Burning pain at epigastric area can be of different causes. The most common reason would be increasing the acid content in stomach, called as gastric or acid peptic condition. When it is due to stress, we called it as Stress Induce Gastritis . Pain is specific at upper region of abdomen and it sometime mimics in chest and back region this sort of pain is relieved only after taking meal.
Several reasons are causing this condition and one of the common causes is the stress which is called as stress induced gastritis. If it is to be defined, it can be said as chronic condition of releasing acid by the acid secreting cells in the stomach due to stimuli to the stress.
Generally it is seen in intensive care units or post-surgical environments. Less common causes are radiation, vascular injury, and trauma. When severe, stress gastritis can result in chest pain, hematemesis, or melena.
The main symptoms of the people will have complaint of epigastric pain during and after stress. It is most common on old aged people and ratio of male to female for stress induced gastritis is same.
Common Symptoms in Gastritis
If you are experiencing psychological stress-induced gastritis, symptoms will typically flare up or worsen during periods of high emotional distress: [1, 2]
- Burning pain or a gnawing sensation in the upper abdomen.
- Bloating, heaviness, or early fullness after eating just a few bites.
- Persistent nausea and occasional vomiting.
- Acid reflux or frequent sour burping
RN. Niru Shrestha of Bhaktapur, working as registered Nurse at Madhyapur Hospital of Nepal also says that ” In females, due to the stress induced stomach problem, Lower back Pain is usually Most common symptoms you can can encounter in the general hospitals in Nepal”. So, this shouldn’t be left behind
Real Physiology of Gastritis
after taking meal, parietal cells in gastric layer of stomach secretes hydrochloric acid (HCL) that helps in food digestion, killing bacteria & maintaining the acidic environment. Another cell, chief cell, produces pepsin converted pepsinogen by HCL and act as helper in digestion.
In the same way gastrin somatostatin hormones are also produced by G- cell of antrum (lower portion of stomach) and somatostatin by D cell of stomach respectively. Gastrin stimulates the acid (HCL) secretion while the somatostatin will suppress working as antagonism.
Bicarbonate ions and mucus together protect the stomach wall. Mucus also produces Prostaglandin E, which help in decrease acid secretion and protects wall of stomach.
And it is believed that the stress will reduce the protective layer (mucus) and cause gastritis.
How Stress Reconfigures the Stomach
There are multiple ways that when you get stress , your stomach mechanism and function is altered. These are the most common things that there is changes in the stomach phyisology and antomy due to stress
- Increases acid secretion: Stress overstimulates your nervous system due to which the parietal cells is stimulated and hence pump out excess stomach acid.
- Thins protective mucus: Your stomach is nomally capble of secreating thick mucus making the protective layer and protect itself from its own acid. The Stress factor diminishes this protective barrier.
- Reduces blood flow: During the stress the “fight-or-flight” response diverts blood away from your digestive tract, due to which there is less healing of the protective layer
Direct Comparison: Psychological vs. Physiological Stress Gastritis
The term “stress gastritis” can refer to two entirely different clinical scenarios depending on the underlying trigger:
| Feature | Psychological Stress Gastritis | Physiological (Severe Medical) Stress Gastritis |
| Root Cause | Chronic anxiety, emotional burnout, or panic disorders. | Severe physical trauma, critical illness, severe burns, or ventilator dependency. |
| Clinical Setting | Managed at home through outpatient medical and psychiatric care. | Managed in hospital Intensive Care Units (ICUs) or surgical wards. |
| Severity Risk | Chronic daily discomfort, burning, and nutrient malabsorption. | Acute, life-threatening upper gastrointestinal bleeding or severe ulcerations (e.g., Curling or Cushing ulcers). |
| Primary Approach | Acid suppression combined with mental health therapy and lifestyle changes. | Intravenous preventative medications (Stress Ulcer Prophylaxis). |
How it is Diagnosis?
Generally mild to severe symptoms can appear according to the different grading but in simple, the symptoms: 1) Repeated episodes of epigastric pain, Coffee or brown colored Vomiting, Black colored stool. (Melena).are the common presentations.
The coffee color of vomit & black color of stool might be due to upper gastrointestinal tract bleeding. Beside these, other investigations are also done but the endoscopy is done for confirming the diagnosis
Physiological Triggers for the Gastritis
These are the most common trigger factors for the stress induced gastritis
- Mucosal Hypoperfusion: Critically low blood flow to the digestive tract.
- Gastric Acid Hypersecretion: Spikes in localized acid output triggered by neural stress pathways.
- Prostaglandin Depletion: The loss of lipid compounds that are necessary to maintain the stomach’s protective gel coating.
- Bicarbonate Deficiency: A breakdown in the alkaline secretions that normally neutralize harsh stomach acid
Â
How to treat gastritis?
As per the doctors recommendation, Simply, this condition can be overcome by simple measures like life style modification, risk factor stoppage or reduction and taking the medications.
Dr. Ram Narayan shah, MD, Internal Medicine of Nepal says that The major cause of the stress can be decreased by life style modification. The regular walk or exercise decreases the stress by increasing the level of serotonin in the body and this increasing level gives the strength to fight against stressful life and The aggravating factors like cessation of smoking alcohol, less use of NSAID pain killers( aspirin or ibuprofen), avoiding Oily, spicy and smoky food, Late night heaving meal intake, regular intake of food (no empty stomach) will also help to reduce this condition
OTC Medications for Gastritis
These are the list of otc medications for the gastritis. you can get in local pharmacy shops or get prescribed by the concerned physician and doctor
- Antacid (aluminum hydroxide, magnesium oxide)
- Gastrointestinal agents sucralfate,
- histamine H2 antagonists (ranitidine, famotidine, cimetidine),
- Proton pump inhibitors (omeprazole, lansoprazole, Pantoprazole, Rabiprazole)
Besides the combination with anti-anxiety medication also provide good relief from this condition
Medical Management & Prophylaxis
These are most commonly used medical management and prophylaxis done at all the hospitals for the treatment [source Research Gate Publication]
- Enteral Nutrition: Early tube feeding used in critical care to keep blood flowing to stomach tissues
- Stress Ulcer Prophylaxis (SUP): Preventive drug therapy routinely administered to high-risk ICU patients.
- Proton Pump Inhibitors (PPIs): Strong acid-reducing medications like omeprazole or pantoprazole.
- H2-Receptor Antagonists (H2RA): Acid-blocking drugs like famotidine used as preventive options.