Medical Conditions A - Z

Butterflies in the Stomach

Did you know that your gut has 100 million neurons linking it to your brain? Thus the gut is also referred as the second brain.

Maybe it’s your first-ever public speaking engagement, or for a crucial business proposal, or having to speak to this person whom you have a crush on.

You may have experienced the feeling of having butterflies in the stomach at least once in your lifetime. And this is not just your emotions acting up due to stress and anxiety.

According to Dr Chua Siew Eng, Specialist in Psychiatry & Consultant, Raffles Counselling Centre: “When you are under stress, your body goes into this fight or flight mode whereby your body is on high alert as your hormones and all parts of the body react to face up to the threat.” This affects your stomach and gut as well, resulting in the proverbial butterflies in the stomach as nervousness sets in.

These are perfectly fine and a normal reaction to stress or nervousness. When they occur infrequently, your body recovers from the physiological, psychological and emotional changes, and return to its normal function quickly. On the other hand, when you experience repeated or dramatic stress responses, your body may have greater difficulty recovering. Due to stress hormones, your body may be in a semi hyper-stimulated state, leading to digestive problems and stomach problems.

Dr Amitabh Monga, Specialist in Gastroenterology & Consultant of Raffles Internal Medicine Centre, suggested that you should seek medical help if you experience these symptoms regularly and without due cause:

  • Nagging, vague abdominal pain
  • Nausea
  • Bloated feeling
  • Irregular consistency of stool
  • Flatulence

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic disease of the intestines that affects 10 to 15 per cent of the population. According to Dr Monga, IBS does not lead to obstruction, bleeding or cancer of the colon, but individuals with severe symptoms may experience impaired quality of life with major disability.


• Food
• Stress
• Hormones
• Other illnesses

Risk factors

• Young
• Female
• Family history
• Mental health problem


• Abdominal pain or cramps
• Bloated feeling
• Gas
• Diarrhoea or constipation
• Mucus in stool

When to see doctor

• Rectal bleeding
• Abdominal pain at night
• Weight loss

Diagnostic Criteria

The Rule of Three

IBS is diagnosed when a patient experiences recurrent abdominal pain or discomfort for at least three days in a month consecutively for the past three months, and in association with two or more of the following:

  • Improvement with defecation
  • Onset associated with a change in frequency of stool
  • Onset associated with a change in form (appearance) of stool

Although these are the usual symptoms of IBS, your doctor will be able to make a definitive diagnosis after hearing you out and a thorough examination.