Managing Chronic Indigestion: Solutions for Bloating and Acid Issues

Dyspepsia, gastric acid, bloating?

I have been experiencing indigestion for 5 years, and despite taking many medications, I have not been able to return to normal.
I often feel very bloated after eating just a little, sometimes only a few bites.
Occasionally, I eat very little in the morning, and by evening, I may vomit it back up.
I have lower abdominal bloating, but currently, I do not have stomach pain.
Previously, when I visited a clinic, the doctor mentioned that I had gastric distension, acid reflux, and indigestion, and prescribed medication, but there was no improvement.
I have undergone an endoscopy, which showed symptoms of gastric hypomotility.
What can I do to get better?

Miss Lin, 10~19 year old female. Ask Date: 2016/12/03

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello,
Additionally, it is important to pay attention to whether there is constipation or fecal impaction.
Gastroparesis refers to the condition where the stomach is excessively distended by food, leading to inefficient gastric motility and prolonged gastric emptying time, which prevents food from moving smoothly into the duodenum.
It is recommended to eat smaller, more frequent meals, consume food only when hungry, avoid high-fat and high-protein foods (as they are more difficult to digest), and chew food thoroughly before swallowing.
You may also consider consulting a gastroenterologist to adjust medications that promote gastric motility.

Changhua Hospital cares about your health.

Dr.
Tsai An-shun

Reply Date: 2016/12/03

More Info

Chronic indigestion, characterized by symptoms such as bloating, acid reflux, and a sensation of fullness after eating only small amounts, can be quite distressing and may significantly impact your quality of life. Given that you have been experiencing these symptoms for five years and have not found relief with various medications, it is essential to explore a comprehensive approach to managing your condition.

Understanding Chronic Indigestion
Chronic indigestion, or dyspepsia, can arise from various causes, including functional gastrointestinal disorders, structural abnormalities, or even dietary habits. In your case, the mention of "gastric atony" (or delayed gastric emptying) suggests that your stomach may not be emptying as efficiently as it should, leading to feelings of fullness and bloating. This condition can be exacerbated by factors such as stress, diet, and lifestyle choices.

Potential Solutions
1. Dietary Modifications:
- Smaller, More Frequent Meals: Instead of three large meals, consider eating smaller meals more frequently throughout the day. This can help reduce the burden on your stomach and may alleviate bloating.

- Identify Trigger Foods: Keep a food diary to track what you eat and how it affects your symptoms. Common culprits include fatty foods, spicy foods, caffeine, and carbonated beverages.
- Increase Fiber Gradually: While fiber is essential for digestive health, a sudden increase can lead to bloating. Gradually incorporate fiber-rich foods like fruits, vegetables, and whole grains into your diet.

2. Hydration:
- Ensure you are drinking enough water throughout the day. Staying hydrated can aid digestion and help prevent constipation, which can contribute to bloating.

3. Physical Activity:
- Regular exercise can promote gastric motility and help reduce bloating. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like walking, cycling, or yoga can be particularly beneficial.

4. Medications:
- Since you have already tried various medications without success, it may be worth discussing with your healthcare provider the possibility of trying prokinetic agents, which can help enhance gastric emptying. Additionally, medications that reduce stomach acid, such as proton pump inhibitors (PPIs) or H2 blockers, may be beneficial if acid reflux is a significant concern.

5. Stress Management:
- Stress can exacerbate digestive issues. Consider incorporating stress-reducing techniques such as mindfulness, meditation, or yoga into your routine.

6. Consult a Specialist:
- If you have not already done so, consider seeking a consultation with a gastroenterologist. They can perform further evaluations, such as gastric emptying studies or additional imaging, to better understand the underlying causes of your symptoms.

7. Consider Psychological Factors:
- Sometimes, chronic digestive issues can be linked to psychological factors such as anxiety or depression. Cognitive-behavioral therapy (CBT) or other forms of counseling may help address these underlying issues.

Conclusion
Managing chronic indigestion requires a multifaceted approach that includes dietary changes, lifestyle modifications, and possibly medication adjustments. Since you have been dealing with this condition for an extended period, it is crucial to work closely with your healthcare provider to develop a tailored plan that addresses your specific symptoms and concerns. Regular follow-ups and open communication with your healthcare team will be key in finding an effective solution to your chronic indigestion.

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