Complex Gastrointestinal Symptoms: Seeking Medical Advice

Complex symptoms, I kindly ask the doctor to take the time to respond. Thank you?

Hello, Doctor.
First, I would like to apologize.
Although I have already been examined, my symptoms have persisted for several months, so there may be multiple issues.
I appreciate your time in responding.

From June to October last year, I lost weight from 92 kg to 77 kg.
Since I stopped working in October, I have been experiencing pain in my shoulders and neck, insomnia, and have been taking sleeping pills, as I can only fall asleep after 3 AM every day.
My weight has increased back to 92 kg.
It has been 5 months, and I still have not improved.
I have undergone many tests and taken various medications with little improvement.

Today, on March 18, I started feeling a slight tightness and pressure just below my chest around March 13.
When I press inward and upward near the bone below my chest with my palm, I feel a sensation that I can't tell if it's fluid or air.
In the first two days after the onset of symptoms, I had a strong urge to burp but couldn't.
In the following days, I constantly felt the need to pass gas, but only a little came out.
After meals, when I go for a walk, I feel nauseous after walking for an hour.
However, I can't distinguish whether the nausea is due to a feeling of pressure in my throat or discomfort in my upper abdomen.
While lying in bed that day, my stomach kept growling, and I felt nauseous.
I do not have the acidic sensation of stomach acid rising to my throat, but occasionally when standing, I sense a slight choking taste in my nose.
1.
Are the above conditions due to indigestion and excessive stomach acid? Is it related to my habit of drinking bitter melon tea immediately after meals?
2.
I have been taking anti-inflammatory medications, muscle relaxants, and sleeping pills for 5 months, and my doctor has not prescribed any antacids.
Could this lead to gastric complications or worsen my condition?
3.
I currently only feel mild discomfort and slight pressure, not severe pain.
If I continue taking medication for how long without improvement should I seek further evaluation?
4.
Lastly, I had an abdominal ultrasound yesterday, and the doctor mentioned that I have small cysts on my liver, which are encapsulated in fat.
However, I feel nauseous when I jog.
What should I do? Thank you very much, Doctor, and I apologize again!

Awei, 30~39 year old female. Ask Date: 2018/03/18

Dr. Chen Qifeng reply Gastroenterology and Hepatology

You may consider undergoing an upper gastrointestinal endoscopy; if no issues are found, it is likely a case of functional dyspepsia.

Reply Date: 2018/03/18

More Info

It sounds like you are experiencing a complex array of gastrointestinal symptoms that have persisted for several months. Your situation is understandably concerning, and I appreciate your detailed description, which helps in understanding the potential underlying issues. Let’s break down your concerns and address them systematically.

1. Digestive Issues and Symptoms: The symptoms you describe, such as chest discomfort, a feeling of pressure, and the urge to belch or pass gas, can indeed be related to digestive issues, including dyspepsia (indigestion) and possibly gastroesophageal reflux disease (GERD). The sensation of pressure in your chest, especially after meals, could indicate that food is not moving efficiently through your digestive tract, leading to discomfort. Drinking bitter melon tea after meals may affect digestion, but it’s essential to consider how your body responds to various foods and beverages. If you notice that certain foods or drinks exacerbate your symptoms, it might be wise to avoid them.

2. Medication Concerns: You mentioned taking anti-inflammatory medications, muscle relaxants, and sleep aids without a prescribed proton pump inhibitor (PPI) or other acid-reducing medications. Long-term use of certain medications can lead to gastrointestinal side effects, including irritation of the stomach lining or changes in gut motility. If you have been experiencing symptoms of gastritis or peptic ulcer disease, it is crucial to discuss these concerns with your healthcare provider. They may recommend an upper endoscopy to evaluate the condition of your stomach and esophagus, especially if you have persistent symptoms.

3. Duration of Symptoms and Need for Further Evaluation: If your symptoms persist despite treatment, it is essential to follow up with your healthcare provider. Generally, if symptoms do not improve after a few weeks of appropriate treatment, further evaluation is warranted. This could include imaging studies, endoscopy, or specialized tests to assess for conditions like gastroparesis (delayed gastric emptying) or other functional gastrointestinal disorders.

4. Ultrasound Findings and Exercise: The ultrasound report indicating small cysts on your liver, described as "oil-filled," should be interpreted in the context of your overall health. While many liver cysts are benign and require no treatment, it’s essential to monitor them, especially if you experience new or worsening symptoms. The nausea you experience while jogging could be related to the pressure in your abdomen or could indicate that your body is not tolerating exercise well at this time. It may be beneficial to start with low-impact activities and gradually increase intensity as your symptoms allow.

In conclusion, your symptoms are multifaceted and may involve both gastrointestinal and possibly psychosomatic components, given your history of stress and anxiety. It’s crucial to maintain open communication with your healthcare provider about your symptoms and treatment progress. They may consider a referral to a gastroenterologist for specialized care. Additionally, lifestyle modifications, including dietary changes, stress management techniques, and possibly cognitive-behavioral therapy, may also be beneficial in managing your symptoms. Remember, it’s essential to listen to your body and seek help when needed.

Similar Q&A

Understanding Digestive Issues: When to Seek Medical Advice

Since the start of last school year (September), I have been experiencing mild pain on the sides of my abdomen and in the four corners. At that time, my bowel movements were not very smooth, and the doctor diagnosed me with constipation, advising me to drink more water and eat ve...

Dr. Luo Yining reply Gastroenterology and Hepatology
If symptoms persist or worsen despite adjustments in lifestyle and dietary habits, it is recommended to consult a pediatrician or a pediatric gastroenterologist for further evaluation and treatment.

Understanding Gastrointestinal Issues: When to Seek Medical Help

Hello, doctor. My cousin seems to have a very poor digestive system. Every time he eats, he has to rush to the bathroom immediately, and it's not just once; it's usually two or three times before he feels better. I would like to ask what kind of problem this symptom mig...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello Ms. Peipei: It is likely that you have Irritable Bowel Syndrome (IBS), which can cause digestive discomfort. You may want to visit a gastroenterology clinic for a basic examination to rule out other possibilities. Additionally, adjusting your diet and managing stress, along...

Understanding Gastrointestinal Issues: Symptoms, Treatments, and Diet Tips

Hello Doctor, I have been experiencing significant gastrointestinal discomfort lately, with a feeling of bloating and fullness in my abdomen. My bowel movements have been watery and frequent. The day before yesterday, I visited a doctor due to fever and vomiting, but I saw a fami...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: The likelihood of acute gastroenteritis is higher, and if accompanied by persistent high fever and abdominal pain in a specific area, it is recommended to consult a gastroenterology specialist. These medications can generally help alleviate your symptoms, and if the acute ...

Chronic Diarrhea and Abdominal Pain: Understanding IBS and Its Symptoms

Hello Dr. Chang, I am 28 years old and have generally had good gastrointestinal health. However, between the ages of 25 and 27, my diet was poor, consuming a cup of bubble tea every day for about six months and frequently eating late-night snacks (grilled food). Around September ...

Dr. Zhang Kebin reply Gastroenterology and Hepatology
Hello, A-Zhen. After examination, no abnormalities were found, and the symptoms have not improved despite treatment. It is recommended that you return to the medical facility where you previously had your check-up (Beirong or Yilan Yangming) for further consultation. Thank you.