Gastrointestinal Symptoms: When to Seek Medical Advice

Gastrointestinal issues?

Hello Doctor, I have been experiencing a sensation of a foreign body in the epigastric region and near the chest for the past few months.
It feels dry and constricted, and sometimes I have belching and a slight warmth in my chest.
I would like to know what symptoms these might indicate.
Additionally, I had an upper gastrointestinal endoscopy a year and a half ago, which showed only mild gastritis.
Is it possible that this could have progressed to the most feared condition, gastric cancer (I found online that a sensation of a foreign body could be a sign of cancer)? Given that I had an endoscopy a year and a half ago, do I need to undergo another one? Or could this be an issue related to the esophagus instead of the stomach? Thank you, Doctor, for your assistance.

A Feng, 40~49 year old female. Ask Date: 2020/02/13

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is likely that the esophagitis or foreign body sensation is caused by acid reflux.
Start by taking antacids, maintain a normal diet while avoiding acidic and sweet foods, and if necessary, use an endoscopy for confirmation.

Reply Date: 2020/02/13

More Info

It sounds like you are experiencing a range of gastrointestinal symptoms that are causing you significant concern. Based on your description, you have been feeling a sensation of something stuck in your chest area, along with occasional belching and a feeling of warmth in your chest. You also mentioned having undergone an endoscopy a year and a half ago, which revealed mild gastritis.
First and foremost, it’s important to understand that gastrointestinal symptoms can arise from a variety of conditions, and not all of them are serious. The sensation of an obstruction or "foreign body" feeling in the chest area could be related to several factors, including gastroesophageal reflux disease (GERD), esophagitis, or even anxiety-related symptoms. GERD, for instance, can cause acid to flow back into the esophagus, leading to discomfort, a burning sensation, and the feeling of something being stuck.

Given that you have a history of mild gastritis, it is also possible that your symptoms are related to this condition. Gastritis can cause discomfort in the upper abdomen and may lead to feelings of fullness or pressure. However, the presence of new or worsening symptoms, especially those that include a sensation of a lump in the throat or chest, warrants further investigation.

Regarding your concern about the possibility of gastric cancer, it is understandable to feel anxious, especially when researching symptoms online. While it is true that certain symptoms can be associated with more serious conditions, it is essential to remember that many benign conditions can also present similarly. The risk of gastric cancer is generally low in individuals with mild gastritis, especially if there are no alarming symptoms such as significant weight loss, persistent vomiting, or gastrointestinal bleeding.

Since it has been a year and a half since your last endoscopy, and considering the new symptoms you are experiencing, it would be prudent to consult with your healthcare provider. They may recommend repeating the endoscopy to assess the current state of your stomach and esophagus. This procedure can help rule out any serious conditions, including cancer, and provide a clearer picture of your gastrointestinal health.

In addition to endoscopy, your doctor may suggest other diagnostic tests, such as an upper gastrointestinal series (barium swallow) or esophageal manometry, to evaluate how well your esophagus is functioning. These tests can help identify any motility issues or structural abnormalities that may be contributing to your symptoms.

In the meantime, there are several lifestyle modifications you can consider to help alleviate your symptoms. Eating smaller, more frequent meals, avoiding trigger foods (such as spicy or fatty foods), and not lying down immediately after eating can help reduce reflux symptoms. Additionally, managing stress through relaxation techniques or counseling may also be beneficial, as stress can exacerbate gastrointestinal discomfort.

In summary, while your symptoms are concerning, they do not necessarily indicate a serious condition. However, given the changes in your symptoms since your last evaluation, it is advisable to seek medical advice promptly. Your healthcare provider can guide you through the necessary steps to diagnose and manage your symptoms effectively. Remember, early intervention is key in addressing any potential issues and ensuring your gastrointestinal health.

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