Digestive Issues: Low Blood Pressure, Bloating, and Appetite Concerns

Dyspepsia

Hello, Dr.
Chen.
My blood pressure seems to be on the low side (85-95/50-60), and I often experience unexplained dizziness, especially after lunch.
Could this be postprandial hypotension? Is this normal? For some time now, I have been experiencing frequent bloating, and I feel the urge to burp but can't.
Sometimes, when I try to burp while bending over, I feel nauseous.
During this bloating period, my bowel movements have been irregular; I either have diarrhea for no apparent reason or feel the urge to go but don't want to once I'm in the restroom.
Additionally, my stools often visibly contain food remnants.
A previous doctor suggested that this could be due to eating too quickly or overeating.
However, I eat a normal amount, not large, and my appetite is poor due to digestive issues, so I don't eat much.

Moreover, there is a family history of diabetes on my father's side, and I seem to be less sensitive to hunger and satiety cues (in my teens, I often went two or three meals without eating and didn't feel hungry until I felt dizzy; after eating, I realized I wasn't dizzy anymore, which made me aware that I might not feel hunger?).
Therefore, even when I don't feel like eating, I still do to avoid being hungry or having irregular meals.
My appetite fluctuates; there are periods when I have no appetite for several days, and even when I eat, I sometimes feel nauseous (feeling bloated or having aversions to greasy foods).

Doctor, given that I eat three meals a day, what could be causing my stomach discomfort and bowel issues? Could the dizziness be related to digestive problems or possibly anemia (as I have mild anemia)? Thank you for your time and answers!

zoo, 20~29 year old female. Ask Date: 2017/10/17

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
Your symptoms should still be evaluated by a physician.
On the other hand, you can monitor for any weight loss and check for occult blood in your stool and anemia.
If everything is normal, you should only need to adjust your mood and dietary habits.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2017/10/17

More Info

Hello! Thank you for your detailed inquiry regarding your digestive issues, low blood pressure, and associated symptoms. Based on the information you've provided, it seems that you are experiencing a combination of gastrointestinal discomfort, low blood pressure, and possibly some underlying issues related to your appetite and digestion.

Understanding Your Symptoms
1. Low Blood Pressure (Hypotension): Your blood pressure readings of 85-95/50-60 mmHg indicate that you are experiencing low blood pressure. This can lead to symptoms such as dizziness, especially after meals, which is often referred to as postprandial hypotension. This condition occurs when blood pressure drops significantly after eating, as blood is redirected to the digestive system to aid in digestion, which can result in insufficient blood flow to the brain and other areas, causing dizziness or lightheadedness.

2. Bloating and Digestive Issues: The bloating and difficulty in passing gas, along with the sensation of wanting to vomit when bending over, could be indicative of gastrointestinal dysmotility or other digestive disorders. The fact that you see food remnants in your stool may suggest that your body is not fully digesting food, which can occur if you are eating too quickly or if there is an underlying issue with your digestive system, such as gastritis or irritable bowel syndrome (IBS).

3. Appetite Concerns: Your description of fluctuating appetite and the inability to sense hunger or fullness properly may be linked to your digestive issues or could be a sign of a metabolic or hormonal imbalance. Given your family history of diabetes, it’s important to monitor your blood sugar levels, as issues with insulin sensitivity can affect appetite and energy levels.

4. Anemia: You mentioned having mild anemia, which can contribute to feelings of fatigue and dizziness. Anemia can be caused by various factors, including nutritional deficiencies (like iron or vitamin B12), chronic diseases, or gastrointestinal bleeding. It’s essential to address this with your healthcare provider, as it could be a significant factor in your symptoms.

Recommendations
1. Dietary Adjustments: Consider eating smaller, more frequent meals rather than larger ones to help manage postprandial hypotension. This can help prevent significant drops in blood pressure after eating. Focus on a balanced diet rich in whole grains, lean proteins, fruits, and vegetables, and avoid overly processed or high-fat foods that may exacerbate bloating.

2. Hydration: Ensure you are well-hydrated, as dehydration can worsen low blood pressure. Drinking fluids before meals can also help maintain blood volume.

3. Monitor Blood Pressure: Keep track of your blood pressure regularly, especially after meals. If you notice significant drops, it’s essential to discuss this with your healthcare provider.

4. Medical Evaluation: Given your symptoms, it would be prudent to consult with a gastroenterologist to evaluate your digestive health further. They may recommend tests such as an upper endoscopy or imaging studies to assess for any underlying gastrointestinal conditions.

5. Blood Tests: Regular blood tests to monitor your hemoglobin levels and check for any nutritional deficiencies can help manage your anemia and overall health.

6. Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating stress-reducing techniques such as mindfulness, yoga, or gentle exercise into your routine.

Conclusion
Your symptoms of low blood pressure, bloating, and appetite issues are interconnected and warrant a comprehensive evaluation. It’s crucial to work closely with your healthcare provider to address these concerns, as they can help tailor a management plan that suits your specific needs. Remember, maintaining open communication with your healthcare team is vital for effectively managing your health.

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