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Ask a Doctor: If I eat too much, will my stomach explode?

You may feel like you’re about to burst, but your stomach can stretch enough to make room for pie even after a hearty Thanksgiving meal.

A photo animation of a man's torso getting larger and larger with blue explosion shapes inside of it.
(Chelsea Conrad/Washington Post/iStock)

Q: I always feel like my stomach is going to explode after I eat on Thanksgiving. Can that actually happen?

A: While theoretically possible, it is extremely unlikely for your stomach to explode from overeating. Your stomach is a tough organ, with thick muscle walls and a rich blood supply that can easily withstand even a hearty Thanksgiving meal.

The stomach also has a remarkable ability to stretch from its resting volume without much change in pressure. Even before that first bite of turkey hits your mouth, the anticipation of it — whether through smell or sight — sends a signal to your brain that’s delivered to your stomach, telling it to prepare for food. As you eat, the stomach stretches, making more and more room.

How much a person’s stomach can stretch varies widely and depends on several factors. The average human stomach can hold about one liter before that feeling of fullness kicks in. But some stomachs can stretch to hold as much as two to four liters.

If the pressure in your stomach significantly increases, you’ll feel nauseous. If the pressure becomes severe, vomiting may occur. Both protect from gastric rupture: The nausea limits how much more you can eat, while the vomiting will decompress the stomach.

In rare cases, the stomach can expand to a dangerous size, known as acute gastric dilatation. When this happens, blood vessels delivering nutrients to the stomach are compressed. The decrease in blood flow can cause damage to the organ’s lining and potentially lead to a tear or rupture. But in the medical literature, there are very few cases of this actually happening due to overeating.

One case report involved a 24-year-old female patient who visited an emergency room in Turkey with sudden abdominal pain, vomiting and nausea after eating an excessive amount of fruit. An abdominal surgery revealed her stomach was perforated and held nearly five liters of partially digested food, including grapes and pomegranate — clearly exceeding a volume that most human stomachs can tolerate or even eat.

Treatment in these life-threatening cases is surgery, which would involve removing the excessive food and repairing the tear.

You may wonder why this doesn’t happen to competitive eaters. Joey Chestnut broke a record last year by devouring 76 hot dogs in 10 minutes. His stomach didn’t explode because it’s possible to train your stomach over time to accommodate such large volumes of food in short spans.

Certain medical conditions can increase risk for experiencing acute gastric dilatation and subsequent perforation, including episodes of severe hyperglycemia, in which a person with diabetes experiences dangerously high levels of blood sugar or if an area of the stomach is obstructed. While it is uncommon, chronic disordered eating, including a genetic condition called Prader-Willi syndrome that results in constant hunger and binge eating, can cause stomach rupture. When not caught in a timely matter, these conditions can indeed be fatal. But again, all are exceptionally rare.

For the vast majority of Americans gathering around the Thanksgiving table, a much more realistic concern is overeating and the uncomfortable feelings that go along with it: Abdominal discomfort, bloating, heartburn and indigestion are common symptoms.

So don’t worry about your stomach exploding. Instead, here are a few tips to help you feel better if you’ve eaten too much.

Take a few deep breaths. Then forgive yourself.

Our anxiety tends to be heightened this time of year, with family dynamics, travel, coronavirus safety measures and hosting duties all adding to the mayhem of the holidays. Worrying over self-control only adds to the stress. If you’ve overindulged, try not to be hard on yourself.

Try some peppermint tea

Peppermint oil capsules and teas, sometimes used in patients suffering from irritable bowel syndrome (IBS), can help get rid of abdominal discomfort and bloating. Some people reach for ginger — in candies or capsules — for relief instead. Though a few studies have found that these forms of ginger may accelerate digestion, more robust research is needed to evaluate their efficacy in improving symptoms associated with overeating. I suggest going with peppermint instead. (Always talk to your health-care provider before starting any supplements.)

Be mindful about dessert and booze

By the time dessert rolls around, you may have already had your fill. Consider skipping or sharing that slice of apple pie to stave off that overstuffed feeling, or perhaps save it for later. Alcohol packs on extra calories and facilitates overeating, so keep that in mind as you reach for that nightcap.

Go for a walk

Walking has many benefits — it’s a great mood-booster, stress reliever and a means of helping you digest after a meal. It’s also a better idea than taking a nap. Lying down soon after a meal, as tempting as it seems, may cause heartburn, acid regurgitation and even slow down the movement of food from the stomach to the small intestine.

Practice mindful eating over the next few days

There’s no need to restrict yourself after Thanksgiving. Instead, fill your plate with certain vegetables (carrots, bok choy, bell peppers and green beans), proteins (lean fish, eggs and egg whites) and fruits (kiwi and strawberry), all of which may be more easily digestible based on a well-studied diet commonly used for patients with IBS called the low FODMAPs diet. After overeating, consuming a variety of these foods, which are low in fermentable short-chain carbohydrates, may help curb bloating, abdominal discomfort and indigestion. You may also want to try practicing mindful and intentional eating without distraction, both of which are helpful strategies to help stave off eating habits that promote overeating.

Meet the doctor: Sophie M. Balzora is an associate professor of medicine at NYU Grossman School of Medicine and a gastroenterologist at NYU Langone Health.

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