Stomach pain and “gastric”: what the location can mean, and when it’s an emergency

What is “gastric”? (Apa itu gastrik?)

In Malaysia, “gastric” (gastrik) is used for several stomach problems that cause similar symptoms:

• Indigestion (dyspepsia): pain or burning in the upper middle tummy, bloating, feeling full quickly, burping and nausea. In most people tests find no damage, which doctors call functional dyspepsia.
• Gastritis: inflammation of the stomach lining, often caused by H. pylori bacteria, painkillers such as ibuprofen and aspirin, or alcohol.
• Stomach (peptic) ulcer: a sore in the lining of the stomach or duodenum, causing burning pain that is often worse at night.
• Acid reflux (GORD): heartburn, a burning feeling rising from the stomach into the chest, and a sour taste.

Indigestion is common in Malaysia: a study in Kuala Lumpur found it in about 1 in 4 adults.

Causes of gastric pain

• H. pylori: a bacteria that infects the stomach lining and is the most common cause of chronic gastritis and ulcers. In Malaysian studies it is much more common among people of Indian and Chinese descent than Malays. In one Kelantan study, it was found in 29% of Indian, 24% of Chinese and 7% of Malay patients.
• Painkillers: regular use of anti-inflammatory painkillers (NSAIDs) such as ibuprofen, diclofenac and aspirin.
• Smoking and alcohol.
• Triggers: large, fatty or spicy meals, coffee, chocolate, being overweight, pregnancy and stress can bring on symptoms. The NHS notes that spicy food and stress don’t cause ulcers, but can make symptoms worse.

Skipping meals is often blamed for gastric. Studies have found links between irregular meals and indigestion, but haven’t shown that it is a cause.

What the location of the pain can mean

The location of pain gives clues, but it isn’t a diagnosis. Many conditions can cause pain in more than one place.

In women, lower tummy pain on one side can also be caused by period pain, ovulation pain, an ovarian cyst, endometriosis, pelvic infection, or an ectopic pregnancy. If there is any chance you could be pregnant, one-sided pain, especially with bleeding, dizziness or shoulder-tip pain, needs urgent assessment. See our pregnancy guide.

How to ease gastric and indigestion

Pharmacy medicines (ubat gastrik di farmasi):

• Antacids and alginates neutralise acid or form a protective layer. They work quickly for occasional symptoms. Take them with or after food, and don’t rely on them long term.
• Acid-reducing medicines such as omeprazole (a proton pump inhibitor) or famotidine reduce stomach acid. Don’t take omeprazole bought from a pharmacy for more than 2 weeks without seeing a doctor. Long-term use needs medical supervision, and it can hide the symptoms of more serious conditions.
• Avoid ibuprofen, diclofenac and aspirin unless a doctor has prescribed them. Use paracetamol for pain instead.

H. pylori: test and treat. If you have ongoing indigestion, your doctor may test for H. pylori, usually with a urea breath test. You need to stop acid-reducing medicines and antibiotics for 2 to 4 weeks beforehand, so ask your doctor. If the test is positive, the Malaysian H. pylori consensus recommends a 14-day course of an acid-reducing medicine plus antibiotics, followed by a repeat breath test to confirm the infection has gone.

Food and lifestyle for gastric

There is no single “gastric diet”. Studies haven’t shown that cutting out particular foods works for everyone. What helps most people:

• Eat smaller meals, and avoid eating 3 to 4 hours before bed.
• Notice and avoid your own trigger foods, such as spicy, fatty or fried food, coffee or chocolate.
• Cut down on alcohol, and stop smoking.
• Lose weight if you are overweight.
• Raise the head of your bed slightly if you get heartburn at night.

Children with stomach pain and vomiting

In children, stomach pain with vomiting is usually a stomach bug (gastroenteritis). Vomiting usually stops within 1 to 2 days and diarrhoea within 5 to 7 days. The main risk is dehydration:

• Give small, frequent sips of water or oral rehydration salts (ORS). Avoid fruit juice and fizzy drinks.
• Watch for fewer wet nappies, dark urine, a dry mouth, or a child who is unusually sleepy.

In Malaysia, remember dengue: severe tummy pain and persistent vomiting are dengue warning signs, often appearing as the fever comes down. See our dengue guide.

When stomach pain is an emergency

See a doctor soon if you have indigestion with unexplained weight loss, difficulty swallowing, persistent vomiting, anaemia, or a family history of stomach cancer, or if new indigestion starts in middle age. Your doctor may arrange an endoscopy, a camera test to look inside the stomach.

Where to get stomach pain checked

A GP can examine your tummy, test for H. pylori, prescribe treatment and refer you for an endoscopy or scan if needed. Stomach pain often strikes at night, so our directory shows clinics open late, at weekends and around the clock across Kuala Lumpur, Selangor and other states.

Browse the clinic directory

Frequently asked questions