Gastrointestinal Issues: Seeking Answers for Nausea and Pain

Gastrointestinal issues

Hello Doctor, I often feel nauseous.
Last summer, I underwent an upper gastrointestinal endoscopy and took Nexium for two months, which improved my stomach pain and gastroesophageal reflux.
This year, last month, I went to the hospital again due to abdominal pain (mainly stomach pain).
Upon the doctor's recommendation, I paid out of pocket for a Helicobacter pylori test, which showed the presence of bacteria but did not meet the criteria for an ulcer.
I then self-funded a two-week course of antibiotics to eradicate the bacteria, and it has been about a month since then.
I can return to the hospital for follow-up testing.
During this month, I also consulted a traditional Chinese medicine practitioner, who indicated that I clearly have acid reflux.
After taking the medication for two weeks, my nausea still fluctuates.
I would like to ask the doctor if I need to undergo any further tests to rule out other diseases.
Thank you for your assistance.

Ellis, 20~29 year old female. Ask Date: 2017/06/15

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Dear Ellis, gastroesophageal reflux disease (GERD) is not something that will resolve on its own; it requires a combination of medication and lifestyle modifications (such as increased exercise, a diet rich in fruits and vegetables, and adequate hydration).
Therefore, symptoms may fluctuate.
If your condition persists, it is advisable to consult your doctor for further evaluation and testing.
Thank you for your inquiry.
Changhua Hospital cares about your health.

Reply Date: 2017/06/15

More Info

Hello! It sounds like you’ve been dealing with a complex set of gastrointestinal issues, and I can understand how concerning this must be for you. Based on your description, it seems that you have experienced a combination of symptoms including nausea, abdominal pain, and gastroesophageal reflux disease (GERD).
From your history, it appears that you had an initial improvement with the use of medications like Naproxen, which is a non-steroidal anti-inflammatory drug (NSAID) that can sometimes exacerbate gastrointestinal issues, particularly if used long-term. The subsequent discovery of Helicobacter pylori (H. pylori) infection is significant, as this bacterium is known to be associated with gastritis and peptic ulcers. Although your infection was not severe enough to meet the criteria for an ulcer, it can still cause considerable discomfort and symptoms like nausea and pain.

You mentioned that you underwent a two-week course of antibiotics to eradicate the H. pylori. This is a standard treatment, and it’s essential to follow up with your healthcare provider to confirm whether the bacteria have been successfully eliminated. A breath test or stool antigen test can be performed to check for the presence of H. pylori after treatment.

Regarding your ongoing symptoms of nausea and the feeling of wanting to vomit, these could be related to several factors. First, the presence of GERD can lead to symptoms of nausea, especially if stomach acid is refluxing into the esophagus. This can irritate the lining of the esophagus and lead to a sensation of nausea. Additionally, if you have gastritis (inflammation of the stomach lining), this can also contribute to feelings of nausea and discomfort.

It’s also worth considering dietary factors. Certain foods can exacerbate GERD symptoms, such as spicy foods, fatty foods, chocolate, caffeine, and alcohol. Keeping a food diary to track what you eat and how it affects your symptoms can be beneficial.
In terms of further investigations, if your symptoms persist despite treatment, it may be worthwhile to consider additional tests. An upper endoscopy (EGD) can provide a direct view of the esophagus, stomach, and duodenum, allowing for the assessment of any inflammation, ulcers, or other abnormalities. If you haven’t had a complete evaluation of your gastrointestinal tract, including the small intestine and colon, a colonoscopy might also be recommended, especially if you have any changes in bowel habits or persistent abdominal pain.

Additionally, if you are experiencing significant anxiety or stress related to your symptoms, this could also exacerbate gastrointestinal issues. It may be helpful to discuss your symptoms with a mental health professional who can assist with strategies to manage anxiety, which can, in turn, help alleviate some of your gastrointestinal symptoms.

In summary, it’s crucial to follow up with your healthcare provider regarding your H. pylori treatment and consider further evaluation if your symptoms do not improve. Keeping track of your diet, managing stress, and possibly seeking a referral to a gastroenterologist for further testing could be beneficial steps in addressing your ongoing issues. Remember, you are not alone in this, and there are effective treatments available to help you feel better.

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