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Why Do You Have a Stomach Burning Sensation? Here are Causes and Treatments

The feeling of your stomach burning can be very uncomfortable. Find out what the different causes could be and how to address them.

An Asian man feeling his stomach burning

Being part of a gastronomic society like Malaysia means that you may occasionally experience stomach burning after a heavy meal. While there is no actual fire burning in your abdomen, the “burn” in “stomach burning” refers to acid burn.

The burning feeling usually stems from the imbalance of acids in your digestive system. We will explore the different conditions and possible root causes that could lead to the burning sensation in your stomach. 

Culprits of Stomach Burning

You may have heard the following different terms used to describe symptoms surrounding stomach burning.

Dyspepsia (Indigestion)  

Dyspepsia or indigestion refers to a general group of symptoms caused by issues in the upper abdomen. When your doctor is unable to pinpoint the exact cause of your recurring indigestion, this is referred to as functional dyspepsia. 

Gastritis and PUD  

Having an intolerance to certain foods or not eating at appropriate times may cause an acid imbalance that irritates the stomach lining, a condition called gastritis. Gastritis is also sometimes caused by non-steroidal anti-inflammatory drugs (NSAIDs) or a symptomatic H. Pylori bacterial infection, both of which compromise the stomach lining, making it less resistant than usual to acidic stomach juices. When the inflammation becomes more severe and leads to painful sores or ulcers, this is called peptic ulcer disease (PUD).

Heartburn and GERD  

A common type of stomach burning is caused by acid reflux or heartburn, which itself is a symptom of gastro-oesophageal reflux disease (GORD or GERD). A common condition worldwide, the incidence is highest in the West at about 20% and lowest in Asia at about 10%.

A study conducted by researchers at University of Malaya found that GERD symptoms were reported in 19.1% of 141 consecutive patients from an asthma clinic in Malaysia. An earlier report from the same centre detected a prevalence rate of 56.7% for GERD using pH monitoring, a symptom questionnaire, and endoscopy in patients with difficult-to-control asthma.

Heartburn refers specifically to a burning sensation in your upper chest, usually after eating. This is due to a weakened lower oesophageal sphincter (LES) muscle that fails to close when it should. It allows stomach acids to wash up and out into the oesophagus (thus the word “reflux”). While our stomach lining can handle the very acidic digestive juices, the lining of the oesophagus cannot. The oesophageal lining will be burned by the acid.

When you experience acid reflux frequently and for an extended period, your condition has turned into full-on GERD, often accompanied by other symptoms of acid burning such as a sore throat, chronic cough, bad breath, hoarse voice, and difficulty swallowing (dysphagia). Other symptoms include regurgitation of food, upper abdominal or chest pain, cramps, bloating, excessive gas, and difficulty sleeping. 

Risk Factors and Lifestyle Habits That Can Lead to Stomach Burning  

A group of people eating several dishes served on a wooden table
The stomach burning sensation usually occurs after eating a large meal or drinking alcoholic beverages.

The conditions that lead to the burning sensation in your stomach could have one clear cause or a combination of factors and causes. Structural issues such as having a weak LES or a hiatal hernia that bulges out the top of your stomach could be what’s causing your heartburn, for example.

Consuming foods that you can’t tolerate well, such as spicy or sour food, eating too much, or not having regular meals can also be culprits. Smoking and stress have also been associated with a compromised digestive system. Drinking certain beverages such as alcohol or coffee and taking certain medications such as aspirin are also can aggravate acid reflux. However, it’s rare that your symptoms could be a sign of stomach cancer. Conversely, not addressing these conditions could potentially lead to more serious conditions.

In Traditional Chinese Medicine (TCM), taking care to address lifestyle factors is an important first line of defence. “Avoid inappropriate diet as well as excessive smoking and drinking. Irregular moods and overthinking are also conditions that make an individual more likely to experience digestive symptoms such as heartburn,” advises TCM Physician Ignatius Ooi. “Other possibilities could be Cold and Heat pathogens invading the stomach, having gallbladder disease, or some kind of congenital Deficiency that causes a weak Spleen and stomach,” he further adds.

Ways to Calm Stomach Burning 

While over-the-counter medicines like antacids may help treat symptoms in the short term, it’s also important to address the root causes of your upset stomach through long-lasting healthy habits. Physician Ooi shares the following self-care tip and remedies: 

Avoid re-agitating your upset stomach  

  • Don’t consume irritating foods such as overly cold, hot, sweet, sour, or spicy dishes to prevent the pain from worsening.  
  • Avoid ingesting large amounts of liquids and food too quickly in a short time.  
  • Since acid reflux tends to occur at night, raise your head by about 15 to 20cm during sleep to help prevent it. 
  • Avoid eating before going to bed. Instead, have dinner at least three hours before bedtime to reduce gastric acid secretion at night.
Woman smiles contently and calmly while sipping a cup of tea in front of her laptop.
Stress and mood management, along with nutritious and calming medicinal foods are important aspects of recovering from an upset digestive system.

Adopt long-term changes to lifestyle and health maintenance  

In TCM, physical and mental health are part and parcel of each other. “Patients with GERD often have a certain level of emotional disorder and Liver Qi Stagnation. Hence, they must maintain a good mood. It’s also advisable for healthcare providers to mentor patients by fostering an optimistic attitude to keep their emotions stabilised. It can be beneficial for their early recovery,” Physician Ooi shares. 

Maintaining a healthy weight is also important for digestive health. “For obese patients, it is necessary to maintain a balanced diet, and lose the excess weight as soon as possible to improve the condition,” he also reminds us. 

Address symptoms while they are still mild  

Digestive issues that cause stomach burning often creep up over time. Treating the symptoms while they’re still mild can prevent the condition from going out of control.

“Mild GERD can be treated with TCM alone, mainly by taking decoctions prescribed based on syndrome differentiation. For patients diagnosed with moderate or severe forms of the condition such as reflux esophagitis or refractory GERD, they can integrate both Chinese and Western treatments but mainly rely on Western medications to treat their symptoms,” recommends Physician Ooi.

Consume herbs that help with stomach burning

Physician Ooi shares some TCM supplements and tea that nourish the stomach: 

  • American Ginseng Tea (xi yang shen cha, 西洋参茶) with an appropriate amount of rose petals plus three red dates: Suitable for those with Liver Qi Stagnation, stress, or anxiety)  
  • Bu Qi Jian Zhong pills (补气健中丸): Suitable for those with Spleen-stomach Deficiency, Phlegm Dampness, frequent indigestion, or bloating)  
  • Dang Gui Jian Pi Qing Bu soup (当归健脾清补汤): Suitable for those with a weak constitution, Spleen-stomach Deficiency, or Cold Intolerance) 

TCM recommends herbal remedies for indigestion such as Hawthorn berry (shan za, 山楂), barley sprout (mai ya, 麦芽), rice sprout (gu ya, 谷芽), chicken gizzard lining (ji nei jin, 鸡内金), Areca seed (bing lang, 槟榔), unripe bitter orange (zhi shi, 枳实), and tangerine peel (chen pi, 陈皮).

Relieve heartburn with processed pinellia (ban xia, 半夏), jujubes (hong zhao, 红枣), liquorice root (gan cao, 甘草), white peony root (bai shao, 白芍), white atractylodes (bai zhu, 白术), bupleurum (chai hu, 柴胡), Chinese angelica (dang gui, 当归), poria mushroom (fu ling, 茯苓), and fresh ginger (xian jiang, 鲜姜). Besides these herbs, a classical TCM formula, Xiao Yao Wan (消遥丸) also helps relieve symptoms. 

Bupleurum (chai hu, 柴胡), liquorice (gan cao, 甘草), peonies (mu dan, 牡丹) and tangerine peel can be beneficial for regulating Liver qi and harmonising the stomach. Herbal decoctions such as Ban Xia Xie Xin (半夏泻心) have been shown in research studies to be effective in treating gastric symptoms specific to disharmonies between the stomach and Spleen. These studies show that the decoctions work just as well as conventional medicines.

Use acupuncture to relieve symptoms

Although the mechanism is not well understood by Western medicine, acupuncture has been shown to regulate gastrointestinal motility (ease of movement), barrier, internal organ sensitivity, and the brain-gut axis. A 2017 meta-analytical study) of 58 studies that included 5,192 patients showed that the Jian Zhong decoction (健中) worked significantly better than Western medicine in treating peptic ulcers. Work with licensed healthcare experts to determine the best course of treatment for you. 

There are many different terms and descriptions out there when it comes to uncomfortable stomach burning. Understanding the mechanics behind each of the different conditions can help you and your healthcare provider zero in on the culprit and assist you on your way to healing and recovery.

References

  1. Journal of Neurogastroenterology and Motility. 2011. Epidemiology of gastroesophageal reflux disease in Asia: a systematic review. [online] Available at: <https://pubmed.ncbi.nlm.nih.gov/21369488/> [Accessed 16 August 2022].
  2. Therapeutics and Clinical Risk Management. 2021. Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review. [online] Available at: <https://www.dovepress.com/dietary-and-lifestyle-factors-related-to-gastroesophageal-reflux-disea-peer-reviewed-fulltext-article-TCRM#cit0003> [Accessed 16 August 2022].
  3. Gastroenterology & Hepatology. 2020. The global, regional, and national burden of gastro-oesophageal reflux disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. [online] Available at: <https://www.thelancet.com/journals/langas/article/PIIS2468-1253(19)30408-X/fulltext> [Accessed 16 August 2022].
  4. Rawal Medical Journal. 2016. Are body mass index and waist over hip ratio associated with gastroesophageal reflux symptoms among outpatients in Hospital Tuanku Ja’afar?, Malaysia? Available at: <https://www.bibliomed.org/mnsfulltext/27/27-1448255656.pdf?1642746082> [Accessed 18 January 2022].
  5. National Health Services (NHS), UK. 2020. Heartburn and Acid Reflux. [online] Available at: <https://www.nhs.uk/conditions/heartburn-and-acid-reflux/> [Accessed 16 August 2022].
  6. Cleveland Clinic. 2019. GERD (Chronic Acid Reflux). Available at: <https://my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn-overview> [Accessed 18 January 2022].
  7. Cleveland Clinic. 2021. Indigestion. [online] Available at: <https://my.clevelandclinic.org/health/symptoms/7316-indigestion-dyspepsia> [Accessed 16 August 2022].
  8. Cleveland Clinic. 2022. Functional Dyspepsia. [online] Available at: <https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia> [Accessed 16 August 2022].
  9. Cleveland Clinic. 2020. Peptic Ulcer Disease. [online] Available at: <https://my.clevelandclinic.org/health/diseases/10350-peptic-ulcer-disease> [Accessed 16 August 2022].
  10. StatPearls. 2021. Stress-Induced Gastritis. [online] Available at: <https://www.ncbi.nlm.nih.gov/books/NBK499926/> [Accessed 11 November 2021].
  11. Digestive Diseases and Sciences. 2013. The Association Between Reflux Esophagitis and Psychosocial Stress. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576549/> [Accessed 18 January 2022].
  12. MyHEALTH. 2015. Stomach Cancer. [online] Available at: <http://www.myhealth.gov.my/en/stomach-cancer/> [Accessed 11 November 2021].
  13. World Journal of Gastroenterology. 2015. Acupuncture and regulation of gastrointestinal function. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507100/> [Accessed 15 November 2021].
  14. BMC Complementary Medicine and Therapies. 2017. Efficacy and safety of Jianzhong decoction in treating peptic ulcers: a meta-analysis of 58 randomised controlled trials with 5192 patients. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391578/> [Accessed 16 August 2022]
  15. PubMed Central, 2006, Gastroesophageal Reflux Disease: An Emerging Disease in Asia,[Accessed 30 September 2022]

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