What Could Stomach Pains After Eating?

I think my father-in-law might have an ulcer. He is a perfectionist and only eats once a day, at dinnertime. Lately, he only eats about two bites and then gives up. He says it's because food hurts his stomach. He is also an alcoholic. I don't know how to approach him, but I've heard that ulcers and drinking can kill you. I am really concerned for him, and he won't go to the doctor. Do you have any answers for me?


Gastroenterologists often see patients who complain of stomach pains after they eat. While no significant problem is detected in many of these people, such complaints deserve investigation. It is especially important to investigate this symptom in older people because the incidence of stomach cancer rises with age.

The most likely cause of pain after eating is an ulcer. The ulcer may be in the stomach or upper intestine, or duodenum. The reason for the pain may be stomach acid or food that irritates the ulcer. Alternatively, if the ulcer blocks the exit from the stomach to the duodenum (the pyloric channel), this may lead to a feeling of fullness after eating. This type of obstruction is often accompanied by nausea and vomiting after eating.

Another possibility in patients who have abdominal pain after eating -- and are afraid to eat as a result -- is blockage of the blood vessels that lead to the intestinal tract. This condition, known as chronic mesenteric insufficiency, is similar to coronary artery disease. During meals, as the demand for blood in the intestinal tract rises, the vessels are not able to supply this increased demand, and angina-like pain results. This condition is most likely to occur patients who also have blockages in other vessels, such as those in the heart, leg or neck; patients who have high blood pressure or high cholesterol; and patients who smoke.

Finally, the most worrisome diagnosis in someone who complains of stomach pain after eating is stomach (gastric) cancer. Although the incidence of stomach cancer has fallen dramatically in the United States since the early 1900s, it is still seen. In fact, the incidence of one type of gastric cancer -- a kind that involves the part of the stomach that is close to the esophagus (the cardia) -- is actually increasing.

In summary, your father-in-law has a significant digestive complaint that should be investigated further by a gastroenterologist. He will likely need an endoscopy to examine his stomach and duodenum further.

Ronen Arai

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