Persistent Stomach Pain and Bloating: When Medications Fail

Q: Persistent Stomach Pain and Bloating: When Medications Fail

Hello： In addition to medication, dietary habits are also very important. <br>Beverages such as tea (black/green/milk tea), coffee, smoking, alcohol, fried foods, spicy foods, sweets, and chocolate can have an impact. <br>Avoid late-night snacks, eat until satisfied without lying

Stomach pain and bloating that do not improve with medication?

Hello, doctor.
I've been experiencing gastrointestinal bloating and stomach pain for two months.
I underwent an endoscopy, and the doctor diagnosed me with gastric erosion and gastroesophageal reflux disease (GERD).
There is no Helicobacter pylori infection.
I was prescribed medication for gastric ulcers as well as medication for bloating, but I still experience bloating after taking the medication.
I also have a liver hemangioma and autonomic nervous system dysfunction.
Recently, I consulted both a gastroenterologist and a psychiatrist, but nothing has helped.
I start to feel bloated after eating, and I was later told it might be irritable bowel syndrome (IBS).
The medications I've taken have not improved my condition.
Is there any way to resolve this, doctor?

Zhanghua Ren, 30~39 year old female. Ask Date: 2022/12/31

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: In addition to medication, dietary habits are also very important.
Beverages such as tea (black/green/milk tea), coffee, smoking, alcohol, fried foods, spicy foods, sweets, and chocolate can have an impact.
Avoid late-night snacks, eat until satisfied without lying down, refrain from exercising immediately after meals, and avoid lifting heavy objects.
Stress and tension, irregular meal times, or eating too quickly without proper chewing can also affect health.
It is recommended to consult your primary physician to discuss your medication situation for more precise adjustments.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2022/12/31

More Info

Persistent stomach pain and bloating can be incredibly distressing, especially when medications fail to provide relief. Based on your description, it seems you have been diagnosed with gastritis, gastroesophageal reflux disease (GERD), and possibly irritable bowel syndrome (IBS). You also mentioned having a liver hemangioma and autonomic nervous system dysregulation, which can complicate your symptoms.
Firstly, it’s essential to understand that the gastrointestinal (GI) system is highly sensitive to stress and anxiety, which can exacerbate symptoms of both gastritis and IBS. The autonomic nervous system plays a crucial role in regulating gut function, and any dysregulation can lead to symptoms like bloating, pain, and altered bowel habits.
Regarding your current treatment, it’s important to ensure that you are taking the medications as prescribed. Proton pump inhibitors (PPIs) like Nexium (esomeprazole) are effective in reducing stomach acid and promoting healing of the gastric mucosa. However, they may not address bloating directly. Medications for bloating, such as simethicone, can help relieve gas but may not be effective for everyone.
If you are experiencing persistent bloating and pain despite medication, consider the following strategies:
1. Dietary Modifications: Certain foods can exacerbate bloating and discomfort. Keeping a food diary can help identify triggers. Common culprits include dairy, gluten, high-FODMAP foods (like beans, onions, and certain fruits), and carbonated beverages. A low-FODMAP diet may be beneficial for managing IBS symptoms.

2. Smaller, More Frequent Meals: Eating smaller meals more frequently can help reduce the burden on your digestive system and may alleviate bloating.

3. Hydration: Ensure you are drinking enough water throughout the day, as dehydration can worsen constipation and bloating.

4. Probiotics: Some patients find relief from bloating and discomfort by taking probiotics, which can help balance gut flora. However, results can vary, so it may take some trial and error to find the right strain.

5. Stress Management: Since you mentioned autonomic nervous system dysregulation, incorporating stress-reducing techniques such as mindfulness, yoga, or cognitive behavioral therapy (CBT) may help improve your symptoms.

6. Follow-Up with Specialists: If your symptoms persist, it may be worthwhile to revisit your gastroenterologist or consider a consultation with a dietitian who specializes in gastrointestinal disorders. They can provide tailored dietary advice and further evaluate your symptoms.

7. Consider Other Conditions: If you continue to experience severe symptoms, further investigations may be warranted to rule out other conditions such as small intestinal bacterial overgrowth (SIBO), celiac disease, or other gastrointestinal disorders.

8. Medication Review: Discuss with your doctor the possibility of adjusting your current medications. Sometimes, a combination of medications or a different class of drugs may be necessary to manage symptoms effectively.

In conclusion, while persistent stomach pain and bloating can be challenging to manage, a comprehensive approach that includes dietary changes, stress management, and close follow-up with healthcare providers can lead to improvement. It’s crucial to communicate openly with your healthcare team about your symptoms and treatment efficacy to find the best management plan for your situation.

Similar Q&A

Persistent Stomach Pain: When Over-the-Counter Meds Fail

Hello, I have been experiencing stomach pain for a week. The symptoms include heaviness, bloating, and cramping, which are especially severe after meals. Over-the-counter antacids have not provided relief, and I have also visited the hospital, but my condition remains the same. S...

Dr. Chen Shidian reply Gastroenterology and Hepatology
You can go to a larger hospital for a gastroenterology examination. When eating, try to eat slowly, avoid spicy foods, and do not overeat.

Persistent Stomach Pain: When Medications Fail to Provide Relief

Hello doctor, I started experiencing stomach discomfort at the end of June this year, and it hasn't improved since then; in fact, it has gotten worse. I have taken many medications, but there has been no improvement. On August 8, I underwent an endoscopy, which revealed mild...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: It may be necessary to look for possible causes in lifestyle and dietary habits. Psychological stress should also be appropriately expressed. Moderate exercise can be beneficial; observe if there is any improvement in symptoms. Changhua Hospital cares about your health. Dr...

Chronic Bloating: Understanding Causes and Seeking Effective Treatments

Hello, Doctor. Since I had food poisoning during last year's Spring Festival, which resulted in vomiting and diarrhea, I sought treatment and recovered. However, I have been experiencing persistent bloating every day since then. I have visited a gastroenterologist multiple t...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Prioritize dietary adjustments by reducing oil, dairy, and刺激ing foods. Avoid overeating. With medication treatment, improvement should be achievable. Wishing you good health.

Chronic Abdominal Pain: Understanding Complications and Treatment Options

Hello, doctor. Since February of last year, I have been experiencing abdominal pain every night, and sometimes I have to rush to the bathroom in the middle of the night. At that time, my bowel movements had a fishy odor, the color was abnormal, and they were not well-formed. Howe...

Dr. Chen Shidian reply Gastroenterology and Hepatology
If the weight is normal, irritable bowel syndrome (IBS) may be the most likely cause. In addition to using gastrointestinal medications for management, a stool occult blood test can be conducted. If necessary, a referral to a mental health specialist may help with anxiety control...