A burning sensation in the stomach, often described as a sharp, hot, or gnawing ache, typically arises in the upper abdomen. This discomfort can manifest as a fleeting irritation or a persistent, intense pain, varying in severity and duration. While many instances of stomach burning are temporary, this symptom can signal underlying health conditions. Understanding potential causes is important for effective management and knowing when to seek medical advice.
Common Everyday Triggers
Dietary choices frequently contribute to stomach burning pain by irritating the stomach lining or increasing acid production. Highly acidic foods, such as citrus fruits or tomatoes, can directly irritate the stomach’s mucosal lining. Spicy foods, due to compounds like capsaicin, activate pain receptors in the digestive tract, leading to a burning sensation. Fatty meals slow gastric emptying, prolonging acid contact with the stomach lining.
Beverages like caffeine, alcohol, and carbonated drinks also exacerbate this discomfort. Caffeine and alcohol can relax the lower esophageal sphincter (LES), the muscular valve preventing acid reflux, and may stimulate increased stomach acid production. Smoking further compromises the digestive system by weakening the LES, reducing saliva’s bicarbonate content, and directly damaging the esophageal lining.
Lifestyle factors like stress and anxiety influence digestive health. Emotional stress activates the body’s “fight-or-flight” response, increasing stomach acid secretion through the vagus nerve and gastrin release. This physiological response can also affect gut motility, contributing to discomfort. Overeating or eating too quickly can distend the stomach, increasing pressure and potentially forcing acid upwards into the esophagus.
Gastrointestinal Conditions
Several gastrointestinal conditions cause persistent stomach burning pain through inflammation, erosion, or impaired organ function. Gastroesophageal Reflux Disease (GERD) is a common disorder where stomach acid frequently flows back into the esophagus. This occurs when the lower esophageal sphincter (LES), a muscle valve between the esophagus and stomach, weakens or relaxes inappropriately, allowing acidic contents to regurgitate. If acid reflux symptoms occur more than twice a week, it may indicate GERD.
Chronic acid exposure in GERD can lead to complications like esophagitis, an inflammation of the esophageal lining causing soreness and swelling. Prolonged inflammation can also result in esophageal stricture, a narrowing due to scar tissue, making swallowing difficult. In some cases, chronic irritation can lead to Barrett’s esophagus, where lower esophageal cells change, increasing esophageal cancer risk.
Gastritis involves inflammation of the stomach lining, which can be acute or chronic. This inflammation makes the stomach lining more vulnerable to damage from its own acid. Causes include bacterial infections, autoimmune conditions, or irritation from chemical agents like bile. Gastritis often presents as a gnawing or burning pain in the upper middle abdomen.
Peptic ulcers are open sores forming on the inside lining of the stomach (gastric ulcers) or the first part of the small intestine (duodenal ulcers). These sores frequently cause burning stomach pain, particularly noticeable on an empty stomach and often improving after eating. The two primary causes are Helicobacter pylori (H. pylori) bacteria infection and regular use of certain medications.
The H. pylori bacterium contributes to both gastritis and peptic ulcers. This spiral-shaped bacterium colonizes the stomach lining and produces urease, an enzyme that neutralizes stomach acid locally. This allows the bacteria to burrow into the protective mucus layer. This action, along with cytotoxic factors, leads to chronic inflammation and weakens the stomach’s defense, making it susceptible to ulceration.
A hiatal hernia occurs when a portion of the stomach pushes up through a small opening in the diaphragm into the chest cavity. This anatomical abnormality can trap stomach acid above the diaphragm and prevent the LES from closing effectively. The most common type, a sliding hiatal hernia, involves intermittent movement of the stomach and LES into the chest, contributing to acid reflux symptoms and associated burning pain.
Medication-Induced and Other Causes
Certain medications can directly irritate the stomach lining, leading to a burning sensation. Nonsteroidal Anti-inflammatory Drugs (NSAIDs), such as ibuprofen, aspirin, and naproxen, are common examples. NSAIDs inhibit prostaglandin production, compounds crucial for maintaining the stomach’s protective mucus barrier, regulating blood flow, and promoting cell repair. This inhibition leaves the stomach lining vulnerable to acid-induced damage, potentially leading to gastritis or peptic ulcers. Other medications, including some iron supplements and certain antibiotics, may also cause gastric irritation.
Less common medical conditions can also manifest as stomach burning. Zollinger-Ellison Syndrome is a rare disorder characterized by gastrinomas, tumors typically found in the pancreas or duodenum. These tumors produce excessive gastrin, leading to abnormally high stomach acid levels. This hyperacidity often results in severe, recurrent peptic ulcers that are challenging to treat and cause intense burning pain.
Gastroparesis refers to delayed stomach emptying, where food remains in the stomach for an unusually long time. This delay is often caused by vagus nerve damage, frequently seen in individuals with long-standing diabetes. The prolonged presence of food and acid in the stomach can lead to bloating, nausea, and a burning sensation due to extended acid exposure.
When to Seek Medical Attention
While many instances of stomach burning pain are not serious, certain symptoms warrant prompt medical evaluation. Consult a healthcare professional if the burning pain is severe, persistent, worsens, or does not improve with over-the-counter remedies. Such characteristics could indicate a more serious underlying condition requiring medical intervention.
Specific “red flag” symptoms necessitate immediate medical attention. These include difficulty swallowing, such as feeling food stuck, painful swallowing, or coughing and choking during meals. Unexplained weight loss, particularly significant and unintentional, is another concerning indicator. Signs of gastrointestinal bleeding, such as black, tarry stools (melena) or vomiting blood resembling coffee grounds, also require urgent care. Additionally, persistent vomiting, severe abdominal pain, or pain accompanied by shortness of breath or dizziness should prompt an emergency visit.