Stomach Pain After Eating
This article describes health conditions that can cause stomach ache, nausea or vomiting after eating, triggering foods, pain locations and associated symptoms.
Common causes of pain after eating include abdominal bloating, constipation, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), food intolerances, such as lactose intolerance, fructose malabsorption and celiac disease, and food allergies. Food poisoning with bacteria and parasites is also quite a common cause of abdominal pain and diarrhea.
If you want to prevent stomach pain after eating, you may try to avoid certain foods or find out if you have any stomach or bowel disease and treat it.
A. UPPER ABDOMEN
B. LOWER ABDOMEN
Irritable bowel syndrome (IBS)
Inflammatory bowel disease (IBD)
Mechanical bowel obstruction
C. FOODS THAT MAY TRIGGER STOMACH PAIN
D. CHILDREN and PAIN AFTER EATING
A. UPPER ABDOMINAL PAIN
Upper abdominal pain is located below the rib cage.
Gastritis is an inflammation of the stomach lining.
- Causes: heavy alcohol drinking, severe stress, drugs (aspirin, ibuprofen, naproxen, steroids), infection by the Helicobacter pylori bacteria
- Symptoms: discomfort (dyspepsia), fullness or burning pain in the upper middle abdomen, which can worsen or improve with eating; sometimes: nausea, vomiting, excessive belching
- Reference: (1)
- Causes: the same as for acute gastritis (see above)
- Symptoms: burning, gnawing pain below the sternum, which can worsen or improve with eating and often occurs at night; pain can be relieved by antacids
- NOTE: Duodenal ulcer pain is usually worse on an empty stomach and relieved by eating.
- Reference: (2,3)
Hiatal Hernia and Gastroesophageal Reflux Disease (GERD)
A hiatal hernia is protruding of the upper part of the stomach through the opening in the diaphragm; it is sometimes associated with the backward flow (reflux) of the stomach acid into the esophagus.
- Burning pain behind and below the breastbone (heartburn), in the throat and between the shoulder blades worse after eating (especially after large meals) or lying down; the pain can last for up to 2 hours and can be relieved by standing upright or taking antacids
- Indigestion, excessive burping, nausea, feeling of a lump in the throat, hoarseness, dry cough, sour or metallic taste in mouth, food regurgitation, bad breath
- Triggering foods: chocolate, peppermint, fatty or fried foods, citrus fruits, tomatoes, vinegar, garlic, onions, spicy foods, coffee, alcoholic and carbonated beverages. Other triggers: bending over, lifting, acidic drugs and supplements (aspirin, ibuprofen, vitamin C)
- Risk factors: pregnancy, obesity, smoking
- References: (5,26)
Bile reflux refers to the backward flow of the bile from the duodenum into the stomach and, eventually, further up into the esophagus, throat and mouth.
- Causes: gastric ulcers, stomach surgery, gastric bypass surgery for weight loss, or gallbladder removal
- Symptoms: upper middle abdominal (epigastric) pain and burning pain in the middle of the chest (heartburn) worse after large meals, sour or bitter taste in mouth, nausea or vomiting greenish-yellow fluid; pain can be relieved by antacids
- Reference: (25)
Functional dyspepsia refers to indigestion without a known cause.
- Symptoms: upper abdominal pain, excessive belching, early satiety, nausea or vomiting after meals, but sometimes also not related to meals; antacids, sometimes, relieve the symptoms
- Triggering foods may be the same as in GERD (see above);
- Reference: (27)
Staph Food Poisoning
- Cause: intoxication by the Staphylococcus aureus bacterial toxins after eating uncooked foods kept at room temperature (sandwiches, meat cuts, salads, dairy)
- Symptoms: stomach cramps, nausea, vomiting and, sometimes, diarrhea, 30 minutes to 6 hours after ingesting contaminated food; symptoms resolve in few days
- Reference: (4)
- Symptoms: upper middle abdominal pain and feeling of fullness after eating small amount of food, nausea, unintentional weight loss, black stools (6)
Gallstones or Gallbladder Inflammation (Acute Cholecystitis)
- Symptoms: severe, constant pain and tenderness in the upper right abdominal quadrant, below the right rib cage or below the sternum, appearing hours after a heavy meal and lasting from 1-6 hours; other symptoms: nausea, vomiting or fever; no pain or other symptoms between the attacks (7,8)
Biliary dyskinesia–a motility disorder of the biliary tract, which includes gallbladder dyskinesia and sphincter of Oddi dysfunction (SOD), can cause pain after meals in the upper right abdomen, lasting at least 30 minutes.
Acute pancreatitis can develop as a complication of gallstones or chronic alcoholism.
- Dull pain and tenderness that develops in few hours, becomes severe and lasts for several days; it can be located in the upper left, middle or right abdomen and can radiate to the middle back or left shoulder blade; it can become worse within minutes of eating or drinking and after lying down and relieved by sitting and leaning forward
- Nausea, vomiting
- Fever, jaundice
- Reference: (9,10)
B. PREDOMINANTLY LOWER ABDOMINAL PAIN
Lower abdominal pain is located at the level of the belly button or below on each side.
Irritable Bowel Syndrome
- Symptoms: abdominal cramps or bloating, or diarrhea within an hour after eating. NOTE: Nausea is NOT a typical symptom of IBS, but can be caused by another associated condition.
- Triggering foods (self-reported): large meals, fatty and fried foods, salami, dairy products (especially cheese), chocolate, foods high in insoluble fiber (grains, beans and lentils), fruits high in fructose (apples, pears, mango), plums, drinks with caffeine (coffee, tea, cola, energy drinks) carbonated beverages, alcohol (beer, wine), foods and drinks with artificial sweeteners (high fructose corn syrup, sorbitol, xylitol)
- Other possible triggers: emotional stress
- Reference: (11)
- Causes: bacteria, like Salmonella or Escherichia coli from improperly stored/cooled foods often in places with bad hygiene
- Symptoms: sudden abdominal cramps and several bouts of diarrhea, which usually start more than 6 hours after eating and last for few days; other: nausea, vomiting and, sometimes, fever
- Reference: (12)
Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis.
- Symptoms: chronic abdominal cramps, nausea, bloating, diarrhea, usually worse after eating; other: skin rash, joint pains
- Reference: (13)
Diverticles are abnormal pouches in the large intestine.
- Symptoms: sudden severe pain in the lower left or, sometimes, in the lower right abdomen several hours after eating certain foods; inflammation of diverticles (diverticulitis) is associated with fever and diarrhea.
- Reference: (14)
Ileus means cessation of bowel motility, usually due to recent abdominal surgery or drugs, such as opioids (morphine, codeine) or anticholinergics (atropine, biperiden)
- Symptoms: vague, mild abdominal pain, bloating, nausea and vomiting within few hours of eating or drinking; the condition is a medical emergency and has to be relieved promptly to avoid bowel rupture.
- References: (15,16,17)
Mechanical Bowel Obstruction
- Causes: obstipation (severe constipation), adhesions (scar-like bands between intestinal loops) due to abdominal surgery, inflammatory bowel disease, endometriosis or pelvic inflammatory disease, small intestinal lymphoma
- Symptoms: abdominal cramps, abdominal swelling, nausea or vomiting worse after eating; inability to pass gas or stools
- Reference: (18)
C. ABDOMINAL PAIN ASSOCIATED WITH SPECIFIC FOOD/INGREDIENTS
Foods High in Soluble Fiber
Large amounts of oats, barley, rye, bananas, beans, peas and lentils can cause abdominal pain with bloating and flatulence (gas pain) starting several hours after ingestion and lasting for several hours.
Several hours after meals low in dietary fiber–containing meats, cheese, white bread, fast food, chocolate and other sweets and no or little fruits, vegetables and whole grains–, you may experience constant, severe abdominal pain lasting for several hours.
- Triggering foods: milk (usually at least a cup–240 mL)–but not hard cheese or butter–, commercial whey and casein powders; also many drugs and supplements that contain lactose
- Symptoms: abdominal cramps, bloating and diarrhea after few hours of lactose ingestion
- Triggering foods:
- Foods that contain more fructose than glucose: fruits/juices (apples, pears, mango), honey, beverage sweetened with high fructose corn syrup (HFCS), mainly soda
- “Low-sugar” foods sweetened with sorbitol: carbonated beverages, chewing gum
Olestra Side Effects
Olestra (a fat substitute in snacks, like chips) may trigger sudden severe abdominal pain, nausea, vomiting, greasy stools or diarrhea in some people; symptoms may last for more than a day (23). However, in one 1999 controlled clinical trial, participants who ingested olestra did not have significantly different symptoms than those who ingested placebo without olestra (24).
- Sudden upper central abdominal or chest pain, nausea, vomiting or diarrhea within few minutes to 2 hours (immediate reaction) or, in some people, only 4-28 hours (delayed reaction) after eating even small amount of food
- Hives (bumpy or patchy red, itchy skin rash)
- Itchy lips, mouth and throat
- Swelling of the face and tongue (angioedema) and shortness of breath
- Common triggering foods in children: wheat, cow’s milk, soy, eggs, wheat, peanuts; in adults: peanuts, tree nuts, fish, shellfish; NOTE: practically any food can trigger allergic reaction in certain people, but one person is usually allergic only to one or few foods.
- Reference: (19,20)
D. CHILDREN AND ABDOMINAL PAIN AFTER EATING
Abdominal migraine refers to recurring sudden, severe abdominal pain of no known cause lasting from 1 hour to up to 3 days, nausea, vomiting, inability to eat and paleness.
- Triggering foods, according to anecdotal reports, may include chocolate, Chinese food with monosodium glutamate (MSG) and processed meats containing nitrites (hot dogs, cold cuts, sausages, salami); other possible triggers: psychological stress. NOTE: the pain can be unrelated to meals.
- Reference: (28)
Hereditary Fructose Intolerance
Hereditary fructose intolerance (HFI) is a rare genetic disorder of fructose metabolism.
- Triggering foods: any food, supplement or drug containing fructose, sucrose, sorbitol, oligofructose or fructooligosaccharides (FOS), so fruits, honey, sugar-free chewing gum, some vegetables, like beets and carrots, and most sweetened foods and beverages
- Symptoms–in order of appearance–: nausea (within an hour), dizziness, hunger, craving for food (due to hypoglycemia), severe upper abdominal pain (after more than 24 hours); other: dark, yellow urine, vomiting, diarrhea.
- Reference: (21,22)
- Acute Gastritis Clinical Presentation Emedicine
- Peptic Ulcer The Merck Manual Home Edition
- Diet for Ulcers and Gastritis Drugs.com
- Staphylococcal Food Poisoning Centers of Disease Control and Prevention
- Hiatal Hernia Symptoms Mayo Clinic
- Stomach cancer FamilyDoctor
- Gallstones Merck Manuals Home Edition
- Acute Cholecystitis and Biliary Colic Emedicine
- Acute Pancreatitis Clinical Presentation Emedicine
- Acute Pancreatitis MedlinePlus
- Böhn L et al, 2013, Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life PubMed
- Foodborne Illnesses: What You Need to Know U.S. Food and Drug Administration
- Bowel Disease: Changing Your Diet WebMed
- FAQs about Diverticulitis and Diverticulosis: What You Need to Know Stony Brook, School of Medicine
- Ileus Merck Manuals Home Edition
- Learning about Post-operative ileus (POI) St. Michael’s
- Ileus, Clinical Presentation Emedicine
- Intestinal Obstruction Symptoms WebMD
- Food Allergies—Just the Facts American Family Physician
- Food Allergy World Allergy Organization
- Sugars & Sweeteners Boston University
- Yasawy MI et al, 2009, Adult hereditary fructose intolerance PubMed Central
- Summaries of Selected Adverse Reactions Reported to Olestra U.S. Food and Drug Administration
- Sandler RS et al, 1999, Gastrointestinal symptoms in 3181 volunteers ingesting snack foods containing olestra or triglycerides. A 6-week randomized, placebo-controlled trial PubMed
- Bile Reflux Symptoms Mayo Clinic
- Gastroesophageal reflux disease (GERD) WebMD
- Non-ulcer (functional) dyspepsia Patient.info
- Migraine & Headache Guide WebMD