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Why Abdominal Pain Is Worse After Eating

Abdominal pain that's worse after you eat is often caused by something bad you ate, but if it's persistent, it may be from gallstones, lactose intolerance, peptic ulcers, GERD, gas, or constipation.
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Last updated October 1, 2021

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Hallmarks of abdominal pain that get worse after eating

Abdominal pain that gets worse after eating, or postprandial pain, can present with a frustrating set of symptoms. Maybe you were hoping a few crackers would settle your stomach pains, especially if you hadn't eaten much earlier in the day, but instead, you're in more pain than you were before. Abdominal pain that gets worse after eating can actually be due to a wide variety of causes, making it important to seek care.

Common characteristics of abdominal pain that gets worse after eating

Postprandial pain in itself has a strong connection to food that you eat. Most people can even pinpoint which foods trigger their symptoms the most. For example, it's common to experience symptoms after eating spicy food or food that's high in fat content. Indigestion (also known as dyspepsia) is also a common characteristic. Indigestion is persistent discomfort or pain in the upper abdomen.

Common accompanying symptoms of abdominal pain that gets worse after eating

Postprandial pain may also be associated with the following:

  • Fever
  • Heartburn
  • Nausea and vomiting
  • Constipation and/or diarrhea
  • Bloating
  • Belching
  • Jaundice: This is a yellow tint or appearance of the skin.

Depending on the cause, postprandial pain and associated symptoms can be very severe and last for many minutes. Make an appointment with your healthcare provider as soon as you notice any of these symptoms.

10 causes of abdominal pain that gets worse after eating

Postprandial pain occurs when there is either inflammation/irritation of the structures of the digestive tract or obstruction of these components. You experience pain after you eat because your body is attempting to digest food normally, but is having to do so within the context of injury.

Inflammatory causes

Any of the organs of the abdomen can become inflamed due to infectious causes or irritation from a variety of substances, including certain foods.

  • Infectious: There are many pathogens, both bacterial and viral, that can infect the organs of the abdomen, particularly in the upper right quadrant. For example, hepatitis is a viral infection that can infect the liver.
  • Irritation: Since the upper abdomen is the primary location for food to be processed for digestion, it is susceptible to irritation in multiple ways. Toxic substances such as alcohol and smoking can cause irritation that leads to inflammation and ulceration. Certain medications such as non-steroidal inflammatory drugs (NSAIDs) can lead to irritation of the stomach lining with overuse. Moreover, the acid that the stomach makes to digest food can irritate the components of the digestive tract, including the esophagus, and this can also cause postprandial pain.

Obstructive causes

The following can result in obstructions of the gastrointestinal system.

  • Cancer: Cancer can develop in any organ of the abdomen/digestive tract. Malignancies of the pancreas or stomach are often related to postprandial pain given their necessity to proper digestion.
  • Gallstones: The upper right quadrant of the abdomen is specifically home to the gallbladder. The gallbladder is part of the digestive system and responsible for making bile, a fluid that helps break down fat. Often, stones (gallstones) can form inside the gallbladder. These gallstones can vary in size and cause many problems that may result in postprandial pain when the body tries to break down fats.

Stomach ulcer

A peptic ulcer is a sore in the lining of the stomach or the first part of your small intestine (the duodenum), which causes pain following meals or on an empty stomach.

Rarity: Uncommon

Top Symptoms: fatigue, nausea, loss of appetite, moderate abdominal pain, abdominal cramps (stomach cramps)

Symptoms that never occur with stomach ulcer: pain in the lower left abdomen

Urgency: Primary care doctor

Acid reflux disease (gerd)

GERD (gastroesophageal reflux disease) in infants refers to the passage of stomach contents into the throat causing troublesome symptoms, such as feeding intolerance, inadequate oral intake of calories and/or poor weight gain. Vomiting or visible regurgitation ...

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Indigestion (dyspepsia)

Indigestion, also called upset stomach, dyspepsia, or functional dyspepsia, is not a disease but a collection of very common symptoms. Note: Heartburn is a separate condition.

Common causes are eating too much or too rapidly; greasy or spicy foods; overdoing caffeine, alcohol, or carbonated beverages; smoking; and anxiety. Some antibiotics, pain relievers, and vitamin/mineral supplements can cause indigestion.

The most common symptoms are pain, discomfort, and bloating in the upper abdomen soon after eating.

Indigestion that lasts longer than two weeks, and does not respond to simple treatment, may indicate a more serious condition. Upper abdominal pain that radiates to the jaw, neck, or arm is a medical emergency.

Diagnosis is made through patient history and physical examination. If the symptoms began suddenly, laboratory tests on blood, breath, and stool may be ordered. Upper endoscopy or abdominal x-ray may be done.

For functional dyspepsia – "ordinary" indigestion – treatment and prevention are the same. Eating five or six smaller meals per day with lighter, simpler food; managing stress; and finding alternatives for some medications will provide relief.

Rarity: Common

Top Symptoms: nausea, stomach bloating, dyspeptic symptoms, bloating after meals, vomiting

Symptoms that always occur with indigestion (dyspepsia): dyspeptic symptoms

Symptoms that never occur with indigestion (dyspepsia): vomiting (old) blood or passing tarry stools, rectal bleeding, bloody diarrhea, fever

Urgency: Self-treatment

Irritable bowel syndrome (ibs)

Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine. It is characterized by recurrent abdominal pain and bowel movement issues that can be difficult to treat. Signs and symptoms of IBS are usually not severe or life-threateni...

Gallstones

Gallstones are small, round deposits found in the gallbladder, the organ where bile is stored. Gallstones can be subclassified a number of ways. Oftentimes, gallstones will be referred to as either cholesterol stones or pigment stones depending on the makeup of the gallstone.

Gallstones can also be class...

Colon damage from impaired blood flow

Acute intestinal ischemia means that the blood flow to the large and/or small intestines has been cut off. It is also called acute mesenteric ischemia, or AMI.

The ischemia is caused by blockage in one of the arteries leading into the abdomen, usually due to atherosclerosis (plaque) or a blood clot.

Most susceptible are those with very high or low blood pressure; heart disease; or using illegal drugs such as cocaine or methamphetamine.

Symptoms include sudden, severe pain in one area of the abdomen; nausea and vomiting; and repeated, urgent bowel movements, often with blood.

Acute intestinal ischemia is a life-threatening medical emergency. If it is suspected, take the patient to the emergency room or call 9-1-1.

Diagnosis is made through arteriogram, which involves injecting dye into the abdominal arteries under x-ray in order to find the exact location of the blockage.

Treatment involves "clot-busting" drugs to destroy a clot, or emergency surgery to remove whatever is causing the blockage and possibly some of the damaged intestine as well.

Rarity: Rare

Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, being severely ill

Urgency: Hospital emergency room

Diverticulosis

Diverticulosis is the common condition of small, sac-like pouches forming and pushing outward along the inside of the colon, called diverticula. With diverticulosis, there may be changes in bowel movement patterns as well as severe abdominal pain, bloating, constipation, diarrhea, or rectal bl...

Chronic pancreatitis

Chronic pancreatitis is an inflammation of the pancreas that does not improve, but slowly gets worse over time.

Causes include alcoholism; a blocked pancreatic duct; autoimmune disease, where the body's natural defenses turn against itself; and possible genetic factors.

Chronic pancreatitis is most common in men from age 30 to 40 with a history of alcoholism and a family history of the disease, but anyone can be affected.

Symptoms include severe pain in the back and abdomen, especially with eating; weight loss; nausea and vomiting; and diarrhea with oily-appearing, pale-colored stools.

The pancreas is vital for blood sugar control and for secreting certain digestive enzymes. If not treated, chronic pancreatitis can lead to permanent pancreatic damage, diabetes, malnutrition, and chronic pain.

Diagnosis is made through patient history, physical examination, and imaging such as x-ray, CT scan, or ultrasound.

Treatment involves pain management through both medication and surgical procedures. Lifestyle improvements through diet, exercise, and stress management can also be very helpful.

Rarity: Rare

Top Symptoms: fatigue, abdominal pain (stomach ache), nausea or vomiting, loss of appetite, abdominal pain that comes and goes

Urgency: Primary care doctor

Celiac disease

Celiac disease is also called gluten-sensitive enteropathy, coeliac, or sprue. It is an autoimmune response in the gut to gluten, a protein in wheat, rye, and barley.

  • Repeated exposure to gluten causes damage to the lining of the small intestine.

Most at risk are Caucasians with:

  • Family history of celiac disease.
  • Down syndrome.
  • Type 1 diabetes.
  • Rheumatoid arthritis.
  • Autoimmune thyroid disease.

Symptoms include digestive upset with gas, bloating, and diarrhea. The malnutrition causes fatigue, weight loss, fragile bones, severe skin rash, mouth ulcers, anemia, and damage to the spleen and nervous system.

A swollen belly, failure to thrive, muscle wasting, and learning disabilities are seen in children, and normal growth and development can be severely affected.

Diagnosis is made through blood testing and endoscopy, and sometimes biopsy of the small intestine.

There is no cure for the condition, but celiac disease can be managed by removing all gluten from the diet. Nutritional supplements will be used and sometimes steroid medication is given to help heal the gut.

Rarity: Rare

Top Symptoms: fatigue, stomach bloating, nausea, constipation, diarrhea

Urgency: Primary care doctor

Lactose intolerance

Lactose is a sugar that naturally occurs in milk. Someone is considered "lactose intolerant" when the small intestine cannot produce enough of the enzyme that digests lactose called lactase.

In primary lactose intolerance, the enzyme is produced during childhood but declines sub...

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Treatments and relief

Treatment for your postprandial pain will be dependent on the cause. There are multiple treatment modalities that may provide relief.

At-home treatments

Fortunately, since most causes of postprandial pain are relatively benign, there are treatments you can first try at home to help alleviate your symptoms. Antacids are common over-the-counter medications (Tums, Pepto-Bismol, etc.) that can be very helpful in relieving some causes of postprandial pain because they work to neutralize excess stomach acid. However, antacids will not help with inflammatory or obstructive causes of postprandial pain.

When to see a doctor

If your symptoms persist despite the at-home remedies above, make an appointment with your doctor to receive a proper diagnosis. Once your doctor has determined a possible cause, he or she may recommend:

  • Medications: For example, in the case of gallstones, there are some medications that can break them up without the need for surgery. If your symptoms are due to infection, you may receive antibiotics to relieve your condition.
  • Surgery: Surgery to remove gallstones or the gallbladder entirely is a very common procedure, especially for people who suffer from chronic gallstones. Often, the entire gallbladder is removed.
  • Bowel rest: Your doctor may suggest a lighter diet that will allow your intestines and digestive system to recover after inflammatory or infectious causes of abdominal pain.

When it is an emergency

Seek immediate medical attention if you experience symptoms including:

  • Sudden, severe pain
  • Fever
  • Bloody stools
  • Nausea and vomiting that persists
  • Weight loss
  • Severe tenderness when you touch your abdomen
  • Swelling of the abdomen

These could be signs of a serious obstruction or inflammation of the organs of the abdomen that needs immediate assessment.

Prevention

There are also many strategies you can try in order to stay a step ahead of your symptoms.

  • Limit NSAID use: Non-steroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can cause and/or aggravate postprandial pain. Talk to your doctor about alternatives you can use.
  • Limit consumption of spicy, fatty, or acidic foods: Certain foods in these categories (caffeine, carbonated beverages, citrus fruits or juices, etc.) are believed to be triggers of postprandial pain.
  • Avoid alcohol and quit smoking: Alcohol and smoking are associated with increased production of stomach acid and thus irritation of the abdominal lining.

Postprandial pain FAQs

Can I prevent postprandial pain?

Yes, depending on the cause. Making lifestyle changes, such as limiting your use of alcohol or NSAIDs, can also reduce the chance for ulceration of your stomach lining (peptic or gastric ulcers). You can also prevent symptoms by stopping smoking or not taking up smoking in the first place.

What is Helicobacter pylori?

Helicobacter pylori are bacteria that specifically infect the gastrointestinal tract. The inflammation and irritation this bacteria causes can lead to conditions such as gastritis, peptic ulcer disease, and even gastric cancer. More than half of the world’s population is colonized by these bacteria. Fortunately, the management and treatment of Helicobacter pylori infections are well-studied.

How are Helicobacter pylori transmitted?

Even though there are many hypotheses for how Helicobacter pylori are transmitted, their major mode of transmission is not specifically known. Possible routes of infection include oral-oral (from human saliva to human saliva), fecal-oral (accidental contamination of food with feces), and sometimes spread via inadvertent use of unsterile medical equipment such as probes or endoscopes.

How can I live without my gallbladder?

Gallbladder removal is a very common surgery. Removal of the gallbladder does not significantly affect digestion because the liver can also make bile to help with the break down of fatty foods. Symptoms experienced after gallbladder removal include gas, bloating, or more watery bowel movements. Fortunately, there is a very small chance that gallstones will recur after removal.

Is postprandial pain life-threatening?

Some causes of postprandial pain such as pancreatitis can be very serious and severe. According to a large epidemiologic study from the United States, approximately 15-25% of patients with acute pancreatitis develop severe pancreatitis [5]. Severe pancreatitis can result in fever, hypotension, and organ failure and require monitoring in the intensive care unit. It is important to not ignore symptoms of pain in the upper abdomen and seek medical attention before the condition worsens.

Questions your doctor may ask about abdominal pain that get worse after eating

  • Have you experienced any nausea?
  • Any fever today or during the last week?
  • Have you lost your appetite recently?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Hear what 3 others are saying
Upper quadrant dIscomfortPosted April 13, 2021 by A.
This started last June after overeating. Right upper quadrant discomfort, like a fist under my rib cage. Went to the doctor who ordered ultrasound...negative. Add to this it's now the pandemic raging, which upended my daily habits. Nausea and just feeling terrible so back to the doctor. This time my Gastro. Endoscopy...negative. C.T scan with contrast...negative. A month or so later MRI...you guessed it. Negative. Upper right settled but fast forward to about a month ago after eating greasy hamburger and had bad upper right pain. Now they think Gallbladder. HIDA scan showed perfectly normal functioning gallbladder. Still get postprandial upper right discomfort after eating. Doctor calling it Functional Dyspepsia. Pepcid and FD Gard, which has helped but still with the fist under my rib cage, though not every day. Today had coffee and have had strong discomfort, which is settling. Don't know where to turn. I have essentially cut out alcohol, i.e cocktails, but do have a glass of wine or 2 at dinner. No vomiting, thankfully but some days nausea is pretty bad. Can anxiety be at the root of these symptoms? Thanks.
Stopping the crampsPosted April 12, 2021 by S.
For many years I had had sporadic unpredictable attacks of lower stomach cramping, occurring approximately 90 minutes after eating, and lasting a miserable 15–30 minutes. As soon as one hit, I dreaded the next half hour. The only upside is that the discomfort left as suddenly as it came on, and the relief made me want to jump for joy. I tried many exercises during the attacks, including induced vomiting (I was desperate) and clenching my abdominal muscles, either sitting or by doing partial sit-ups. These actually stopped the pain for 10 seconds or so, but it always returned. The other tactics proved just to be distractions. In truth, it was a gastrointestinal specialist who referred to my pain description as "cramps" (while checking the surgery result of an umbilical hernia patch). I had been having the pains several times a month, for many years, when I started thinking of them as "cramps," which helped in my search for relief. The other clue was from grade school or high school science, where we learned that digestion begins in the mouth, with saliva being an important digestion aid. The cramping seemed inevitable with things like Chicago deep-dish pizza, which is loaded with pork sausage and cheese, and which I (and many guys) inhale, at least the first couple of mouthfuls. I started thinking that none of this heavy spicy food is getting the advantage of being partially digested in the chewing process. So I began (which is mother's common sense that many boys ignore) taking smaller bites and making sure to chew them for at least a half of a full minute or longer if I didn't remember and chewed off a mouthful. Since being mindful of this, I rarely have the cramping, and if I do, it's because the nature of the food somehow got me forgetting the "slow down and chew" rule. Most important is to remember that you are helping your system by beginning the digestion process in your mouth. At least it seems to work for me.
Awfully bad pain while eatingPosted February 26, 2021 by K.
My story is so unusual. It has no telltale signs. It happens about 1 time a week. I can be home or out eating. It has happened with almost any food. I take 1 or 2 bites and I start to get severe pain in the middle of my stomach. My doctor has seen me twice and has scheduled an appt with a gastrointestinal doctor for a scope. Appointments are 3 months out. I do not have any other symptoms. No fever, no back pain, no nausea, etc. I already take Prilosec and one called famotidine. My bloodwork was good. ????????
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Stenschke F, Nemetz A, Dancygier H. Chronic abdominal pain aggravated by eating: diagnosis by video capsule endoscopy. Gut. 2006;55(4):443, 497. NCBI Link
  2. Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014;5(3):105-12. NCBI Link
  3. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006;19(3):449-90. NCBI Link
  4. Cave DR. How is Helicobacter pylori transmitted?. Gastroenterology. 1997;113(6 Suppl):S9-14. PubMed Link
  5. Fagenholz PJ, Castillo CF, Harris NS, Pelletier AJ, Camargo CA. Increasing United States hospital admissions for acute pancreatitis, 1988-2003. Ann Epidemiol. 2007;17(7):491-7. PubMed Link