Gastrointestinal Issues: Causes and Solutions for Bloating and Belching

Q: Gastrointestinal Issues: Causes and Solutions for Bloating and Belching

Hello： 1. Do not drink too quickly; if swallowing other substances is not an issue, there is no need to worry too much. 2. Belching may indicate that there is gas in the stomach, which could be due to poor gastric emptying or gas in the intestines. 3. If there

Gastrointestinal issues

Hello Doctor, regarding the question I asked you last time, I later went to see a gastroenterologist.
The doctor tested my stool again and said there was no trace of blood, and my blood tests were normal.
My bowel movements are also normal now.
I forgot to ask you a question last time: I started coughing with phlegm around September 25, and I think it started in early October.
I don't know why I have been choking on water easily; it happens almost every time I drink.
This has continued until today, and sometimes I choke while eating as well.
I would like to ask what the reason for this might be.
The frequency of choking on water is not as high as it was at first, but I still experience it almost every day.

1.
Why is this happening, Doctor? Do I need to undergo any tests? Is the choking related to my esophagus? Is there a possibility of esophageal pathology? I am very anxious about this.

2.
Additionally, I had an endoscopy in May, and the doctor mentioned mild gastroesophageal reflux disease (GERD) and prescribed medication for three months.
However, I still experience belching immediately after eating.
On October 27, I had nearly 20 bowel movements, and on the 28th, I was passing gas continuously.
On the 29th, my stool had bubbles, and I was still passing gas.
For these three days, I did not experience any belching after eating.
Why is that? Is my belching issue related to GERD?
3.
Or is it as my liver transplant doctor said, that it is due to poor gastric motility combined with mild intestinal adhesions, causing food to not be digested in time, leading to gas being expelled immediately after eating, even with water? The doctor mentioned that this would not harm the esophagus, correct?
4.
Can excessive gas in the intestines come out through the mouth?
5.
I have undergone endoscopies at both National Taiwan University Hospital and Taipei Medical University.
National Taiwan University Hospital never mentioned that I have GERD, while Taipei Medical University stated that I have mild GERD.
I have another endoscopy scheduled at National Taiwan University on December 19, and I have been having endoscopies every six months.
I seem to have started experiencing constipation, bloating, and gas since August of last year, which has led to my current belching issues.
Previously, I hardly passed gas, but since last August, I have been passing gas daily.
Why is this happening? Thank you, Doctor.

Wenwen, 40~49 year old female. Ask Date: 2018/11/15

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
Do not drink too quickly; if swallowing other substances is not an issue, there is no need to worry too much.
2.
Belching may indicate that there is gas in the stomach, which could be due to poor gastric emptying or gas in the intestines.
3.
If there is not too much stomach acid reaching the esophagus, water or air will not harm the esophagus.
4.
It will.
5.
It is recommended to exercise more and manage your mood; there is no need to be overly concerned about belching and flatulence symptoms.
After all, releasing gas is certainly better than having it accumulate in the body.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2018/11/15

More Info

Gastrointestinal issues, particularly bloating and belching, can be quite distressing and are often linked to various underlying conditions. Based on your description, it seems you have been experiencing a range of symptoms, including difficulty swallowing, frequent belching, and changes in bowel habits. Let's break down these issues and explore potential causes and solutions.

Understanding Your Symptoms
1. Bloating and Belching: These symptoms can arise from several factors, including dietary choices, gastrointestinal motility issues, and even stress. Bloating often occurs when gas builds up in the digestive tract, which can be exacerbated by swallowing air while eating or drinking. Foods that are high in fiber, carbonated beverages, and certain carbohydrates can also contribute to gas production.

2. Difficulty Swallowing (Dysphagia): The sensation of choking or difficulty swallowing water could indicate a problem with the esophagus. This could be due to inflammation, strictures, or motility disorders. Given your history of gastroesophageal reflux disease (GERD), it’s possible that the reflux has caused some irritation or changes in the esophagus, leading to these symptoms.

3. Gastroesophageal Reflux Disease (GERD): You mentioned a diagnosis of mild GERD. This condition can lead to symptoms like heartburn, regurgitation, and belching. The reflux of stomach contents can irritate the esophagus, and if the esophagus is inflamed, it may not function properly, contributing to swallowing difficulties.

4. Bowel Changes: The changes in your bowel habits, including episodes of diarrhea and gas, may be related to dietary factors or an underlying condition such as irritable bowel syndrome (IBS). IBS can cause symptoms like bloating, gas, and altered bowel habits, often triggered by stress or certain foods.

Potential Causes
- Dietary Factors: High-fat foods, dairy products, and certain carbohydrates (like beans and lentils) can lead to increased gas production. Keeping a food diary may help identify specific triggers.

- Gastrointestinal Motility Issues: Conditions that affect how food moves through the digestive tract can lead to symptoms like bloating and belching. If food moves too slowly, it can ferment in the gut, producing gas.

- Esophageal Issues: As mentioned, inflammation or structural changes in the esophagus can lead to dysphagia and may also contribute to reflux symptoms.

Recommendations
1. Dietary Modifications: Consider a low-FODMAP diet, which can help reduce bloating and gas. This diet limits certain fermentable carbohydrates that can cause gastrointestinal distress. Additionally, eating smaller, more frequent meals can help reduce the amount of air swallowed and ease symptoms.

2. Hydration and Eating Habits: When drinking water, try to sip slowly to minimize the risk of choking. Avoid talking while eating, as this can increase air swallowing.
3. Medical Evaluation: Given your ongoing symptoms, it may be beneficial to undergo further evaluation. An esophagogastroduodenoscopy (EGD) can assess for any structural abnormalities in the esophagus. Additionally, a motility study may help determine if there are issues with how your esophagus is functioning.

4. Follow-Up with Specialists: Since you have a history of liver transplant and gastrointestinal issues, maintaining regular follow-ups with your gastroenterologist and transplant team is crucial. They can provide tailored advice and monitor any changes in your condition.

5. Stress Management: Stress can exacerbate gastrointestinal symptoms. Techniques such as mindfulness, yoga, or cognitive behavioral therapy may help manage stress levels and improve your overall digestive health.

Conclusion
Your symptoms of bloating, belching, and difficulty swallowing can be interconnected and may stem from a combination of dietary habits, gastrointestinal motility issues, and underlying conditions like GERD. By making dietary adjustments, monitoring your symptoms, and seeking further medical evaluation, you can work towards alleviating these distressing symptoms. Always consult with your healthcare provider before making significant changes to your diet or treatment plan.

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