Managing Acid Reflux and Bowel Noises: When to Seek Further Testing

Gastroesophageal reflux and bowel sounds?

1.
Three years ago and one year ago, I underwent gastroscopy, which revealed gastroesophageal reflux disease (GERD) and some gastric mucosal erosion.
I was prescribed pantoprazole, and there was improvement at that time.
However, recently the symptoms have started to recur, including frequent belching, regurgitation of sour fluid, and occasional stomach pain after meals (which typically lasts a few seconds and then subsides).
Should I go back to the hospital for another gastroscopy? I am concerned about the long-term risk of developing gastric cancer or esophageal cancer, but I also do not want to undergo repeated endoscopies.
2.
For patients with gastroesophageal reflux, besides plain water, are there other suitable beverages? Additionally, I used to enjoy unsweetened soy milk; can I still drink it now? The information I found online is inconsistent.
3.
During last year's gastroscopy, I frequently experienced borborygmi and flatulence, so a fecal occult blood test was performed, which returned negative.
The doctor mentioned it was not a concern but did not specify any diagnosis.
My symptoms improved slightly afterward, but recently the borborygmi has returned, especially louder at night, and the location of the sounds is variable (sometimes on the right side, sometimes on the left).
Pressing on my abdomen sometimes causes sounds as well, leading to irritability and decreased sleep quality.
Additionally, the shape of my stool varies from being long to somewhat watery, with colors ranging from yellow to dark brown.
I would like to know what my symptoms might indicate and whether I need to undergo further testing.
Thank you, doctor.

Niming, 20~29 year old female. Ask Date: 2020/06/05

Dr. Chen Shidian reply Gastroenterology and Hepatology

To manage reflux symptoms, it is advisable to avoid acidic and sweet foods, as well as coffee and tea.
In short, if a food causes discomfort after eating, it should be avoided.
Additionally, symptoms like abdominal rumbling may indicate irritable bowel syndrome, which can be managed with medication and dietary adjustments.

Reply Date: 2020/06/05

More Info

Managing acid reflux and bowel noises can be quite challenging, especially when symptoms persist or worsen over time. Based on your description, it seems you have a history of gastroesophageal reflux disease (GERD) and have experienced some gastrointestinal symptoms that warrant further evaluation. Here’s a comprehensive response to your concerns:
1. Need for Further Testing: Given your history of GERD, the recurrence of symptoms such as belching, acid regurgitation, and intermittent stomach pain suggests that your condition may not be adequately controlled. While it’s understandable to be apprehensive about undergoing another endoscopy, it is crucial to monitor any changes in your symptoms closely. If you are experiencing significant discomfort or if your symptoms are impacting your quality of life, it may be advisable to consult your gastroenterologist about the possibility of repeating the endoscopy. This can help rule out any complications, such as esophagitis or Barrett's esophagus, which can increase the risk of esophageal cancer over time. Your doctor may also consider other diagnostic tests, such as pH monitoring or esophageal manometry, to assess the severity of your reflux and the function of your esophagus.

2. Dietary Considerations: For individuals with GERD, dietary modifications can play a significant role in managing symptoms. In addition to drinking water, other suitable beverages include herbal teas (like chamomile or ginger tea), which can be soothing. However, it’s best to avoid caffeinated drinks, carbonated beverages, and citrus juices, as these can exacerbate reflux symptoms. Regarding soy milk, it can be a good alternative, but it’s essential to monitor how your body reacts to it. Some individuals with GERD find that soy products can trigger symptoms, while others do not. It may be beneficial to keep a food diary to identify any specific triggers.

3. Bowel Noises and Stool Changes: The bowel noises you are experiencing, especially if they are accompanied by changes in stool consistency and color, could be indicative of several gastrointestinal issues. The intermittent nature of your symptoms, along with the presence of yellow or dark brown stools, may suggest a functional bowel disorder, such as irritable bowel syndrome (IBS). IBS can cause symptoms like abdominal cramping, changes in bowel habits, and increased gas production, leading to audible bowel sounds. It’s also important to consider dietary factors, as certain foods can contribute to gas and bloating. If your bowel noises are persistent and bothersome, or if you notice any alarming changes in your bowel habits (such as blood in the stool, significant weight loss, or persistent abdominal pain), it would be prudent to seek further evaluation from a healthcare professional.

In summary, while it’s understandable to have concerns about undergoing additional testing, monitoring your symptoms closely and discussing them with your healthcare provider is essential. They can help determine the best course of action, whether that involves further testing, medication adjustments, or dietary changes. Remember, managing GERD and gastrointestinal symptoms often requires a multifaceted approach, including lifestyle modifications, dietary changes, and sometimes medication. Keeping an open line of communication with your healthcare team will be key to effectively managing your condition.

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