Abdominal Bloating: Symptoms, Causes, and Solutions

Abdominal bloating

Doctor, this issue has been bothering me for a long time.
I have repeatedly visited the outpatient clinic many times.
In August of last year, I had my first gastroscopy, and the doctor said I had Helicobacter pylori and gastritis.
He prescribed medication for the Helicobacter pylori.
Later, a stool test showed that the virus was eradicated.
In May of this year, because I was still experiencing gastrointestinal discomfort, I had another gastroscopy.
The doctor said I had mild inflammation and gastroesophageal reflux disease (GERD), and that my lower esophageal sphincter was not closing properly.
He prescribed medication for me, which I have been taking since then.
I keep thinking that just taking medication is not a solution, as my symptoms have not improved.

My symptoms include feeling bloated in the morning, frequent burping and flatulence, and feeling bloated after meals.
I also experience significant stress, and sometimes due to my posture, I feel pressure on my stomach, even when taking deep breaths.
Occasionally, my heart will beat strongly.
I have searched online and would like to ask if my symptoms could be indicative of a hiatal hernia, or if they are related to something else.
These symptoms have troubled me for a long time, and every time I go back for a follow-up, the doctor just prescribes more medication for me to continue taking.
I am still quite young, and taking medication continuously may not be good for my health.

I would like to ask the doctor what I should do.
In my daily life, I have been trying to avoid overeating and have been eating slowly.
Is it possible that I truly have symptoms of a hiatal hernia? If not, what should I do?

Gao, 10~19 year old female. Ask Date: 2022/12/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

You can discuss with the gastroenterologist whether the imaging diagnosis is consistent with a hiatal hernia.
Additionally, the dosage of gastric medication can be adjusted based on symptoms or may be temporarily discontinued.
It is also recommended to take a walk after meals and to avoid overthinking, as it can add unnecessary stress.

Reply Date: 2022/12/08

More Info

Abdominal bloating can be a frustrating and uncomfortable condition, especially when it persists despite medical interventions. Your symptoms, including a feeling of fullness in the stomach, frequent belching, and gas, can be indicative of several underlying issues. Given your history of gastritis and Helicobacter pylori infection, it’s essential to consider both gastrointestinal and lifestyle factors that may contribute to your discomfort.

Possible Causes of Abdominal Bloating
1. Gastroesophageal Reflux Disease (GERD): Since you mentioned having gastroesophageal reflux and a loose lower esophageal sphincter, this could lead to symptoms of bloating. GERD can cause the stomach contents to flow back into the esophagus, leading to discomfort and bloating.

2. Irritable Bowel Syndrome (IBS): This condition is characterized by abdominal pain and changes in bowel habits, including bloating. Stress and dietary choices can exacerbate IBS symptoms.

3. Food Intolerances: Lactose intolerance or gluten sensitivity can lead to bloating after meals. Keeping a food diary may help identify any specific triggers.

4. Hiatal Hernia: You mentioned the possibility of a hiatal hernia, which occurs when part of the stomach pushes through the diaphragm. This can cause symptoms similar to GERD, including bloating and discomfort.

5. Delayed Gastric Emptying: If your stomach takes longer to empty, it can lead to feelings of fullness and bloating. This condition is known as gastroparesis and can be associated with diabetes or other metabolic disorders.

6. Stress and Anxiety: Psychological factors can significantly impact gastrointestinal function. Stress can lead to increased gas production and altered gut motility, contributing to bloating.

Recommended Solutions
1. Dietary Modifications:
- Eat Smaller, More Frequent Meals: This can help reduce the feeling of fullness and bloating.

- Identify Trigger Foods: Consider an elimination diet to identify foods that may be causing your symptoms, such as dairy, gluten, or high-FODMAP foods.

- Stay Hydrated: Drinking plenty of water can aid digestion and reduce bloating.

2. Medications:
- Proton Pump Inhibitors (PPIs): If you are not already on them, PPIs can help reduce stomach acid and alleviate GERD symptoms.

- Prokinetics: These medications can help improve gastric emptying if delayed gastric emptying is an issue.

- Antacids or Simethicone: Over-the-counter options can help relieve gas and bloating.

3. Lifestyle Changes:
- Regular Exercise: Physical activity can help stimulate digestion and reduce bloating.

- Stress Management: Techniques such as yoga, meditation, or cognitive behavioral therapy can help manage stress and its impact on your gut.

4. Follow-Up with Your Doctor: Since your symptoms have persisted despite treatment, it may be worthwhile to seek a second opinion or consult a gastroenterologist who can perform further evaluations, such as imaging studies or motility tests, to rule out conditions like a hiatal hernia or gastroparesis.

5. Consider Psychological Factors: If stress and anxiety are contributing to your symptoms, consider speaking with a mental health professional who can provide strategies to manage these feelings.

Conclusion
While it’s understandable to be concerned about the long-term use of medications, it’s crucial to address the underlying causes of your symptoms. A comprehensive approach that includes dietary changes, lifestyle modifications, and possibly further medical evaluation can help you find relief from your abdominal bloating. Remember, effective communication with your healthcare provider is key to finding the right treatment plan tailored to your needs.

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