Ask a Really Smart Doctor: Why Does My Stomach Hurt So Much?

Do you feel nauseated even if you eat well? What could be making you so sick? We got the lowdown on stomach problems from two top doctors.
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I often get bellyaches after I eat, whether I've had a healthy salad or greasy pizza. Any idea what could be going on?

It might be an ulcer. Do you take a lot of ibuprofen or aspirin? NSAIDs are one of the leading causes of ulcers. Or it could be a problem with your gallbladder, the organ where bile is stored. Bile is important for digestion because it helps you absorb fat. If you have gallstones or your gallbladder isn't working properly, you can get a nasty upset stomach after you eat, especially if you had a fatty meal. There are tests your doc can do to rule out both.

What if I have diarrhea regularly, too?

You might have an infection, a parasite or an allergy to something, like gluten. Ask your doctor about a blood test to check for celiac disease. You could also try an elimination diet guided by a GI specialist or dietitian. It's a good place to start, but often food is just the innocent bystander to something else going on in your digestive tract.

When I googled my symptoms, I found a lot of information about irritable bowel syndrome. Could it be that?

It's possible. The definition of IBS is chronic abdominal pain and discomfort with no known cause. Some estimates show that as many as 10 percent of women have it. My theory is that many people who've been told they have IBS actually have other undiagnosed problems. For example, Crohn's disease and other inflammatory bowel diseases can have symptoms similar to IBS. If you're feeling bloated, too, it could be low-grade inflammation caused by eating certain foods your body doesn't like. Dietary changes may help. Another thing to consider: Have you taken antibiotics lately? These drugs can create an imbalance in your gut bacteria that can cause stomach distress.

Shouldn't killing bacteria make me feel better?

Not always. In cases of serious bacterial infection, antibiotics are helpful and necessary, of course. But they can cause problems, too. There are trillions of bacteria living in your GI tract right now, including helpful and harmful strains. A large part of your immune system is located in the lining of your gut, and the right balance of bacteria keeps it working well. Antibiotics don't only kill off the bad guys but can also eradicate the essential bacteria that help you digest food and protect you from harmful bugs. Taking medicines that block stomach acid can also encourage bad bacteria.

How can I get my gut back in balance?

Start with your diet. Choose antibiotic-free meat and milk. You want to eat plenty of prebiotic foods, like green leafy vegetables and high-fiber beans. They all contain nondigestible fiber, which feeds the healthy bacteria and helps them thrive. Probiotic foods, like some yogurt, kefir, and pickled vegetables, actually contain the good types of bacteria, which means these foods can help repopulate them in your gut.

Any foods I shouldn't eat while balancing my gut?

Too much sugar, fat and processed carbs like chips and cookies can send bad bacteria into a feeding frenzy and lead to overgrowth.

Can supplements help?

You can buy probiotic supplements at any drugstore, but it's unlikely a pill will solve the problem. It's like eating junk food and then thinking a multivitamin will make up for it. Many of the products out there don't have enough strains of live bacteria to make a real difference. You're better off encouraging the growth of good bacteria by eating a healthy high-fiber diet.

Meet the Doctor

Robynne Chutkan, MD, author of Gutbliss, founder of the Digestive Center for Women, in Chevy Chase, Maryland, and a member of the LHJ Medical Advisory Board.


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