Tummy ache is caused by a variety of factors. Broadly speaking, these factors can be divided into two distinct groups:

• Problems within the digestive tract or “digestive tract diseases”.
• Problems involving important organs in the body or “systemic diseases”.

In the digestive tract, functional digestive disorders remain the commonest cause of tummy ache. Of significant concern, however are ulcers of the stomach, colorectal malignancies or pancreatic cancers. Although the latter causes are less common, they remain a cause of significant health concerns when symptoms of tummy ache occur.

Functional digestive disorders remain the commonest cause of tummy ache. In Non-ulcer Dyspepsia (NUD) and Irritable Bowel Syndrome (IBS), the problems involve disordered function of the stomach and colonic function respectively.

NUD is commonly related to irregular meals and dietary indiscretion. In a small proportion of patients, Helicobacter pylori contribute to symptomatic disease. The cause of Irritable bowel syndrome is multifactorial in origin. In functional digestive disorders, psychological factors play an important role in driving the health seeking behavior. It is important that the role of psychological factors be understood and appropriately addressed in functional digestive disorders.

Systemic diseases are important and significant causes of symptoms troubling the digestive system. As an example, patients with diabetes mellitus often experience poor digestion due to poorly controlled diabetes. Alternatively, patients experiencing insomnia will experience daytime somnolence which will potentially manifest as poor appetite. Lastly, patients with heart failure will experience poor digestion when symptoms of shortness of breath occur.

It is important that the diagnosis of functional digestive disorders not be assumed. Rather, a positive diagnosis is important in ensuring that significant medical conditions like thyroid disorders, celiac disease or chronic pancreatitis be appropriately managed.