Common Gastrointestinal Questions After Doctor Visits: Insights and Answers

Follow-up questions after seeing the doctor~

Hello Dr.
Chen, I received a lot of information during my medical visit, and there are still some areas I'm unclear about, so I have some questions online:
1.
Can lesions in the fundus of the stomach be seen through an endoscopy?
2.
How can wounds or bloating in the colon and stomach cause left chest tightness and heart pain? (I previously consulted with thoracic and cardiology specialists for a long time...
even had a chest CT scan that showed no abnormalities.
Later, an X-ray revealed that the colon's pathway is very high, climbing along the ribs to the xiphoid process and then descending, so I'm unsure whether the symptoms in my chest are caused by the fundus of the stomach or the colon.)
3.
Is belching on an empty stomach a common symptom of ulcers and reflux? Where does this gas come from? (Even when taking medication to suppress gastric acid secretion, I still experience some gas on an empty stomach, and I'm curious where it originates from without gastric acid!) Thank you for clarifying my doubts!

YYY, 20~29 year old female. Ask Date: 2017/02/05

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Endoscopic examination of lesions in the gastric fundus is visible.
Gastric diseases, including gastroesophageal reflux disease (GERD), are more likely to present with symptoms such as retrosternal discomfort.
The occurrence of belching is associated with impaired gastric emptying, which can be caused by conditions such as gastritis, peptic ulcers, or gastroparesis.

Reply Date: 2017/02/05

More Info

Hello! Thank you for your questions regarding gastrointestinal issues. It's completely understandable to feel overwhelmed with information after a doctor's visit, and I'm here to help clarify your concerns.

1. Can lesions in the fundus of the stomach be seen during an endoscopy?
Yes, lesions in the fundus of the stomach can typically be visualized during an upper gastrointestinal endoscopy (EGD). The fundus is the upper part of the stomach, and during the procedure, the endoscope allows the physician to examine the lining of the stomach for any abnormalities, such as ulcers, tumors, or inflammation. If a lesion is detected, the doctor may take a biopsy for further analysis. However, the visibility can depend on the size and nature of the lesion, as well as the skill of the endoscopist.

2. How can wounds or bloating in the colon or stomach cause left chest tightness and heart pain?
Gastrointestinal issues can indeed manifest as referred pain in the chest area. The vagus nerve, which innervates both the heart and the gastrointestinal tract, can transmit pain signals that may be interpreted as originating from the heart. Conditions such as bloating or distension in the stomach or colon can lead to increased pressure in the abdominal cavity, which may irritate the diaphragm and cause discomfort in the chest. Additionally, gas buildup can create sensations that mimic cardiac symptoms. It's crucial to differentiate between gastrointestinal pain and cardiac issues, so if you experience persistent chest pain, it’s essential to seek medical attention.

3. Is belching on an empty stomach a common symptom of ulcers and reflux? Where does this gas come from?
Yes, belching can be a common symptom associated with both peptic ulcers and gastroesophageal reflux disease (GERD). When the stomach is empty, the production of gastric acid continues, and if there is an imbalance, it can lead to irritation of the stomach lining and esophagus, resulting in symptoms like belching. The gas that is belched can come from swallowed air (aerophagia) or from the breakdown of food in the stomach. Even when acid production is suppressed by medications, gas can still form due to fermentation processes in the stomach or intestines, or from the air that is swallowed during eating or drinking.

In summary, your symptoms are interconnected, and it’s essential to communicate openly with your healthcare provider about them. If you continue to experience discomfort or if your symptoms worsen, further evaluation may be necessary. This could include additional imaging studies or referrals to specialists, such as a gastroenterologist, who can provide more targeted care based on your specific situation.

If you have any more questions or need further clarification, feel free to ask! Your health is important, and understanding your condition is a key part of managing it effectively.

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