Abdominal Bloating: Causes, Symptoms, and Solutions

Abdominal bloating issues?

Hello Doctor: A month ago, I initially only experienced some noises in my abdomen, which I thought were related to digestion and didn’t pay much attention to.
However, over the past month, my symptoms have gradually developed into the following conditions: 1.
Persistent upper abdominal bloating (sometimes it feels better), but there is no pain or diarrhea.
2.
My stomach makes gurgling and watery sounds every time I eat.
3.
Regardless of whether I am full or hungry, I frequently pass gas and burp (the frequency has significantly increased).
4.
When I lie flat to sleep, my stomach makes gurgling and watery sounds, and when I sit up, I burp to release gas.
5.
Recently, I have started to feel something rising in my esophagus while sleeping at night, and I have to sit up to let it go down, followed by burping, but it does not cause pain.
6.
After having a bowel movement in the morning, my stomach also makes noises, and I feel the urge to defecate again.

Here are my current physical conditions: 1.
I do not smoke or drink alcohol, do not eat spicy food or late-night snacks, and do not eat for two hours before bedtime.
I rarely consume desserts or snacks.
My meal times are irregular but not frequent.
2.
I have a bowel movement almost every day, and it feels normal as it used to.
The stool is formed, with a color of light brown to yellowish, although there have been a few instances of unformed stool recently.
3.
I have been experiencing a scratchy throat and cough.
Two weeks ago, I visited an ENT specialist, who examined my nose and throat and asked if I had any abdominal issues.
After informing him of my symptoms, he suspected gastroesophageal reflux disease (GERD) and prescribed medication to prevent reflux.
4.
Yesterday, I saw a pulmonologist, had an X-ray, and the doctor also inquired about any abdominal issues.
After explaining my situation, he prescribed medication for bloating and to prevent reflux.
My questions are: 1.
What do you think about the symptoms I described above? I would like to hear your opinion.
2.
The previous two doctors diagnosed me with GERD, but I have not felt any significant reflux symptoms this month, and my throat continues to feel itchy with occasional coughs that are not painful.
Is this really related? 3.
I plan to see a gastroenterologist soon; will I need to undergo an endoscopy? 4.
Could these symptoms be related to stress? Thank you, Doctor, for taking the time to answer my questions.

Chung, 20~29 year old female. Ask Date: 2018/11/22

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, I have been experiencing sounds in my abdomen, frequent belching, and occasional discomfort and pain in the upper abdomen.
At night, I feel something rising into my esophagus, causing a scratchy throat and cough.
After an examination by an otolaryngologist, there is a suspicion of gastroesophageal reflux disease (GERD), and a recommendation has been made for an endoscopy to check for ulcers, duodenal deformities, or signs of reflux.
GERD is related to the pressure at the junction of the esophagus and stomach, which can be influenced by medications and diet.
Increased stress can lead to higher gastric acid secretion, which may contribute to the development of duodenal or gastric ulcers.
Typical symptoms of GERD include acid reflux and heartburn, but atypical symptoms may also occur, such as asthma, chest pain, hoarseness, difficulty swallowing, dental erosion, and sleep disturbances.
Wishing you peace and health! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2018/11/22

More Info

Abdominal bloating can be a perplexing and uncomfortable condition, often accompanied by various symptoms that can lead to confusion regarding its underlying causes. Based on your description, it seems you have been experiencing a range of gastrointestinal symptoms for about a month, including persistent upper abdominal bloating, increased flatulence, audible bowel sounds, and sensations of reflux. Let's break down these symptoms and explore potential causes, as well as solutions.

Possible Causes of Your Symptoms
1. Gastroesophageal Reflux Disease (GERD): Your symptoms of bloating, belching, and the sensation of something rising in your esophagus could indeed be related to GERD. This condition occurs when stomach acid frequently flows back into the esophagus, leading to irritation. The fact that you have been prescribed medication for reflux suggests that your healthcare providers are considering this diagnosis.

2. Irritable Bowel Syndrome (IBS): The combination of bloating, increased gas, and changes in bowel habits could indicate IBS, a common functional gastrointestinal disorder. Stress and dietary factors often exacerbate IBS symptoms. While you mentioned that you manage stress well, it’s worth considering whether there are any underlying stressors that might be affecting your gut health.

3. Food Intolerances or Sensitivities: Sometimes, specific foods can trigger bloating and gas. Common culprits include lactose (found in dairy), gluten (found in wheat products), and certain fermentable carbohydrates (FODMAPs). Keeping a food diary to track what you eat and how it affects your symptoms could be beneficial.

4. Gastritis or Stomach Ulcers: Inflammation of the stomach lining (gastritis) or the presence of ulcers can lead to bloating and discomfort. If you have a history of NSAID use or excessive alcohol consumption, these could be contributing factors.

5. Functional Dyspepsia: This condition is characterized by chronic or recurrent pain or discomfort in the upper abdomen, often associated with bloating, early satiety, and nausea. It can be triggered by stress, dietary habits, or gastrointestinal motility issues.

Recommendations for Management
1. Dietary Modifications: Consider adopting a low-FODMAP diet temporarily to identify any food triggers. This involves eliminating high-FODMAP foods and gradually reintroducing them to see if symptoms worsen.

2. Medication: Since you have already been prescribed medications for GERD and bloating, ensure you follow up with your healthcare provider if symptoms persist. They may consider adjusting your medication or exploring other options, such as prokinetics or antispasmodics.

3. Stress Management: Even if you feel you manage stress well, incorporating relaxation techniques such as mindfulness, yoga, or deep-breathing exercises can positively impact gut health.

4. Follow-Up with a Gastroenterologist: Since you plan to see a gastroenterologist, it may be worthwhile to discuss the possibility of an endoscopy (gastroscopy) if your symptoms do not improve. This procedure can help visualize the esophagus and stomach lining to rule out any serious conditions.

5. Regular Monitoring: Keep track of your symptoms, dietary intake, and any changes in your bowel habits. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

Conclusion
Your symptoms of abdominal bloating and associated discomfort can stem from various gastrointestinal issues, including GERD, IBS, food intolerances, or functional dyspepsia. It’s essential to work closely with your healthcare providers to identify the underlying cause and develop an effective management plan. By making dietary adjustments, managing stress, and following up with specialists, you can work towards alleviating your symptoms and improving your overall digestive health.

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