach feels during and after eating. Should any burning or heaviness occur, or if burning has been present previously (before taking the supplement) and is now worsened with the use of the Betaine HCL, do not continue using this supplement!!! This is an indication that your stomach is overproducing acid, or that your stomach lining may be damaged. In such cases, please consider the use of Alkabase, Gastric Complex-HP and/or Mastica, to normalize excess acid production and heal the stomach lining.
2. If the first dose of Betaine HCL produced no noticeable stomach discomfort, try taking two capsules at the start of your next meal, again monitor for burning and or heaviness during and after eating. If taking two capsules produces some discomfort, but one capsule does not, restrict yourself to one capsule at the start of each meal. If the two capsule dose produced no discomfort, try three capsules at the start of your next meal.
3. If all goes well when taking three capsules at the start of each meal, stay with that dosage, most individuals will not require increasing the dosage to four capsules. Regular use of supplemental hydrochloric acid will in most cases “re-train” the stomach to produce higher concentrations of acid on its own. This process may take anywhere from several weeks to several months, depending on the individual. The most significant indication that acid production is improving is that Betaine HCL supplementation can no longer be comfortably tolerated.
The Heidelberg Stomach Acid Test
The gold standard medical test for low stomach acid available right now is called “The Heidelberg Stomach Acid Test”. This test is costly, but it will give exact, non-biased results to analyze stomach acid.
The Heidelberg test works by using a small capsule with a radio transmitter that records the pH of the stomach as the person drinks a solution of Sodium Bicarbonate. The result of the test is a graph showing the pH levels at regular intervals of time.
The Heidelberg Stomach Acid Test
Warning signs of low stomach acid
acid reflux symptoms like GER❑ (gastro-esophageal reflux disease), heartburn,
pressure in the epigastrium, feeling of fullness,
flatulence,
cravings for sweets or strong flavored foods,
leaky gut syndrome or inflammatory bowel disease,
skin issues,
a lack of certain nutrients (vitamin B12, zinc, iron, magnesium).
Normally the stomach is the least populated area of the digestive system due to its extremely acid environment. However, in a person with hypochlorhydria all sorts of pathogenic and opportunistic bacteria and fungi can grow on the stomach wall, such as Helicobacter Pylori, Enterobacteria, Candida, Salmonella, E. Cali, Streptococci, etc. The most research in this area has been done in stomach cancer patients, the majority of which show low levels of stomach acid production. Microbes, which populate low acid stomach, play a very important role in causing stomach cancer, ulcers and gastritis.
LOW HCL LEVELS AFFECTS ON HEALTH
A hydrochloric acid deficiency can have many consequences and has been associated with the following:
Malnutrition — reduction of absorption of nutrients from foods
Iron deficiency anemia, owing to poor iron absorption
Osteoporosis, resulting in part from decreased calcium absorption
Periodontal disease — receding gums
General allergies and food allergies
Leaky gut syndrome
B12 deficiency
Gallstone risk — more than half the people with gallstones show decreased HCL secretion compared with gallstone-free patients
Diabetes — elevated blood sugar
Impaired tissue repair
Skin problems — eczema, psoriasis, seborrheic dermatitis, vitiligo
Increased number of bacteria, yeasts, and parasites growing in the intestines
Lowered pancreatic secretion — which contains the majority of enzymes that actively break down foods, which then further contributes to poor assimilation and nutritional problems
Heartburn and acid reflux (commonly thought to be due to too much stomach acid and if there isn’t enough stomach acid the valve that closes the end of the esophagus at the stomach won’t close properly)
Ulcer formation — lack of protection from infectious agents such as H. Pylori
Rapid aging — HCL is necessary for restoring cellular methylation reserves
Fermentation and putrefaction
Reduced liver function
Reduced oxidation of lactic acid
Reduced white blood cell activity
Retention of carbon dioxide
Bloating, belching, and flatulence immediately after meals
Indigestion — heavy feeling in the stomach
Candida
Upset stomach
Nausea
Natural remedies for low gastric acid
A pinch of mountain salt or unrefined, highly mineralized sea salt in each glass of water to allow the stomach to secrete gastric acid.
Apple cider vinegar (ACV) is recommended 10′ before the meals in the amount of 1-2 tablespoons diluted in 1/2 glass of water.
Bitter drops or digestive bitters may be added to ACV before meals. Bitters can also be used after meals when upset stomach, indigestion, bloating or heartburn is being experienced. They are a natural plant based tonic, which stimulates the digestive process including digestive enzyme production, bile secretion, and stomach acid levels. Specific digestive organs triggered to action include the pancreas, gall bladder, liver and stomach.
Digestive enzymes in the amount of one to two capsules right before a meal. They, too, can be taken with the apple cider vinegar.
Betaine HCL (with or without Pepsin) pills help heal the GI tract, help fight acid re-flux and improve low stomach acid. It’s also one of the best leaky gut supplements around.
Manuka Honey. One teaspoon a day or a teaspoon twice a day can actually help to improve stomach ulcer symptoms, treat conditions like SIBO (small intestinal bacterial overgrowth) and it’s also great for low stomach acid.
Thorough chewing of the food and smaller meals.
Signs of too much stomach acid
Mild discomfort
An increase in the production of stomach acid also stimulates gas production, which can build up. This may give a mild discomfort and some pain. There may also be nausea, flatulence, bloating, burping, vomiting.
GERD
When there is a dysfunction of the lower esophageal sphincter (LES), then the stomach acid may flow backward up into the esophagus (acid reflux). This is also known as gastrointestinal reflux disease (GERD). Heartburn is the most common symptom. Other symptoms include cough, asthma attacks and hoarseness. GERD can lead to bronchial asthma, chronic bronchitis, chronic laryngitis, COPD, cancer of the esophagus and cardia inlet)
Gastric ulcers
Too much acid over time can damage the lining of the stomach. Gastric ulcers can form and if not treated, they can progress to bleeding ulcers and tears in the stomach wall.
Causes of Excess Stomach Acid
The main causes of excess stomach acid include H. pylori infection and the use of NSAIDs. They are likely to result in gastritis and a peptic ulcer respectively.
Nutrient points and protein metabolism
In all cases of stomach complaints it is important to take under consideration and treat, when needed, the nutrient points which are related to the digestion processes.
The points that are related to protein metabolism are: HCL, pepsin, methionine and acidophilus.
Most important nutrient points related to stomach problems.
Yellow points — protein metabolism nutrient points. Green points — vitamins.
The most frequently “weak” nutrient point is HCL. Either too much or too little is related to disorders in both the structure and the function of the stomach. I always test this point even when a person has no stomach complaints as about in 80 % of people it is sensitive and even painful!
Moreover, this point is related to the hormonal system. Hypothyroidism results in the decrease of the hormone gastrin, on which the production of HCL depends. Low cortisol levels lead to insufficient acid production. Also increased adrenaline has the tendency to decrease function in the stomach and small intestine, while increasing the activity in the colon.
The HCL point is found between the xiphoid process (tip of the sternum) and the beginning of the ribs on the left side of the body.
Since hydrochloric acid comes from hydrogen chloride, the points for chlorine (at the lower left intercostal arch) and hydrogen (at the right hip joint) should also be treated.
The pepsin point is found between the xiphoid process (tip of the sternum) and the beginning of the ribs on the right side of the body. When the pepsin point is “weak” this is an indication of bad protein metabolism. The patients confirm that when they eat a particular type of protein it sits “heavy” on the stomach. This can be caused by meat, fish, poultry, eggs, cheese, yogurt, pulse.
I strongly recommend the lecture by Urlike Nigmann, a German naturopath, on “the HCL point and it’s significance for metabolism and immunity” in RTI 28 (2002).
Amongst other things, she states that whenever there is deficiency of both HCL and pepsin the following symptoms may occur:
coated tongue
bad breath
pressure in the upper abdomen as if “food was sitting on the stomach like a rock”
belching
hypoglycemia
hypotension.
The methionine point is found two fingers width above the tip of the breastbone (xiphoid process). Methionine is an essential amino acid, which contains sulphur, found in the body used to make proteins and peptides. It protects the intestinal and gastric mucous membrane. Problems with its absorption may result in cramps and foul-smelling diarrhea. It’s found in meat, fish and dairy products, as well as nuts and grains.
The Lactobacteria Acidophilus point is located at the lower rib in the middle of the right costal arch. It is related to the intestinal flora. When it is weak it’s a sign of intestinal dysbiosis, which can be due to low production of gastric acid.
Coenzyme Q10 is a substance similar to a vitamin. It is found in every cell of the body. It is used to produce energy the body needs for cell growth and maintenance. It also functions as an antioxidant, which protects the body from damage caused by harmful molecules. Amongst others, it plays a role in fat metabolism. CoQ10 is naturally present in small amounts in a wide variety of foods, but levels are particularly high in organ meats such as heart, liver, and kidney, as well as beef, soy oil, sardines, mackerel, and peanuts. So, if protein digestion is not right there may be a deficiency in coQ10.
Vitamin B12 (cyanocobalamin) point has a reference to cobalt.
This point is found at the same place as the Acidophilus point on the left side of the body. Whenever there is chemical or radioactive stress from the environment or there is not enough vit. B12 in the body, this point will be painful. Cobalt improves the absorption of iron in the intestinal tract and influences the thyroid gland’s ability to absorb iodine.
With age, it can become harder to absorb this vitamin. Vitamin B12 deficiency may develop because of:
Atrophic gastritis, in which the stomach lining has thinned
Pernicious anemia, which makes it hard for the body to absorb vitamin B12
Conditions that affect the small intestine, such as Crohn’s diease, celiac disease, bacterial growth, or a parasite
Immune system disorders, such as Graves’ disease or lupus
A vegan diet or a vegetarian diet without eggs or dairy products.
Vitamin B12 is found in pulse, in the roots of plants, nuts, cocoa, grains, herring, tuna, rosefish, beef kidneys, beef and chicken heart.
In the middle between the Acidophilus and the Bitter salts points we find the Bismuth point, on the right side of the body at the lower costal arch. The Bismuth point may feel painful or numb with inflammatory diseases of the mucous membranes of the stomach and the intestines. This point should be checked and treated in patients undergoing chemotherapy to avoid the damaging of the stomach’s mucous membrane.
Two fingers width below the vit. B12 point on the left costal arch we find the Chlorine point. Chlorine is found in the stomach acid. There may be a lack in chlorine in people who are on a low-sodium (low salt) diet.
If pH is too high (not enough acid in the stomach), then zinc, iron, calcium, magnesium, Vit. B12 will not be absorbed.
Stomach ailments
Stomach pain
Stomach pain is located in the left upper abdomen and may be described as a burning feeling, a sense of weight on the stomach, bloating or indigestion and accompanied by other events such as belching, nausea, vertigo, vomiting.
Stomach pain may appear after meals or as hunger pain.
The main diseases that occur with stomach pain are gastritis and peptic ulcer. The main causes that are implicated in stomachaches are:
Intolerance to lactose or gluten; millions of people all over the world suffer from intolerance to lactose and gluten substances found in milk and dairy products, respectively.
Food poisoning; another common cause of stomach pain is food poisoning.
Anxiety, stress, depression; all these factors may cause severe abdominal pain, weight loss and loss of appetite.
Chewing gums; sorbitol, found in sugar-free chewing gum, may be the cause not only of stomach pain but also of abrupt weight loss and diarrhea.
Appendicitis; the acute and sudden pain caused by appendicitis can often be misinterpreted as a severe stomachache. Early diagnosis in this case really saves lives as an appendicitis that is not treated early can develop into peritonitis and threaten the life of the sufferer.
Drug-related side-effects; medicines such as analgesic or antipyretic and anti-inflammatory drugs and those that prevent osteoporosis tend to cause swelling and possibly stomach pain.
Stomach ulcer; in this case the stomach pain appears mainly after meals.
Endometriosis; this condition can also be responsible for pain in the stomach.
Inflammatory bowel diseases; these diseases can occur in both the large and small intestine and are characterized by intense pain, diarrhea, and spontaneous bleeding.
Carcinoma; it is not a very common possibility, but stomach pain may indicate some form of cancer in the liver, stomach or ovaries – and unfortunately cancer at an advanced stage. Together with intense pain, other symptoms, such as loss of appetite, vomiting and change in the hours and quantities of the discharge, also appear.
Parasites; There are hundreds of kinds of parasites that can infect internal organs. This may be caused by the consumption of contaminated water, but also by swimming in a pool or lake. The same applies to eating half-cooked or infected food.
Irritable Bowel Syndrome; It is observed in 20% of adults and is due to a disturbance of the gastrointestinal tract. It includes gastrointestinal disturbances lasting over three months, bumps, bowel disorders (constipation, diarrhea).
Gastro-esophageal reflux disease (GERD)
An estimated 20 % of adults experience weekly or daily, a more severe case of acid reflux called GERD. There are many common causes of GERD and acid reflux, which include gastro-esophageal reflux disease:
Hiatal Hernia; a hiatal hernia happens when the upper part of the stomach protrudes above the diaphragm, allowing acid to escape. These hernias are associated with most, but not all, cases of GERD.
Carbohydrate malabsorption; research seems to reflect that acid reflux and GERD are probably exacerbated by too much intra-abdominal pressure (gas throughout the intestines). Many researchers believe this pressure is the result of bacterial overgrowth, such as SIBO, and malabsorption of carbohydrates. The root of this pressure may ultimately trace back to the low stomach acid of those suffering from acid reflux.
Underdeveloped digestive system; babies can develop acid reflux or GERD due to an underdeveloped digestive system, which usually self-corrects by the age of 1.
Aging; aging is associated with lack of the appropriate amount of stomach acid needed to digest food fully, often considered a side effect of taking antacids regularly and/or malnutrition.
Pregnancy; the fetus can put extra pressure on the esophageal valve, causing the release of acid and symptoms of acid reflux.
Obesity; being overweight or obese can put extra pressure on the valves and sphincter that allow release of acid.
Large meals; eating bigger meals is a culprit, as is snacking too close to bedtime. An overly full stomach places excessive pressure on the diaphragm, causing acid to travel upward.
Smoking cigarettes; this impairs muscle reflexes and increases production of acid, and it should be avoided for anyone suffering from acid reflux. Smoking cessation is associated with significant improvement of GERD/acid reflux symptoms.
Medications and supplements; certain medications, including ibuprofen, muscle relaxers, some blood pressure prescriptions, antibiotics and aspirin can cause acid reflux and GERD. Potassium and iron supplements can also aggravate reflux symptoms.
Heartburn; heartburn can be the first symptom of an H. pylori infection that’s common in two-thirds of the population and tied to stomach ulcers.
Excessive exercise: Due to taxing the nervous system, overtraining and getting too little rest can cause acid reflux by putting extra pressure on the abdominal cavity. This includes running and other aerobic high-impact exercises.
Magnesium deficiency; low magnesium levels may lead to improper functioning of the sphincter that prevents acid from escaping.
Chronic cough; there is a strong correlation between cough and acid reflux. Although this relationship is not causal (meaning researchers have not definitely proven one causes the other), cough may be either a factor in developing GERD or a symptom of the process of acid escaping into the esophagus.
Common symptoms:
Heartburn
Bitter taste in your mouth, periodically or (for some people) throughout the day (some people taste regurgitated food or sour liquid at the back of their mouths/throats)
Waking up in the middle of the night feeling like one is choking or coughing
Dry mouth
Gum irritation, including tenderness and bleeding
Bad breath
Regurgitation of acidic foods
Bloating after meals and during bouts of symptoms
Nausea
Bloody vomiting (possible sign of damage in the lining of the esophagus)
Black stools
Belching, gassiness, burping and flatulence after meals
Hiccups that are difficult to stop
Difficulty swallowing (a possible sign of narrowing esophagus)
Unexpected weight loss
Increased discomfort when bending over or lying down
Hoarseness upon waking or throughout the day
Chronic throat irritation, soreness and dryness
Dyspepsia
It is more commonly known as indigestion. Dyspepsia can be caused due to a number of factors, including bacterial infection, over-eating and a high intake of junk food. Common symptoms include bloating, nausea, vomiting, acid reflux and abdominal pain.
Common symptoms:
Discomfort or pain in belly.
Bloating and uncomfortable feeling of fullness after meals.
Regurgitation of food or liquid.
Nausea and heartburn.
Loss of appetite.
Gastritis
Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).
Gastritis can be caused by any of the following:
Excessive alcohol use
Chronic vomiting
Stress
Certain medications (such as aspirin or other anti-inflammatory drugs)
Helicobacter pylori — a bacteria that lives in the mucous lining of the stomach; withou