Digestive Issues: When to See a Doctor for Your Symptoms

Q: Digestive Issues: When to See a Doctor for Your Symptoms

Dear Mr. <br>Pig： <br>1. <br>The typical symptoms of gastroesophageal reflux disease (GERD) include heartburn, acid regurgitation, dysphagia, epigastric pain, and early satiety. <br>Other atypical symptoms may include endogenous asthma, chronic night cough, hoarseness, reflux lar

Gastrointestinal diseases

Recently, after eating, I feel a sense of hunger as if my stomach is empty.
Could this be a peptic ulcer? I have a history of gastroesophageal reflux disease (GERD) and other stomach issues, but lately, I just feel like my stomach is empty shortly after eating.
I've been eating normally and haven't overeaten.
I'm worried it might be diabetes, but I haven't experienced increased thirst or urination.
Should I see a gastroenterologist or another specialist?

Xiao Zhu, 30~39 year old female. Ask Date: 2021/08/05

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Pig:
1.
The typical symptoms of gastroesophageal reflux disease (GERD) include heartburn, acid regurgitation, dysphagia, epigastric pain, and early satiety.
Other atypical symptoms may include endogenous asthma, chronic night cough, hoarseness, reflux laryngitis, vocal nodules, laryngostenosis, paroxysmal laryngospasm, paranasal sinusitis, non-cardiac chest pain, chronic hiccups, loss of dental enamel, and night sweating, among others.

2.
The clinical manifestations of peptic ulcers are varied and may not be clear-cut.
Patients may present with no symptoms or may experience nausea, vomiting, loss of appetite, belching, bloating, burning sensation, epigastric pain, pressure, or hunger pangs.
Occasionally, pain may radiate to the back or lower abdomen.

3.
According to the diagnostic criteria for diabetes set by the American Diabetes Association, the criteria are: a.
Fasting plasma glucose level ≥126 mg/dL after fasting for more than 8 hours, b.
Plasma glucose level ≥200 mg/dL during a 2-hour oral glucose tolerance test, c.
HbA1c ≥6.5% (this must be confirmed with a method that is NGSP and DCCT certified, and there should be no disproportionate hyperglycemia), and any of the above a, b, or c must be confirmed on two separate occasions.
d.
Clinical symptoms of diabetes (such as polyuria, polydipsia, polyphagia, and weight loss) with a random plasma glucose level ≥200 mg/dL (this can be confirmed with just one test).

4.
Your discomfort may be due to gastroesophageal reflux disease, peptic ulcer, diabetes, or other causes, and there are many uncertainties that need clarification.
Based on your statements, a diagnosis cannot be made lightly.
It is recommended that you discuss this in detail with your primary care physician before making any decisions, or seek care at a gastroenterology clinic at a regional hospital or higher.

Reply Date: 2021/08/05

More Info

When it comes to digestive issues, understanding when to seek medical attention is crucial for your health. Based on your symptoms, it seems you are experiencing a sensation of hunger shortly after eating, along with a history of gastroesophageal reflux disease (GERD). This can indeed be concerning, especially if you are also worried about conditions like diabetes.

Firstly, it's important to clarify that the feeling of hunger soon after eating can have various causes. It could be related to your existing gastrointestinal issues, such as GERD or even gastritis, which can affect how your stomach processes food. In some cases, the sensation of an empty stomach shortly after eating may be due to rapid gastric emptying, where food moves too quickly from the stomach to the small intestine. This can lead to feelings of hunger even when you have recently eaten.

Your concern about diabetes is valid, especially if you have noticed other symptoms such as increased thirst or urination, but you mentioned that you have not experienced these. It's worth noting that diabetes can sometimes present with gastrointestinal symptoms, including gastroparesis, which is a condition that affects the stomach muscles and prevents proper stomach emptying. However, since you are not experiencing the classic symptoms of diabetes, it may be less likely to be the cause of your current symptoms.

Given your history of GERD and the new symptoms you are experiencing, it would be advisable to consult a gastroenterologist. They specialize in digestive system disorders and can provide a thorough evaluation. During your visit, be prepared to discuss your symptoms in detail, including when they started, how often they occur, and any other relevant medical history. This information will help the doctor determine the best course of action, which may include diagnostic tests such as an endoscopy or imaging studies to assess your gastrointestinal tract.

In addition to seeing a gastroenterologist, consider keeping a food diary to track what you eat and how it correlates with your symptoms. This can help identify any potential triggers or patterns that may be contributing to your discomfort. For instance, certain foods may exacerbate GERD symptoms, leading to a sensation of hunger or discomfort after meals.

Moreover, lifestyle modifications can also play a significant role in managing GERD and digestive issues. Eating smaller, more frequent meals rather than large meals can help reduce the burden on your digestive system. Additionally, avoiding trigger foods (such as spicy, fatty, or acidic foods) and not lying down immediately after eating can help alleviate symptoms.

In summary, while your symptoms may be concerning, they can often be managed effectively with the right medical guidance. Consulting a gastroenterologist is a prudent step to take, as they can help determine the underlying cause of your symptoms and recommend appropriate treatment options. Remember, early intervention is key in managing digestive health, so don’t hesitate to seek help.

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