Gastrointestinal Discomfort: Causes and Solutions - Gastroenterology and Hepatology

Gastrointestinal discomfort

Hello, Dr.
Chang.
About a month ago, I started feeling discomfort in my abdomen.
I thought it might be the same gastrointestinal issues I had before, so I went to a general clinic for medication and injections, but after visiting two clinics, I still didn't see any improvement.
My bowel movements became thinner, sometimes I experienced urgency, or I had diarrhea.
One day, I was a bit shocked to see blood in my stool; it was a small dark strip with blood.
I immediately went to a major hospital for a check-up, where they performed a colonoscopy and gastroscopy.
The results indicated some bleeding in my stomach, but nothing else was significant.
However, I still feel uncomfortable in my abdomen, particularly in the lower left quadrant, which hurts more when pressed.
I also experience bloating below my chest after eating, and my bowel movements remain irregular.

I'm curious because I took laxatives but didn't have a bowel movement.
On the day I reviewed my report, I asked the doctor if I was cleared out, and he said it was about 60% okay.
However, I still experience constipation when eating normally, and I wonder where all that food goes.
I feel like my intake and output are disproportionate.
I told the doctor that my abdomen often involuntarily tightens and feels like it's contracting inward, which he suggested could be related to constipation.
I've lost about 3 to 4 kilograms, and despite eating normally, I continue to lose weight.
Sometimes my abdomen feels hard and bloated, and if I wear tighter pants, it becomes uncomfortable.
I'm quite worried.
Dr.
Chang, do you have any suggestions?

SKY, 40~49 year old female. Ask Date: 2022/02/25

Dr. Zhang Kebin reply Gastroenterology and Hepatology

Hello! If you have not experienced relief from your discomfort after previous medical treatment or if new symptoms have emerged, please return for a follow-up evaluation.
Thank you!

Reply Date: 2022/02/25

More Info

Gastrointestinal discomfort can manifest in various ways, including constipation, abdominal pain, diarrhea, and even more severe symptoms like rectal bleeding. Based on your description, it seems you are experiencing a combination of these issues, which can be quite distressing. Let's break down the potential causes and solutions for your symptoms.

Causes of Gastrointestinal Discomfort
1. Irritable Bowel Syndrome (IBS): This is a common functional gastrointestinal disorder characterized by symptoms like abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). Stress and dietary factors often exacerbate IBS symptoms.

2. Gastrointestinal Infections: Sometimes, infections can lead to symptoms like diarrhea and abdominal pain. These can be viral, bacterial, or parasitic in nature.

3. Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic inflammation in the gastrointestinal tract, leading to symptoms such as abdominal pain, diarrhea, and rectal bleeding.

4. Gastric Ulcers: As noted in your case, you have been diagnosed with a slight gastric ulcer, which can cause abdominal pain and discomfort, especially after eating.

5. Constipation: This can lead to abdominal pain and discomfort, as well as a feeling of bloating. The fact that you mentioned your stools have become thinner or you experience infrequent bowel movements could indicate a significant issue with bowel motility.

6. Dietary Factors: Certain foods can trigger gastrointestinal symptoms. High-fat foods, dairy, gluten, and artificial sweeteners are common culprits.

Suggested Solutions
1. Dietary Adjustments: Keeping a food diary can help identify any food triggers. Increasing fiber intake through fruits, vegetables, and whole grains can help with constipation. However, if you suspect IBS, you might want to consider a low-FODMAP diet, which eliminates certain fermentable carbohydrates that can cause bloating and discomfort.

2. Hydration: Ensure you are drinking enough water throughout the day. Dehydration can worsen constipation and lead to harder stools.

3. Regular Exercise: Physical activity can help stimulate bowel movements and reduce stress, which is beneficial for overall gastrointestinal health.

4. Medications: Since you mentioned using laxatives without success, it might be worthwhile to discuss other options with your doctor. Over-the-counter medications like fiber supplements or stool softeners could be beneficial. Additionally, if IBS is suspected, medications specifically for IBS may help alleviate symptoms.

5. Stress Management: Since stress can significantly impact gastrointestinal function, consider incorporating stress-reduction techniques such as yoga, meditation, or deep-breathing exercises into your routine.

6. Follow-Up with a Specialist: Given your symptoms, especially the rectal bleeding and persistent abdominal pain, it is crucial to follow up with a gastroenterologist. They can provide a more comprehensive evaluation and may recommend additional tests or treatments.

7. Monitor Symptoms: Keep track of your symptoms, including when they occur and their severity. This information can be invaluable for your healthcare provider in determining the best course of action.

Conclusion
Your symptoms indicate a complex interplay of factors affecting your gastrointestinal health. It is essential to work closely with your healthcare provider to explore these issues further. Given the potential for serious underlying conditions, timely follow-up and possibly additional testing may be necessary to ensure that you receive the appropriate treatment. Remember, you are not alone in this, and with the right approach, many people find relief from their gastrointestinal discomfort.

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