Gastrointestinal Discomfort: Causes and When to Seek Help

Gastrointestinal discomfort with a feeling of nausea?

Hello Dr.
Chen, I have recently been experiencing a lack of appetite and nausea during meals (I can still eat more than half).
Upon waking, I notice bowel sounds and a feeling of bloating above my navel.
Two weeks ago, I visited a clinic and received medication, which helped a lot, but the same symptoms have returned in the past couple of days.
Additionally, for the past two months, I often experience diarrhea after eating (I have lost about 1-2 kg in weight).
I used to weigh around 58-59 kg, but now I am at 56-57 kg.
I would like to ask the doctor what might be the cause of these symptoms and whether I should go to a larger hospital for further examination.
Last year, I underwent several tests, including blood tests, X-rays, CT scans, MRIs, and an endoscopy.
Except for not having a colonoscopy, most of the test results were normal.
The only finding was some bloating near the small intestine, which was initially assessed as irritable bowel syndrome.
I am somewhat concerned about inflammatory bowel disease.
Could you please help clarify this for me?

NJ, 30~39 year old female. Ask Date: 2022/10/05

Dr. Chen Shidian reply Gastroenterology and Hepatology

It doesn't seem like colitis (which often presents with bloody stools).
If symptoms persist, it is still recommended to return for a follow-up consultation.

Reply Date: 2022/10/05

More Info

Gastrointestinal discomfort can arise from a variety of causes, and understanding these can help you determine when to seek medical assistance. Based on your symptoms, which include decreased appetite, nausea, abdominal bloating, and changes in bowel habits, it’s essential to consider several potential underlying issues.

Firstly, your symptoms may suggest functional gastrointestinal disorders, such as Irritable Bowel Syndrome (IBS). IBS is characterized by abdominal pain and changes in bowel habits, including diarrhea and constipation. It is often triggered by stress, dietary changes, or infections. Given that you have experienced a decrease in appetite and weight loss, it’s crucial to monitor these symptoms closely, as they can indicate a more serious condition if they persist.

Another possibility is that you may be experiencing a gastrointestinal infection or inflammation. Conditions such as gastroenteritis can cause nausea, vomiting, diarrhea, and abdominal discomfort. If you have had recent exposure to contaminated food or water, this could be a contributing factor. Additionally, inflammatory bowel diseases (IBD) like Crohn's disease or ulcerative colitis could also present with similar symptoms, particularly if there is a family history of gastrointestinal diseases.

Given your previous medical history, including various imaging studies and endoscopic examinations, it is reassuring that no significant abnormalities were found. However, the fact that you are experiencing recurrent symptoms warrants further investigation. While your previous tests were largely normal, it may be beneficial to consider a colonoscopy, especially since you mentioned concerns about inflammatory bowel disease and your family history of colorectal cancer.

The presence of bloating and changes in bowel habits, coupled with your weight loss, should not be overlooked. It is crucial to rule out any serious conditions, including malignancies or significant inflammatory processes. A gastroenterologist can provide a comprehensive evaluation, which may include additional tests such as stool studies to check for infections, inflammatory markers, or even a repeat imaging study if deemed necessary.

In terms of dietary management, keeping a food diary can help identify any potential food intolerances or triggers that may exacerbate your symptoms. Common culprits include dairy products, gluten, and high-fat foods. Additionally, ensuring adequate hydration and a balanced diet rich in fiber can help alleviate some gastrointestinal discomfort.

If your symptoms worsen or if you experience additional concerning signs such as severe abdominal pain, persistent vomiting, or blood in your stool, it is imperative to seek immediate medical attention. These could be signs of a more serious underlying condition that requires prompt intervention.

In summary, while your symptoms may suggest functional gastrointestinal issues, the possibility of more serious conditions cannot be ruled out. Given your history and current symptoms, it would be prudent to consult with a gastroenterologist for a thorough evaluation and possibly further testing, including a colonoscopy. This will help ensure that any potential issues are identified and managed appropriately, allowing you to regain your health and well-being.

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