Digestive Issues: Gas, Bloating, and Abdominal Pain Explained

Q: Digestive Issues: Gas, Bloating, and Abdominal Pain Explained

Hello： If you have already undergone an endoscopy and have taken medication, it is possible that you may experience symptoms related to adhesions. <br>If there are no significant issues, it may be helpful to adjust your mindset and accept these symptoms, engage in more physical a

Gastroenterology and Hepatology

Doctor, my bowel movements are normal, occurring once every one to two days.
I experienced constipation two years ago, and an X-ray showed that I had a lot of stool in my abdomen.
I took laxatives and then my bowel movements returned to normal.
In April of the year before last, I had intermittent sharp pain in my right abdomen that lasted for a short time.
Last June, I underwent a colonoscopy, which was normal.
However, starting in August, I experienced constipation again, and by September, I began to have frequent belching and flatulence, along with bloating.
In November, I had an upper endoscopy at National Taiwan University Hospital, which showed mild inflammation but was otherwise normal.
In December, I consulted a liver transplant doctor about my persistent belching and the intermittent sharp pain in my right abdomen, which lasts a few seconds.
The doctor suggested that the right abdominal pain might be due to adhesions from my previous liver transplant surgery, and that the belching could be a result of slower gastric emptying.
This June, I went to Taipei Medical University for another upper endoscopy, and the doctor diagnosed me with mild gastroesophageal reflux disease (GERD) and prescribed medication for three months.
I have been taking the medication for almost three months, but I still experience belching, which occurs immediately after eating and has the taste of the food I just consumed.
I would like to know if my belching is caused by GERD or if, as the liver transplant doctor suggested, it is due to poor gastric digestion, causing me to belch right after eating.
Additionally, I have been feeling tightness around my clavicle intermittently for the past two and a half years.
An ENT specialist said it was due to laryngeal muscle tension, while a pulmonologist indicated that I have asthma.
However, I feel better after waking up from sleep.
I would like to know what tests I should undergo to determine the cause of the tightness around my clavicle, as well as the cause of my belching.
My bowel movements are currently normal, occurring once every one to two days.
Thank you, doctor, for advising me on what tests I should do to understand the reasons behind my clavicle tightness and belching, as well as the frequent flatulence.

Wenwen, 40~49 year old female. Ask Date: 2018/08/18

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you have already undergone an endoscopy and have taken medication, it is possible that you may experience symptoms related to adhesions.
If there are no significant issues, it may be helpful to adjust your mindset and accept these symptoms, engage in more physical activity, and increase your intake of fruits and vegetables.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2018/08/18

More Info

Digestive issues such as gas, bloating, and abdominal pain can be quite complex and multifactorial. Based on your description, it seems you have been experiencing a range of gastrointestinal symptoms, including gas, bloating, and intermittent abdominal pain, particularly in the right lower quadrant. You also mentioned a history of constipation and a previous diagnosis of gastroesophageal reflux disease (GERD).
Firstly, let's address the issue of gas and bloating. These symptoms can arise from several factors, including dietary choices, gastrointestinal motility issues, and even stress. Foods that are high in fiber, such as beans, lentils, and certain vegetables, can lead to increased gas production. Additionally, carbonated beverages can introduce excess air into the digestive tract, contributing to bloating and discomfort.
You mentioned that you have been experiencing frequent belching and flatulence, which can be indicative of aerophagia (swallowing air) or delayed gastric emptying. The fact that you experience belching immediately after eating could suggest that your stomach is not processing food as efficiently as it should, leading to the rapid release of gas. This could be related to your diagnosis of GERD, as the reflux of stomach contents can irritate the esophagus and lead to increased swallowing of air.

Regarding your abdominal pain, particularly in the right lower quadrant, it is essential to consider various potential causes. While you have undergone a colonoscopy that returned normal results, it is still possible for functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), to be at play. IBS can manifest as abdominal pain, bloating, and changes in bowel habits, including constipation and diarrhea.
The tightness you feel around your clavicle area could be related to muscle tension or anxiety, especially if you have a history of stress or anxiety disorders. It is not uncommon for individuals to experience physical symptoms related to emotional stress, which can manifest as muscle tightness or discomfort in various areas of the body.

To further investigate your symptoms, I would recommend the following steps:
1. Dietary Review: Keep a food diary to identify any specific foods that may trigger your symptoms. Consider working with a dietitian to develop a diet that minimizes gas-producing foods while ensuring you receive adequate nutrition.

2. Gastroenterology Follow-Up: Since you have a history of gastrointestinal issues, a follow-up appointment with a gastroenterologist may be beneficial. They may recommend further testing, such as a gastric emptying study, to assess how well your stomach is processing food.

3. Esophageal Function Testing: If GERD symptoms persist despite medication, esophageal manometry can evaluate how well the esophagus is functioning and whether there are any motility issues contributing to your symptoms.

4. Stress Management: Since muscle tightness can be exacerbated by stress, consider incorporating stress-reduction techniques such as mindfulness, yoga, or cognitive-behavioral therapy.

5. Physical Examination: A thorough physical examination by a healthcare provider can help assess any musculoskeletal issues contributing to your symptoms, particularly around the clavicle area.

6. Pulmonary Evaluation: Given your history of asthma, it may be worthwhile to have a pulmonary function test to ensure that your respiratory symptoms are well-managed and not contributing to your overall discomfort.

In summary, your symptoms of gas, bloating, and abdominal pain could be related to a combination of dietary factors, gastrointestinal motility issues, and possibly stress. A comprehensive approach involving dietary modifications, further gastrointestinal evaluation, and stress management may help alleviate your symptoms. Always consult with your healthcare provider before making any significant changes to your treatment plan.

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