What’s Normal: Stomach

You eat…later you get hungry and eat again…and so on. Are you pretty vague about what happens in between—what’s part of the normal digestive process and what’s a sign that something’s not right? The following quiz will help you keep your tummy feeling good and working well…and might surprise you in the process! See how much you know…

Stomach acid is even more acidic than battery acid.

It’s true that stomach acid, also called gastric acid, is composed primarily of hydrochloric acid—but battery acid still beats it for acidity. Acidity is measured according to “potential for hydrogen,” more familiar as “pH,” and refers to the ability to attract hydrogen ions—the fewer, the more acidic. On the acid/alkaline scale, 0 pH is totally acidic, while 14 pH is completely alkaline. Pure water is neutral at 7 pH. To activate enzymes needed to break down food and kill harmful bacteria and parasites ingested with food, stomach acid is about 1.35 pH to 3.5 pH. Battery acid is almost as acidic as it gets—1 pH or lower.

If you eat a very fatty meal and then your stomach hurts, don’t worry—that’s to be expected.

Pain, usually in the upper abdomen or including up to the right shoulder, after eating a high-fat meal can be a sign of a gallbladder attack, also called biliary colic. The gallbladder delivers bile to the small intestine where it breaks down fat from food and allows fat-soluble nutrients to be absorbed into the bloodstream. The pain is caused when a gallstone blocks one of the bile ducts and the gallbladder repeatedly contracts to clear the blockage. High-fat or heavy meals often trigger attacks because fats stimulate gallbladder contractions. Signs that you should get immediate medical help: Pain that lasts hours or longer, especially if accompanied by nausea and/or vomiting, fever, tea-colored urine, light-colored stools, yellow tinge to skin and/or whites of eyes.

Indigestion, even just once in a while, is a health problem that should be treated with medication.

An occasional bout of indigestion or stomach irritation is normal—it happens to nearly everyone and usually doesn’t require medical care. But do tell your doctor if the discomfort lasts longer than two weeks, is severe or accompanied by unintentional weight loss, vomiting (especially if you vomit blood), black or tarry stools, increasing difficulty swallowing, fatigue or weakness. Also let your doctor know if you have stomach pain after taking prescription or over-the-counter drugs—including pain relievers such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, Anaprox). These drugs can deteriorate the protective lining of your stomach if used too often. And get to the ER immediately if you’re also short of breath, sweating or have chest pain radiating from your jaw, neck or arm, with exertion or with stress—all potential signs of heart attack.


A sudden pain in the lower right part of the abdomen—like a “stitch” when you’re running—is normal when exercising hard.

A sudden pain in the lower right of the abdomen is the hallmark sign of appendicitis, an acute inflammation of the appendix. Typically, the pain begins near the belly button and becomes worse over time—especially with jarring movements such as coughing or walking. Pain can also be accompanied by fever. Important: Appendicitis is serious and can turn deadly as quickly as 48 to 72 hours from the first sign of symptoms. Call your doctor immediately if you also have worsening fever, constipation or diarrhea, difficulty passing gas, vomiting and/or increasing or intense pain. When it is appendicitis, treatment usually requires surgical removal of the appendix.

Peptic ulcers are caused by spicy foods and will heal on their own if you switch to a bland diet.

Despite what many people believe, spicy foods do not cause ulcers—and neither does stress. Peptic ulcers are sores on the protective lining of the stomach (gastric ulcers) or first part of the small intestine (duodenal ulcers) caused by stomach acid—most commonly because of infection with the Helicobacter pylori bacterium, which can degrade the protective lining. Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can also cause ulcers. Taking antacids and/or drinking milk won’t heal a peptic ulcer, nor will it heal on its own. The condition requires medical intervention, typically medicines to reduce stomach acids and/or antibiotics to kill the bacterium…or surgery when conservative treatment isn’t effective. While spicy foods and stress don’t cause ulcers, they can aggravate them, as can smoking and drinking alcohol.

If you have lactose intolerance, you have to consume lactose-free milk or avoid milk completely.

Lactose, a sugar found in highest amounts in cow’s milk but also in goat and sheep milk, can cause digestive problems—such as bloating, nausea, diarrhea and gas—for people whose small intestines do not produce enough lactase, the enzyme that breaks down lactose. But people with lactose intolerance usually can tolerate small amounts of milk or milk products, particularly if consumed with other foods. It just depends on how much lactase a particular person’s intestine produces. Declining lactase production starting at about age two is the most common cause of lactose intolerance. Other causes include disease or injury to the small intestine…premature birth…or a rare congenital disorder. It’s also more common among certain ethnic groups, for instance, African Americans, Hispanics, Native Americans and Asian Americans. Note: Since dairy is a major source of calcium and vitamin D, if you’re avoiding milk, be sure to get adequate amounts of those nutrients from other sources.


Losing weight fast can cause gallstones.

Quickly shedding unwanted pounds sounds like a good thing, especially when dropping pounds also reduces cholesterol. The problem lies in how quickly you do it. As the body metabolizes stored fat, it causes the liver to secrete more bile, which is composed mainly of cholesterol. But if too much cholesterol piles up in the gallbladder, it can turn the liquid bile into a sludge that hardens into lumps that block the bile ducts—a painful and potentially health-threatening condition. (See question #2 above.) Losing weight more gradually—about one or two pounds a week—helps avoid risk for gallstones.

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