Chronic Stomach Pain and Gastroesophageal Reflux in Teens

Prone to stomach pain, regardless of diet?

Hello, doctor.
I have had stomach pain issues since middle school, which later improved, but I started experiencing recurrent pain.
My gastrointestinal motility is much slower than others; for example, if I eat breakfast at 7 AM, it takes until noon for digestion to complete, leading to pain around 11 or 12 PM.
In high school, I had almost no issues during the first year, but in the past two years, the pain has become more severe, and I even experienced gastroesophageal reflux with a burning sensation in my chest.
Although it only happened once, I discovered that I produce excess stomach acid.
I usually don't eat a lot of unhealthy foods, but regardless of what I eat at school, I always have stomach pain.
I switched to eating steamed buns for a month, which gradually improved my condition, allowing me to slowly reintroduce other foods.
However, I have noticed that in the past month, when I experience stomach pain, it can be severe enough to make me feel dizzy and need to squat down.
The pain often triggers a strong urge to have a bowel movement.
I can only take medication to relieve the pain, but the effects are not immediate, so I frequently endure the pain during class.
I considered getting an endoscopy due to the frequent production of stomach acid.
My parents believe that taking medication will suffice, but I would like to hear the doctor's opinion.
The frequency of the pain is truly concerning, and the gastroesophageal reflux is very uncomfortable.
I hope to avoid future occurrences.
I apologize if my explanation is not clear, but these are the issues I am facing.
Thank you for your help!

Yun, 10~19 year old female. Ask Date: 2018/01/21

Dr. Hong Yuanbin reply Internal Medicine

Hello, the issue you mentioned is indeed a common symptom of gastroesophageal reflux disease (GERD).
It is advisable to consider undergoing an endoscopy to confirm the diagnosis.
If the endoscopy confirms GERD, relevant medications can be prescribed under health insurance.
However, these medications primarily treat the symptoms, as GERD is often related to individual physiological factors.
It is recommended to eat smaller, more frequent meals, avoid lying down immediately after eating, limit coffee and tea intake, engage in appropriate physical activity, and maintain a regular routine.
These measures can help alleviate the symptoms.
Thank you for your inquiry.

Reply Date: 2018/01/21

More Info

Chronic stomach pain and gastroesophageal reflux disease (GERD) are increasingly common issues among teenagers, often exacerbated by lifestyle factors, dietary habits, and stress. Your experience of recurrent stomach pain, slow digestion, and the onset of GERD symptoms is concerning and warrants a comprehensive understanding of the underlying causes and potential management strategies.

Firstly, the symptoms you describe, including delayed digestion and pain that intensifies after meals, suggest a possible functional gastrointestinal disorder. Conditions such as gastroparesis, where the stomach empties slowly, can lead to prolonged feelings of fullness, bloating, and discomfort. This could explain why you experience pain several hours after eating breakfast. Additionally, the burning sensation in your chest is characteristic of GERD, which occurs when stomach acid flows back into the esophagus, often triggered by certain foods, overeating, or lying down shortly after eating.

The fact that you have noticed a correlation between your diet and symptoms is significant. While you mentioned that you do not consume many unhealthy foods, it's essential to recognize that even seemingly healthy foods can trigger reflux in some individuals. Foods that are high in fat, spicy, or acidic can exacerbate GERD symptoms. It may be beneficial to maintain a food diary to identify specific triggers that worsen your condition.

Your decision to switch to a diet of steamed buns for a month seems to have provided some relief, indicating that a bland diet may be easier on your stomach. Gradually reintroducing other foods while monitoring your body's response is a prudent approach. However, persistent pain that leads to dizziness and the need to squat down is concerning and suggests that further evaluation is necessary.

Regarding the use of medication, while it can provide symptomatic relief, it is crucial to address the root cause of your symptoms. Long-term reliance on medications such as proton pump inhibitors (PPIs) or antacids without understanding the underlying issue may not be the best approach. These medications can sometimes mask symptoms rather than treat the condition, and they may have side effects if used excessively.

Given the frequency and severity of your symptoms, I recommend discussing the possibility of undergoing an upper endoscopy (gastroscopy) with your healthcare provider. This procedure allows for direct visualization of the esophagus and stomach, helping to identify any structural abnormalities, inflammation, or ulcers that may be contributing to your symptoms. It can also rule out more serious conditions.

In addition to medical intervention, lifestyle modifications can play a significant role in managing GERD and chronic stomach pain. Here are some strategies you might consider:
1. Dietary Changes: Focus on smaller, more frequent meals rather than large meals. Avoid eating close to bedtime, and try to maintain an upright position for at least two to three hours after eating.

2. Identify Triggers: Keep a food diary to track what you eat and any symptoms that arise. This can help you pinpoint specific foods that may be causing issues.

3. Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating stress-reducing activities such as yoga, meditation, or regular physical exercise into your routine.

4. Hydration: Ensure you are drinking enough water throughout the day, as dehydration can also affect digestion.

5. Consult a Specialist: If symptoms persist, consider consulting a gastroenterologist who can provide specialized care and may recommend additional tests or treatments.

In conclusion, while medications can help manage symptoms, it is essential to investigate the underlying causes of your chronic stomach pain and GERD. A combination of dietary adjustments, lifestyle changes, and possibly further medical evaluation will likely provide the best path toward relief and improved quality of life. Don't hesitate to advocate for your health and seek the necessary evaluations to ensure you receive comprehensive care.

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