Abdominal Discomfort: Causes and When to Seek Help - Gastroenterology and Hepatology

Slight discomfort in the abdomen and lower back?

Hello Doctor, I have recently been experiencing a feeling of pressure in my abdomen (in different areas).
A few days ago, I felt a rhythmic poking sensation around my navel, accompanied by frequent burping, poor appetite, nausea, and gastroesophageal reflux.
Additionally, I had diarrhea for two days, and the stool color was darker (I didn't pay much attention at the time, but upon reflection, it seemed somewhat black).
However, subsequent bowel movements have mostly been yellow-brown, somewhat loose, with a frequency of once a day, although some stools are greenish-brown (a bit gray).
Whenever my stomach makes noises, I worry whether it's gas or a bowel movement.
I also feel like I have some urinary frequency and a bit of orthostatic hypotension.
I visited a gastroenterologist who prescribed medication for my stomach and gas relief, and I also had an abdominal ultrasound.
The radiologist mentioned that everything looked fine, but I am still experiencing nausea and gastroesophageal reflux.
I would like to ask: 1.
Do you think I need to return for a follow-up to discuss the report with the doctor? 2.
What conditions could be causing the persistent poking sensation around my navel and the feeling of pressure in my abdomen? I am feeling quite anxious about these issues, and I find myself checking my condition frequently after waking up at night, which has led to some numbness in my hands and feet and cold sweats.
This morning, I noticed more muscle twitching in my left calf.
I have already scheduled a full-body health check, but I tend to have an anxious personality.

Ran, 20~29 year old female. Ask Date: 2023/07/29

Dr. Chen Shidian reply Gastroenterology and Hepatology

Continue to return for follow-up visits to discuss the treatment plan and health education.
It is advisable to take a walk after meals and learn relaxation techniques (such as meditation, etc.).

Reply Date: 2023/07/29

More Info

Abdominal discomfort can arise from a variety of causes, and understanding these can help in determining when to seek medical attention. Based on your symptoms, which include a feeling of pressure in the abdomen, a stabbing sensation around the navel, frequent belching, poor appetite, gastroesophageal reflux, diarrhea, and changes in stool color, it is important to consider several potential underlying issues.

1. Gastrointestinal Disorders: Your symptoms suggest possible gastrointestinal disturbances. Conditions such as gastritis, peptic ulcers, or even functional gastrointestinal disorders like irritable bowel syndrome (IBS) could explain the discomfort and changes in bowel habits. The presence of dark or black stools can indicate bleeding in the upper gastrointestinal tract, which should be evaluated promptly. The fact that you have experienced diarrhea and changes in stool color, including greenish or grayish hues, may also suggest a disruption in digestion or absorption, possibly related to bile production or pancreatic function.

2. Anxiety and Stress: Given your history of anxiety, it is crucial to acknowledge the role that psychological factors can play in physical symptoms. Anxiety can manifest as gastrointestinal discomfort, including increased sensitivity to abdominal sensations, changes in appetite, and even gastrointestinal motility issues. The physical symptoms of anxiety, such as tingling in the extremities and cold sweats, can further exacerbate your discomfort and lead to a cycle of worry and physical symptoms.

3. When to Seek Help: It is advisable to follow up with your healthcare provider regarding the results of your abdominal ultrasound, especially since you are experiencing persistent symptoms despite initial treatment. If your symptoms worsen, such as experiencing severe abdominal pain, persistent vomiting, or changes in bowel habits that concern you, it is essential to seek medical attention immediately. Additionally, if you notice any signs of dehydration due to diarrhea or if your stools remain dark or black, you should consult a doctor without delay.

4. Further Investigations: If your symptoms persist, further investigations may be warranted. This could include blood tests to check for anemia (which could indicate bleeding), liver function tests, or even an endoscopy if gastrointestinal bleeding is suspected. Your healthcare provider may also consider a referral to a gastroenterologist for more specialized care.

5. Management of Anxiety: Since you mentioned a tendency towards anxiety, it may be beneficial to address this aspect of your health as well. Techniques such as cognitive-behavioral therapy (CBT), mindfulness, and relaxation exercises can help manage anxiety symptoms. Additionally, discussing your anxiety with your healthcare provider may lead to appropriate interventions, whether through therapy or medication.

In summary, while your abdominal discomfort may stem from gastrointestinal issues, the influence of anxiety cannot be overlooked. It is essential to maintain open communication with your healthcare provider, follow up on test results, and seek further evaluation if your symptoms do not improve. Taking care of both your physical and mental health is crucial in achieving overall well-being.

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