Constant nausea and gas: Increased Passing Gas, Nausea Or Vomiting And Upset Stomach
What Your Upset Stomach is Trying to Tell You
Was it that chicken you ate late at night or something else? Whether it’s indigestion, heartburn, nausea or gas, these symptoms are all commonly associated with an upset stomach. Doug Purdy, MD, Gastroenterologist at UnityPoint Health, explains why tummy troubles happen and how to get relief.
What Causes an Upset Stomach?
An upset stomach can be the result of several different factors and have a variety of symptoms, such as:
“Constipation is typically defined as having less than three bowel movements in a week,” Dr. Purdy says.
Feeling constipated isn’t uncommon, but for some people, it can be chronic and present a real problem, making daily tasks feel less enjoyable. The reason someone might be constipated varies greatly. Signs and symptoms often include:
- Having stools that look like pebbles and are difficult to pass
- Straining while trying to have a bowel movement
- Feeling like you can’t empty your bowel near the rectum
How to get relief greatly depends on why you’re constipated, but Dr. Purdy says the following are often recommended to give your bowels some extra assistance:
- Moving your body. This increases the muscle activity in the colon.
- Getting more fiber. A good source is fresh fruits and vegetables.
- Using a laxative. This can include stool softeners, suppositories, bower stimulants, fiber supplements and lubricants.
- Taking prescription medication. If you aren’t having luck with dietary changes and over-the-counter medication, your doctor may write a prescription that can help get things moving.
Nausea is a symptom commonly associated with an upset stomach or uneasiness of the stomach. However, what causes nausea can sometimes be hard to pinpoint. Nausea is commonly caused by:
- Gastroenteritis (Stomach flu)
- GERD (Acid reflux)
- Peptic ulcer disease
- Morning sickness
- Motion sickness
- Food poisoning
- Diet (junk food, overeating)
- Severe pain (pancreatitis, cholecystitis, kidney stones)
Nausea could also be a warning sign for certain medical conditions, such as:
- Crohn’s disease
- Heart attack
- Intestinal blockage
How to Get Rid of Nausea
When feeling nauseous, the fastest way to relief is by taking an over-the-counter anti nausea medication like Dramamine or Pepto-Bismol, but there are other things you can do as well, including:
- Sipping clear or ice-cold drinks
- Drinking peppermint, chamomile or ginger tea
- Eating slowly and smaller, more frequent meals
- Getting some fresh air by opening a window or stepping outside
- Trying to focus on something other than your nausea
- Putting an ice pack or cool, wet cloth on the back of your neck to decrease body temperature
Dr. Purdy says heartburn feels like burning in your chest and is often worse after a meal or when bending over or lying down.
What Causes Heartburn
“The main cause of heartburn is acid reflux, which is the backup of stomach acid into a person’s esophagus,” Dr. Purdy says. Factors that can contribute to heartburn include:
- Eating meals too quickly
- Alcohol, caffeine, chocolate
- Fatty and greasy foods
- Eating too close to bedtime
- Wearing tight fitting clothes
Occasionally experiencing heartburn is common and shouldn’t cause alarm.
“In addition to adjusting your diet and making lifestyle modifications, your doctor may prescribe medication, called h3-blockers (Famotidine/Pepcid) or proton pump inhibitors (Omeprazole, Pantoprazole), to help suppress your stomach acid. If your heartburn doesn’t start to subside once the medication kicks in and your diet has been modified, then it’s time to talk to your doctor to see if further evaluation is needed,” Dr. Purdy says.
Indigestion, also called dyspepsia or upset stomach, is the discomfort a person feels in the upper part of their abdomen. They often experience feeling full soon after starting a meal or an uncomfortable fullness after a meal, discomfort or burning in their stomach and bloating.
Indigestion can be triggered by medication, different foods and drinks. More specifically, it can be caused by:
- Eating too quickly
- Spicy or greasy foods
- Too much caffeine, alcohol or chocolate
- Antibiotics, pain relievers and supplements
Some medical conditions can cause indigestion, like ulcers, gallstones, constipation or Celiac disease. Relief can come from eating smaller meals, eliminating caffeine and avoiding certain pain relievers.
“Bloating is when your abdomen (stomach) feels full, tight and uncomfortable with the sensation of having too much gas,” Dr. Purdy says. Bloating can cause abdominal pain that ranges from mild to moderate. Common causes of bloating include:
- Carbonated beverages
- Eating too quickly
- Gastrointestinal infection
- Celiac disease
- Lactose/fructose intolerance
- Irritable bowel syndrome
Natural Ways to Relieve Bloating
Commonly, flatulence (farting), burping or having a bowel movement will help put an end to bloating. Other forms of relief for bloating include reducing your intake of gas-producing foods, including:
- Beans or lentils
- Vegetables like broccoli, Brussel sprouts or asparagus
- Corn, pasta and potatoes, which are rich in starch
- Lactose, which is a natural sugar in milk
- Fructose, another natural sugar found in pears, wheat and some sodas
- Sorbitol, an artificial sweetener
- Fruits high in soluble fiber
Most of these foods are healthy, so be sure to figure out what your troublemakers are so you can add nutrient-dense food back into your diet. Another great way to reduce bloating after eating is to move your body. Try going for a walk after your meal to help ease discomfort. If your bloating is persistent, talk to your doctor.
Other Causes for an Upset Stomach
The build-up of gas in the intestines can be really uncomfortable for people and is another common reason for digestive distress. If you’re experiencing trapped gas that feels constant, and it’s interfering with your daily activities, talk to your doctor about pinpointing the cause, so you can find some relief.
Vomiting is another common by-product, and many times goes hand-in-hand with feelings of nausea. There are several reasons for vomiting ranging from issues such as motion sickness, overuse of alcohol to gastroenteritis (stomach flu) and allergic reactions. The color of your vomit can also be a telltale sign on an underlying health issue.
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Causes and what to do
If a person is bloated, nauseous, and tired, changing their eating habits may help. However, if these symptoms persist, it may be a sign of an underlying health condition.
People with a bloated stomach, nausea, and tiredness may find their stomach feels enlarged, tight, and uncomfortably full.
They may have a stomach ache or pass more gas than usual. In some cases, salty foods and carbohydrates can make someone feel sleepy or bloated.
In this article, we look at the causes of bloating, nausea, and tiredness, and what people can do to relieve these symptoms.
Share on PinterestEating habits, constipation, stress, and other medical conditions may lead to bloating, nausea, and tiredness.
There are many reasons why a person might have a bloated stomach and be feeling sick and tired. Read on for some potential causes.
There are several ways a person’s eating habits and diet can contribute to feeling bloated, nauseous, or tired.
- eating too quickly
- eating large portions
- drinking carbonated drinks
- eating foods high in salt
- eating a lot of carbohydrates
Eating moderate portions of food slowly and mindfully may aid digestion and ease symptoms.
Constipation occurs when someone has less frequent bowel movements than usual. The bowel movements they do have may feel difficult, uncomfortable, or painful.
Other symptoms of constipation include:
- feeling sluggish
- stomach pain
According to John Hopkins Medicine, constipation is the most common digestive condition in the United States.
Constipation has a range of causes, including:
- sudden changes in diet or lifestyle
- not eating enough fiber
- medication that has constipation as a side effect
Treatment for constipation depends on the cause but often involves dietary and lifestyle changes. If these do not work, a doctor may prescribe a laxative.
Stress and anxiety can affect the nerves of the digestive system, slowing down the movements of the intestines. This may cause people to feel bloated, nauseous, and tired.
Stress can also contribute to constipation, as well as other gastrointestinal conditions.
The American Institute of Stress list a wide range of other symptoms that stress can cause, including:
- nervous habits, such as fidgeting
- muscle tension or pain
- cold or sweaty hands and feet
- insomnia or nightmares
- headaches or jaw clenching
- changes in appetite
- frequent illness, such as colds or flu
Stress can be difficult to manage. However, there are many ways someone can relieve stress, such as:
- deep breathing exercises
- yoga or meditation
- massage or self-massage
It is a good idea for people to experiment with different stress management techniques to find what helps.
Small intestinal bacterial overgrowth
Small intestinal bacterial overgrowth (SIBO) occurs when too many bacteria grow in the small intestine.
SIBO can cause:
- bloating and gas
- diarrhea or constipation
- stomach pain
People with SIBO often have low motility, meaning the small intestine does not push food through the digestive tract as it should.
Diverticulitis, abdominal surgery, and adhesions can also make SIBO more likely.
There are several types of SIBO, and the type someone has will determine their treatment. Doctors may prescribe an antibiotic or combination of antibiotics.
People with SIBO may feel relief from symptoms by following a low FODMAP diet.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are compounds that bacteria ferment, sometimes causing SIBO symptoms.
Learn more about the low FODMAP diet.
Irritable bowel syndrome
Irritable bowel syndrome (IBS) describes a group of symptoms that affect the gastrointestinal tract, including:
- abdominal pain and cramping
- diarrhea or constipation
- white mucus in stools
Because of the range of causes, treatment for IBS varies. The low FODMAP diet, reducing stress, and medications that alleviate the symptoms can help someone manage the condition.
A variety of factors can cause IBS. Stress, early life trauma, and bacterial infections may play a role. Some people with IBS also have SIBO, food intolerances, or mental health conditions.
Gastroparesis means stomach paralysis and occurs when the stomach cannot contract. This causes food to sit in the stomach, disrupting digestion.
According to the American College of Gastroenterology, gastoparesis can cause the following symptoms:
- feeling full quickly
- abdominal pain
Abdominal pain of gastroparesis occurs under the ribs, especially in the center of the upper abdomen.
As a result of these symptoms, a person may lose weight or not get enough nutrients, which can result in tiredness.
People often manage gastroparesis by changing their diet. Foods high in fat or fiber take longer to digest. Switching to softer foods, such as nutritional drinks, soups, and stews, can help.
Dumping syndrome happens when food empties from the stomach too quickly.
The International Foundation Gastrointestinal Disorders state that dumping syndrome can occur after people have had surgery to remove part of the stomach. It may also occur in people with other digestive conditions.
Along with bloating, nausea, and fatigue, the symptoms of dumping syndrome include:
- abdominal cramping
- cold sweats
Symptoms may appear during or straight after eating, or 1–3 hours after eating. Dietary changes can often help people to relieve symptoms.
Changes can include:
- eating smaller meals more frequently
- increasing complex carbohydrates, such as whole grains
- increasing foods high in soluble fiber, such as apples, carrots, and oats
- increasing protein
It can help to talk to a dietician so that a person with dumping syndrome can maintain their weight.
According to the Centers for Disease Control and Prevention (CDC), persistent bloating for 2 weeks or more can be a sign of ovarian cancer in females.
People may also experience:
- unusual vaginal bleeding
- pelvic pain or pressure
- feeling full quickly while eating
- difficulty eating
- constipation or more frequent bowel movements
- more frequent urination
If people have any of these symptoms, they should see their doctor right away. A doctor can request tests to determine if these symptoms are due to cancer or another condition.
In mild or temporary cases of bloating, nausea, and tiredness, a person may find their symptoms resolve with rest, bowel movements, or passing gas.
Home remedies and lifestyle changes can also help relieve symptoms. These include:
- eating smaller meals more regularly
- eating slowly and mindfully, chewing thoroughly
- trying to reduce stress
- drinking enough water throughout the day
- reducing processed foods, which can be high in fat and salt
- stopping smoking or drinking alcohol that can cause heartburn
Depending on the underlying cause, people may find increasing or decreasing fiber intake helps ease symptoms. People can talk to a healthcare professional to work out a helpful fiber intake.
If someone has persistent symptoms of SIBO or IBS after meals, they can try the low FODMAP diet to see if it eases their symptoms.
People should see their doctor if they have experienced persistent bloating for 2 weeks or more. People should also see their doctor if they have:
- unexplained weight loss
- persistent or severe abdominal pain
- blood in their urine or stool
- changes in the color of frequency of bowel movements
- loss of appetite or feeling full quickly
Bloating, nausea, and tiredness can occur due to a wide range of causes. Temporary explanations can include eating rich or salty meals, eating too much, or short-term stress. Longer-term causes include conditions such as IBS, SIBO, and gastroparesis.
People may feel an improvement in symptoms by changing their diet, eating habits, and by reducing stress if possible. However, for persistent or severe symptoms, a person can seek help from a doctor.
Treatment of the gastrointestinal tract – Services
Diseases of the digestive system are by far the most common of all diseases of the internal organs. The “field of responsibility” of gastroenterology is the treatment of diseases of the esophagus, stomach, pancreas, intestines, gallbladder and liver.
Digestion is the process of mechanical and chemical processing of food, as a result of which nutrients are absorbed and assimilated by the body, and decay products and undigested products are removed from it.
Digestion is the initial stage of metabolism. With food, a person receives energy and all the necessary substances for the renewal and growth of tissues. However, the proteins, fats and carbohydrates contained in food, as well as vitamins and mineral salts, are foreign substances for the body and cannot be absorbed by its cells. First, these substances must be converted into smaller molecules that are soluble in water and lack specificity. This process takes place in the digestive tract and is called digestion. The causes of indigestion are insufficient secretion of gastric juice or a violation of the evacuation of contents due to a pathological process in any organ of the digestive system.
Manifestations of indigestion: loss of appetite, feeling of heaviness, fullness in the epigastric region, nausea, sometimes vomiting, diarrhea or constipation, bloating.
Symptoms of gastrointestinal diseases:
- colicky or aching girdle pain, headaches, irritability;
- dyspeptic disorders:
- appetite disorder
- bad taste in the mouth
- stool retention
- frequent loose stools
Causes of diseases of the gastrointestinal tract
The modern rhythm of life, constant stress, unhealthy diet, unfavorable environmental conditions – all this has an extremely negative impact on the state of the human body, including the functioning of the gastrointestinal tract.
The number of patients with chronic gastroenterological diseases is growing every year. And often the cause of the flow of the disease into a chronic form is self-medication.
Do not self-medicate! This will only aggravate the course of the disease, bringing only a temporary improvement in the condition.
Dyspepsia is a collective term for digestive disorders of a functional nature arising from insufficient secretion of digestive enzymes or poor nutrition.
Dyspepsia is distinguished:
Fermentative dyspepsia is associated with excessive consumption of carbohydrates (sugar, honey, flour products, fruits, grapes, peas, beans, cabbage, etc.), as well as fermentation drinks (kvass). As a result, conditions are created in the intestine for the development of fermentative flora.
The cause of putrefactive dyspepsia is the consumption of predominantly protein foods, especially lamb, pork meat, which is digested more slowly in the intestines. Sometimes putrefactive dyspepsia occurs due to the use of stale meat products in food.
Fatty dyspepsia occurs as a result of excessive consumption of slowly digested, especially refractory, fats (pork, lamb). Dyspepsia may accompany gastritis, pancreatitis.
Symptoms of dyspepsia
- Fermentative dyspepsia – bloating, rumbling in the intestines, release of large amounts of flatus; frequent, faintly colored loose, frothy, sour-smelling stools.
- Putrid dyspepsia – diarrhea with a rich dark color of feces and a putrid odor. Against the background of general intoxication with decay products, patients often complain of a deterioration in appetite, weakness, and a decrease in efficiency.
- With fatty dyspepsia, stools are light, copious, with a greasy sheen.
Treatment of dyspepsia
Drug therapy includes enzyme preparations.
As a symptomatic treatment of dyspepsia, the following drugs can be used: Almagel, Maalox and other acid-reducing agents; drugs that reduce gastric secretion – omeprazole, ranitidine, famotidine, etc. ; enzyme preparations – acidinpepsin, abomin, pancreatin, etc.; prokinetics – motilium, etc.; preparations for the restoration of microflora – bifikol, colibacterin and a number of other groups.
Normalization of nutrition plays a very important role in the treatment of dyspepsia.
Fasting is usually prescribed for 1–1.5 days, then:
It is necessary to identify and treat the underlying disease that caused dyspepsia! All kinds of folk remedies can relieve the symptoms, but the reason why they arose will not be removed! The disease will manifest itself again and again, and the disease that caused it will go into a chronic stage, in which the treatment will be much more difficult or not beneficial at all.
If any dyspeptic symptoms appear and if they last for a long time, for diagnosis, correct diagnosis and further treatment, you should contact a gastroenterologist at the Medline Medical Center in Barnaul.
Primary appointment with a gastroenterologist (history taking, appointment of the necessary examination for diagnosis, (primary diagnosis)
Repeated examination by a gastroenterologist (diagnosis, appointment of the necessary course of treatment)
Dyspepsia | Floris
- Non-Ulcer Functional D…
- right hypochondrium.
- the actual epigastric region.
- left hypochondrium.
- right side area
- umbilical region.
- left side area
- right iliac (inguinal) region.
- suprapubic area.
- left iliac (inguinal) region.
Dyspepsia is a subjective manifestation of diseases of the digestive system, which are associated with a violation of the digestive processes. Dyspepsia can be manifested by: loss of appetite (anorexia), a feeling of “bursting” or a feeling of fullness in the stomach, heartburn, belching, swallowing disorders (dysphagia), nausea, vomiting, excessive gas formation in the intestines (flatulence), diarrhea, constipation.
What are functional diseases of the gastrointestinal tract (GIT)?
This is a complex of persistent or intermittent gastrointestinal symptoms that cannot be explained by any structural organ changes, biochemical changes, or any other organic disorder.
To accurately indicate the location of any changes or pain found during the examination of the abdomen, the anterior abdominal wall is conditionally divided into separate areas and departments.
Draw two horizontal lines first. The upper one connects the lowest points of both costal arches. The inferior connects both anterior superior iliac spines. Thus, the abdomen is divided into three floors: the upper one is the epigastrium, the middle one is the mesogastrium and the lower one is the hypogastrium. Two vertical lines run along the outer edges of the right and left rectus abdominis muscles. A solid curved line runs along the edge of the costal arches. The dotted line represents the dome of the diaphragm.
The following areas are distinguished.
The most common symptom in functional diseases of the stomach, intestines and biliary tract is abdominal pain, ie. abdominal pain . The most common cause of such pain is excessive activity of the intestines and biliary tract, which leads to the development of spasm. But you should not forget about such serious diseases as peptic ulcer of the stomach and duodenum.
Heartburn. The second most common symptom is heartburn. E that sensation of discomfort or burning sensation behind the sternum, spreading upward from the epigastric (pit of the stomach) along the esophagus. Instead of the burning sensation of heartburn, some people experience a feeling of pressure, fullness, warmth, or a lump. Heartburn can be with any acidity of gastric juice, but most often it occurs with increased acidity. It is important not to confuse this feeling with chest pain. Pain behind the sternum can be caused by both functional diseases of the gastrointestinal tract, and diseases of the heart and some other organs. In all cases, chest pain requires careful evaluation for an accurate diagnosis. For this purpose, it is necessary to conduct a joint study of the cardiovascular system and the gastrointestinal tract.
Belching . In diseases of the stomach and duodenum, belching often occurs. involuntary or arbitrary entry into the oral cavity of a small amount of food or air contained in the stomach, accompanied by a characteristic sound of air escaping through the mouth. Belching can also occur with other diseases of the abdominal cavity, for example, the liver, gallbladder, as well as with cardiovascular diseases (coronary heart disease, myocardial infarction, etc.).
Dysphagia – swallowing disorder, manifested by difficulty or inability to swallow, pain at the time of swallowing, ingress of food or liquid into the nose, larynx, trachea. The causes of dysphagia can be inflammatory processes of the oral cavity, pharynx, esophagus, larynx, mediastinum, foreign bodies, cicatricial narrowing and tumors, diffuse spasm of the esophagus, and some nervous diseases. The most common cause of dysphagia is gastroesophageal reflux disease. Acid from the stomach enters the mucosa of the patient’s esophagus, damage is formed on it and this causes slight narrowing of the esophagus – a stricture. Spasm of the esophagus is one of the causes of dysphagia
Nausea – an unpleasant painful sensation in the epigastric region, chest, mouth, often preceding vomiting.
Nausea, like vomiting, is one of the symptoms of stomach diseases, such as acute and chronic gastritis, peptic ulcer of the stomach and duodenum, cancer, as well as functional disorders that accompany a number of diseases (chronic pancreatitis, chronic cholecystitis, cholelithiasis, chronic hepatitis and cirrhosis of the liver, diseases of the small and large intestine), intoxications of various origins, including helminthic and parasitic invasions.
Flatulence – excessive accumulation of gases in the stomach and intestines. It is manifested by bloating, swelling, belching, hiccups, a feeling of heaviness and fullness in the abdomen, attacks of cramping pains that disappear after the passage of gases.
Flatulence is a common symptom of some diseases, such as intestinal dysbacteriosis, pancreatitis, colitis, enteritis, liver cirrhosis, acute intestinal infections, and impaired motor function.
Constipation is a bowel disorder with retention of stool for more than 48 hours. the passage of hard stools, often accompanied by a feeling of tension and discomfort.
The causes of constipation are very different, among them are peptic ulcer, chronic pancreatitis, dysbacteriosis, irritable bowel syndrome, colon tumors.
Diarrhea (diarrhea) is a stool disorder characterized by frequent or single bowel movements with the release of liquid or mushy feces in a large volume (more than 200 g per day). As a rule, diarrhea occurs against the background of diseases of the gastrointestinal tract (both infectious and non-infectious). In addition, diarrhea can be a symptom of food poisoning, nervous disorders, stress, taking certain medications, physical overload, eating after a long period of fasting, climate change and nutritional conditions (traveler’s diarrhea), etc.
Abdominal pain is one of the most common complaints of patients who come to the doctor. Indeed, every person in his life has felt pain in the abdomen more than once, and the discomfort that this pain causes is difficult to compare with other pain sensations. The causes of this symptom can be both diseases of the intestines, stomach, liver and gallbladder, as well as pancreas, inflammation of the appendix and kidneys. In some cases, heart problems can also cause abdominal pain. In a special group, diseases can be distinguished that cause pain in the lower abdomen, more characteristic of women, which indicate possible diseases of the genitourinary system.
Depression, spinal disorders, thyroid disease, anemia, urinary tract infections may appear under the guise of abdominal pain. Abdominal pain may be accompanied by alcohol, drugs, antibiotics, anti-inflammatory drugs, iron supplements.
It is extremely important for diagnosing to correctly determine all the characteristic features of abdominal pain:
Localization of pain – the place of the greatest pain sensations. For an accurate determination, it is necessary to lie on your back and gently feel the stomach, finding the place that causes the most pain. In classical cases, there is a correspondence between the localization of pain and the affected organ. So, in diseases of the esophagus, stomach, duodenum, pain is localized in the projection of the stomach. Pain in the right hypochondrium indicates diseases of the biliary tract of the gallbladder and liver. With pancreatitis, pain is often localized in the left hypochondrium. In diseases of the small intestine – in the umbilical region, the caecum and appendix – in the right iliac region, the sigmoid colon – in the left iliac region. Pathological processes in the bladder, uterus and appendages manifest themselves as pains in the lower abdomen.
Type of pain – pain can be sharp and dull, aching, bursting and squeezing, etc.
Accompanying symptoms – vomiting, nausea, fever, diarrhoea, increased pain with certain actions or assuming a certain body position;
What preceded the onset of pain and how pain sensations developed – after nervous tension, physical exertion, eating, drinking alcohol, etc.
Chest pain and gastrointestinal disorders
Chest pain requires careful evaluation for an accurate diagnosis. For this purpose, it is necessary to conduct a joint study of the cardiovascular system and the gastrointestinal tract.
Consider the manifestations of pain in various diseases.
In esophagitis caused by gastroesophageal reflux, patients usually complain of a burning sensation deep in the chest. Burning increases after taking aspirin, drinking alcohol and certain foods. Relief is provided by antacids, sometimes by small amounts of food or water. Concomitant symptoms – dysphagia, belching of undigested food, weight loss.
Hernia of the esophageal opening of the diaphragm is characterized by the appearance or increase of pain in the supine position. For diseases associated with an increase in the acidity of the stomach, such as gastroesophageal reflux disease, fasting pain is typical, especially in the early morning, food brings relief (food neutralizes the effect of hydrochloric acid).
Spasm of the esophagus (especially against the background of gastroesophageal reflux) is accompanied by constrictive retrosternal pain, which is difficult to distinguish from angina pectoris, since even its irradiation may be the same. Another cause of severe chest pain is damage to the esophagus – a rupture of the lining of the esophageal-gastric junction with severe, repeated vomiting, retching, or severe coughing.
Other less common causes of chest pain are stomach ulcers, cholecystitis and pancreatitis.
With a stomach ulcer, pain is localized in the epigastrium or behind the sternum, usually occurs 1-1.5 hours after eating and decreases or disappears a few minutes after taking antacids.
In acute cholecystitis, the pain is usually aching, localized in the epigastrium or behind the sternum. It occurs approximately 1 hour after eating and is not associated with physical activity.
The fact that the patient has some kind of gastrointestinal disease does not mean that it is the cause of chest pain.