Gastrointestinal issues and concerns related to autonomic nervous system imbalance?
Hello doctor, I used to have a habit of eating late-night snacks and going to bed immediately after, which led to issues with chest tightness.
At the time, I didn't know what the problem was.
After undergoing an echocardiogram and an electrocardiogram, which showed no issues, I was referred to a gastroenterology clinic.
Before seeing the doctor, I experienced symptoms such as heartburn, chest tightness, diarrhea, and chills.
The physician diagnosed me with gastroesophageal reflux disease (GERD) and prescribed medication.
After taking the medication, the chest tightness resolved.
I also asked the doctor about stomach cancer; while the heartburn has subsided, I still feel some discomfort in my gastrointestinal tract, occasionally experiencing sudden nausea.
I tend to research medical information online, but I often come across alarming information suggesting stomach cancer, which makes me very anxious.
So far, I have undergone abdominal ultrasound, autonomic nervous system testing, and the ultrasound showed no issues.
The doctor felt that an endoscopy was unnecessary, and after the ultrasound, he indicated that I do not have fatty liver disease.
I am naturally prone to anxiety, and the gastroenterologist explained that the incidence of stomach cancer at my age is very low and advised me not to overthink it.
I have consulted many doctors, including family medicine, hepatobiliary gastroenterology, and traditional Chinese medicine practitioners, all of whom suggested that I have health anxiety.
I frequently visit clinics, and after seeing a psychiatrist, I was diagnosed with significant health anxiety.
Many doctors have explained that I have autonomic nervous system imbalance, as I have multiple discomforts in my body.
Recently, my gastrointestinal discomfort has returned.
Additionally, I used to feel nauseous whenever I was anxious, which has been the case since childhood.
Recently, I have experienced some sharp pain in my upper abdomen, which feels like a tender spot when I press on it.
Online sources suggest that upper abdominal pain could be a precursor to stomach cancer, along with heartburn and bloating, which heightens my anxiety.
I also consulted a traditional Chinese medicine doctor about whether I should have an endoscopy, and he said it was unnecessary.
However, I am very sensitive, and any discomfort in my stomach makes me anxious.
Previously, I asked the gastroenterologist about my stomach discomfort, and he explained that there are many nerves in the stomach, suggesting that my discomfort could be related to autonomic nervous system issues.
Whenever I feel unwell, I immediately think of cancer.
After the autonomic nervous system testing, the gastroenterologist confirmed that I indeed have autonomic nervous system dysregulation.
Could you please clarify if early symptoms of stomach cancer include pain in the stomach area? Should the pain be something that can be pressed on? I apologize for having so many questions.
Additionally, when I get anxious, I experience irritable bowel syndrome.
As for my previous nausea, could it be due to gastritis? Thank you, doctor.
Niming, 20~29 year old female. Ask Date: 2021/08/11
Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Most cases of gastric cancer do not present symptoms and usually only show symptoms in the middle to late stages.
If you are experiencing persistent discomfort in your stomach, it is advisable to first examine your diet and lifestyle: tea (black tea/green tea/milk tea), coffee, chocolate, sweets, spicy foods, fried foods, high-fat, and high-protein foods, as well as being underweight or overweight, and experiencing constipation.
If stomach discomfort persists, an endoscopy can help clarify any concerns.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.
Reply Date: 2021/08/11
More Info
Understanding gastrointestinal issues, particularly those linked to autonomic nervous system (ANS) imbalances, is crucial for managing symptoms and improving overall health. Your experience reflects a common scenario where anxiety and stress exacerbate gastrointestinal discomfort, leading to a cycle of worry and physical symptoms.
The autonomic nervous system regulates involuntary bodily functions, including digestion. When the ANS is out of balance, it can lead to various gastrointestinal problems, such as gastroesophageal reflux disease (GERD), functional dyspepsia, and irritable bowel syndrome (IBS). These conditions can manifest as symptoms like heartburn, abdominal pain, bloating, nausea, and changes in bowel habits, which you have described.
Your history of nighttime eating and lying down immediately afterward could contribute to GERD, as this position can allow stomach acid to flow back into the esophagus, causing discomfort. The symptoms you experienced, such as chest tightness and abdominal pain, may have been related to this reflux. It's reassuring that cardiac evaluations returned normal, as this rules out serious cardiac issues that can mimic gastrointestinal symptoms.
Regarding your concerns about stomach cancer, it’s important to note that while anxiety can amplify your perception of physical symptoms, the likelihood of developing gastric cancer at a young age is relatively low, especially if you have undergone thorough evaluations like abdominal ultrasounds and autonomic nervous system assessments. The reassurance from multiple healthcare providers about the low incidence of gastric cancer in your age group is significant.
The symptoms of early gastric cancer can sometimes include vague abdominal discomfort, but they are often accompanied by more specific signs such as significant weight loss, persistent vomiting, or difficulty swallowing. The pain you describe as "pinching" when pressing on your abdomen is more likely related to muscle tension or gastrointestinal motility issues rather than a direct indicator of cancer.
Your history of anxiety and the tendency to worry about health issues can lead to a condition known as health anxiety or hypochondriasis, where individuals become preoccupied with the fear of having a serious illness. This can create a feedback loop where anxiety exacerbates gastrointestinal symptoms, leading to more anxiety.
To manage your symptoms effectively, consider the following strategies:
1. Cognitive Behavioral Therapy (CBT): This form of therapy can help you address the thought patterns that contribute to your anxiety and gastrointestinal symptoms. It can provide you with tools to manage stress and reduce health-related fears.
2. Mindfulness and Relaxation Techniques: Practices such as meditation, yoga, or deep-breathing exercises can help calm the nervous system and improve your overall sense of well-being.
3. Dietary Modifications: Keeping a food diary can help identify any specific triggers for your symptoms. Eating smaller, more frequent meals and avoiding heavy or spicy foods may also alleviate discomfort.
4. Regular Physical Activity: Exercise can help reduce anxiety and improve gastrointestinal motility, which may alleviate symptoms like bloating and constipation.
5. Medication: If anxiety significantly impacts your quality of life, discussing medication options with a psychiatrist or primary care physician may be beneficial.
6. Follow-Up Care: Continue to communicate with your healthcare providers about your symptoms. If new symptoms arise or existing ones worsen, further evaluation may be warranted.
In conclusion, while your symptoms are concerning, they are likely related to an interplay of anxiety and gastrointestinal function rather than a serious underlying condition like cancer. Maintaining open communication with your healthcare providers and employing strategies to manage anxiety will be key in improving your gastrointestinal health and overall quality of life.
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