The term “empty stomach” is commonly used to describe the sensation of hunger. This sensation (also known as “hunger pangs”) occurs when the blood glucose level dips and the stomach does not contain any food. The contents of the stomach are regularly emptied into the first part of the small intestine (also known as the duodenum). Therefore, the sensation of empty stomach is perfectly normal when the body needs food.
Why does the stomach feel empty?
In some stomach problems, however, the sensation of empty stomach may persist even after the consumption of food. The sensation of empty stomach is caused by the onset of strong muscular contractions in the wall of the stomach. Hunger pangs are also associated with increased secretion of digestive enzymes and gastric acid in the stomach.
A low blood glucose level elicits the feeling of hunger through a neural mechanism. Upon feeding, the wall of the stomach stretches to accommodate the incoming food. After a certain point, the stomach is full and the sensation of satiety occurs. This is an indication to stop further food intake. As the food gets digested and the blood glucose level increases, the feelings of hunger are further suppressed.
It is sometimes possible to mistake certain abnormal sensations in the stomach such as burning sensation, pain, discomfort or cramping as hunger pangs.
Other Signs and Symptoms
The feeling of an empty stomach can occur in both normal and abnormal conditions. The signs and symptoms that accompany the sensation of empty stomach under normal conditions include loud noises emanating from the stomach (also referred to as borborygmi) and increased salivation. In some cases, an empty stomach may also elicit feelings of nausea.
The signs and symptoms that accompany the sensation of empty stomach in abnormal stomach conditions include pain in the chest region (also referred to as heartburn), nausea, stomach pain, vomiting, abnormal taste sensations and changes in appetite. These signs and symptoms occur commonly in most stomach ailments that cause the feeling of an empty stomach. Some stomach ailments may also display other signs and symptoms that are specific to those conditions.
Abnormal Causes of an Empty Stomach Feeling
The feeling of an empty stomach may indicate either hunger or the presence of some underlying disease. It is important to distinguish these different scenarios. When the feeling of empty stomach is caused by genuine hunger, eating food immediately mitigates the sensation. Depending on the amount of food consumed, the sensation may take hours to return. The duration between hunger pangs also depends on the type of food that is consumed. Some foods provide feelings of satiety for a longer duration than others.
Feelings of empty stomach that are unrelated to hunger may not subside upon feeding. In some cases, the symptoms attributed to hunger pangs may also get worse after eating. This is mainly caused by increased secretion of gastric acid during feeding. Stomach discomfort and pain caused by eating may also be due to increased contractions of the stomach.
Gastritis refers to an inflammation of the stomach wall. It is one of the most common causes of hunger pangs or the feeling of an empty stomach. Infection with the bacterium, Helicobacter pylori, and indiscriminate use of non-steroidal anti-inflammatory drugs are the two main causes of gastritis. The reason for the empty stomach feeling in gastritis is constant irritation of the walls of the stomach by gastric acid.
Read more on diet for gastritis.
Peptic ulcers refer to open sores that form in the walls of the stomach and the duodenum. This condition, also referred to as peptic ulcer disease, is a common cause of empty stomach sensation. The ulcers in peptic ulcer disease cause abdominal pain upon coming in contact with ingested food material or stomach acid. Eating may temporarily provide some relief from the pain as the gastric acid acts on the food material. The causes of peptic ulcer disease are similar to that of gastritis.
Gastroesophageal reflux disease
Acid reflux refers to a backward flow of gastric acid into the esophagus. This reflux is prevented under normal circumstances by the lower esophageal sphincter. Weakening of the lower esophageal sphincter can allow gastric contents to enter the esophagus in some situations. The esophageal wall gets irritated when it comes into contact with the acid and digestive enzymes from the stomach.
Irritation and inflammation of the esophagus causes a burning pain sensation (also known as the heartburn) in the chest region. Chronic acid reflux is referred to as gastroesophageal reflux disease (commonly abbreviated as GERD). Nausea and heartburn caused by gastroesophageal reflux disease may sometimes be mistaken for a feeling of empty stomach.
Ulcers in the esophagus
Chronic acid reflux (as in gastroesophageal reflux disease) and infection with the Helicobacter pylori bacterium can cause formation of ulcers in the esophagus. Most of these open sores are located near the stomach in the lower esophageal region. One may mistake the discomfort or pain caused by esophageal ulcers with the empty stomach feeling.
Bile is a digestive fluid that is synthesized in the liver and stored in the gallbladder. Upon feeding, bile from the gallbladder is released into the duodenum, where it aids emulsification and digestion of fats in the food. Bile reflux is a rare condition in which the bile from the duodenum manages to enter the stomach. Bile reflux usually occurs alongside gastric acid reflux, which may result in the bile reaching the esophagus. Symptoms of bile reflux may include the empty stomach feeling.
Hiatal hernia refers to a condition which the upper part of the stomach manages to enter the chest cavity via the opening in the diaphragm. The discomfort or squeezing pain caused by hiatal hernia may be mistaken for an empty stomach feeling.
Inflammatory bowel disease
Inflammatory bowel disease mainly affects the intestine. However, one type of inflammatory bowel disease known as the Crohn’s disease can also cause inflammation and ulcer formation in the walls of the stomach. This can lead to discomfort and pain that may be erroneously attributed to an empty stomach feeling.
Stress and anxiety
An empty stomach feeling could also arise due to certain distressing mental states. Stress and anxiety often produce an uncomfortable feeling in the stomach that is commonly referred to as “butterflies” in the stomach. This could be due to increased production of gastric acid in stressful situations. However, an empty stomach feeling could also be psychogenic, with no clear physiological cause.
Read more on nervous stomach.
An empty stomach feeling may also accompany diseases such as pancreatitis, gallstones and hepatic disease.