Managing Gastrointestinal Discomfort: Insights on Symptoms and Treatment

Gastrointestinal discomfort, with intermittent nausea and dry heaving?

Hello Dr.
Chang, I had two gastroscopies 1 to 2 years ago, during which Helicobacter pylori was detected.
After treatment and medication, I underwent another gastroscopy to confirm that the treatment was successful and my gastric discomfort had alleviated.
The doctor noted that aside from the abnormal H.
pylori, I had excessive gastric acid secretion, bile reflux (possibly due to anxiety during the procedure), a relaxed lower esophageal sphincter, gastroesophageal reflux disease (GERD), and redness in the gastric wall without ulceration.
I also experienced some insomnia, but there were no abnormalities in the esophagus.
An abdominal ultrasound showed no issues.
However, to this day, my condition fluctuates.
Whenever I consume foods that are high in sugar or fat, I experience persistent nausea, dry heaving, and discomfort, which leads to a loss of appetite.
Additionally, I have poor gastric absorption, with a height of 177 cm and a weight of 53 kg, indicating a problem with being underweight.
I have bowel movements every 1 to 2 days and often feel a sensation of tightness in my throat.
I also have nasal allergies, which make me feel like there is phlegm stuck in my throat, but I tend to swallow it.
I often feel overly anxious, and I'm unsure if this contributes to my symptoms.
Could you please advise me on how to improve my overall condition, and are there any other potential symptoms I should be aware of? Thank you for your guidance!

Xiang, 20~29 year old female. Ask Date: 2020/12/20

Dr. Zhang Kebin reply Gastroenterology and Hepatology

Dear Mr.
Hsiang,
Regarding your previous upper gastrointestinal endoscopy, the findings included: 1.
Helicobacter pylori infection, 2.
Bile reflux, 3.
Relaxation of the lower esophageal sphincter, 4.
Gastroesophageal reflux disease (GERD), and 5.
Erythema of the gastric wall without ulceration.
Additionally, you mentioned that consuming excessive amounts of sweet or fatty foods leads to persistent nausea, dry heaving, and discomfort, resulting in a lack of appetite and low body weight, along with a sensation of tightness in the throat.
I am not certain about the treatment you received following your endoscopy.
Given the possibility of recurrent gastritis and gastroesophageal reflux, I recommend that you consult with a gastroenterologist at a hospital for further discussion.
Thank you!

Reply Date: 2020/12/20

More Info

Managing gastrointestinal discomfort can be quite challenging, especially when symptoms are persistent and affect your quality of life. Based on your description, it seems you have a history of gastrointestinal issues, including the presence of Helicobacter pylori, acid reflux, and possibly functional gastrointestinal disorders. Here’s a comprehensive overview of your situation and some suggestions for self-management and treatment options.

Understanding Your Symptoms
1. Gastroesophageal Reflux Disease (GERD): Your symptoms of heartburn, regurgitation, and discomfort after eating high-sugar or fatty foods suggest that you may be experiencing GERD. This condition occurs when stomach acid flows back into the esophagus, leading to irritation and discomfort.

2. Functional Dyspepsia: The sensation of fullness, nausea, and the feeling of having a lump in your throat could indicate functional dyspepsia, which is characterized by chronic or recurrent pain or discomfort in the upper abdomen without any identifiable organic cause.

3. Anxiety and Stress: You mentioned being overly anxious, which can exacerbate gastrointestinal symptoms. Stress can lead to increased stomach acid production and may contribute to feelings of nausea and discomfort.

4. Dietary Triggers: Foods high in sugar and fat can slow gastric emptying and increase the likelihood of reflux. It’s essential to identify and avoid these triggers to manage your symptoms better.

Self-Management Strategies
1. Dietary Modifications:
- Avoid Trigger Foods: Stay away from spicy, fatty, or sugary foods that can exacerbate your symptoms. Instead, focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.

- Eat Smaller Meals: Instead of three large meals, try eating smaller, more frequent meals throughout the day to reduce the burden on your digestive system.

- Stay Hydrated: Drink plenty of water, but avoid drinking large amounts during meals, as this can increase stomach pressure and reflux.

2. Lifestyle Changes:
- Elevate Your Head While Sleeping: If you experience nighttime symptoms, consider elevating the head of your bed to prevent acid reflux during sleep.

- Avoid Lying Down After Eating: Wait at least two to three hours after eating before lying down to allow for proper digestion.

- Manage Stress: Incorporate stress-reducing techniques such as mindfulness, yoga, or deep-breathing exercises into your daily routine.

3. Medication Adherence:
- Continue taking any prescribed medications, such as proton pump inhibitors (PPIs) or H2 blockers, as directed by your physician. These medications can help reduce stomach acid production and alleviate symptoms.

4. Regular Follow-ups:
- Since your symptoms have been persistent, it’s crucial to maintain regular follow-ups with your healthcare provider. They may recommend further testing or adjustments to your treatment plan based on your ongoing symptoms.

When to Seek Further Medical Attention
If your symptoms worsen or do not improve with self-management strategies, it’s essential to consult your healthcare provider. They may consider additional diagnostic tests, such as an upper GI series or esophageal pH monitoring, to assess the severity of your condition. Given your history of weight loss and gastrointestinal discomfort, it’s vital to rule out any serious underlying conditions.

Conclusion
Managing gastrointestinal discomfort requires a multifaceted approach that includes dietary modifications, lifestyle changes, and adherence to medication. By identifying triggers and making conscious choices about your diet and stress management, you can significantly improve your symptoms and overall quality of life. Always keep an open line of communication with your healthcare provider to ensure that your treatment plan is effective and tailored to your needs.

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