Gastrointestinal Issues: When to Seek Further Evaluation

Gastrointestinal issues

Hello doctor, I would like to ask you some gastrointestinal-related questions.
Last year, from February to March, I experienced persistent bloating for about two to three months.
I underwent an upper endoscopy and a fecal occult blood test, both of which showed no abnormalities.
Later, I took probiotics and gradually improved.
Recently, however, I have started to feel bloated again, often feeling like there is a lot of gas in my stomach, which makes me need to burp.
When I burp, I also feel a lot of pressure and bloating in my abdomen.
Sometimes, I need to pass gas to relieve the bloating.
My stomach occasionally has a burning sensation, and sometimes I experience stomach pain.
Eating even a small amount makes me feel very full.
Regarding bowel movements, there are times when I feel the urge to have a bowel movement, but when I go to the bathroom, only a small amount comes out.
After leaving the bathroom, I often feel the urge to go again, and there are times when I need to go to the restroom up to four times a day.
Sometimes my stool is very thin and long, while other times it is loose and crumbly, resembling shredded meat.
Given this situation, do you think I need to undergo another upper endoscopy, or what kind of treatment should I pursue? Thank you.

Nìmíng, 20~29 year old female. Ask Date: 2024/02/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may be a slight abnormality in digestive peristalsis; you can consider following a low FODMAP diet as suggested online.

Reply Date: 2024/02/26

More Info

It sounds like you're experiencing a range of gastrointestinal symptoms that are causing you significant discomfort and concern. Based on your description, you have been dealing with bloating, gas, abdominal pain, and changes in your bowel habits, including the frequency and consistency of your stools. Given the complexity of your symptoms, it's important to approach this situation systematically.

Firstly, let's break down your symptoms:
1. Bloating and Gas: This can be caused by various factors, including dietary choices, gut microbiota imbalances, or gastrointestinal disorders. Foods that are high in fiber, certain carbohydrates, and dairy can lead to increased gas production. Additionally, conditions like irritable bowel syndrome (IBS) can cause bloating and excessive gas.

2. Abdominal Pain and Discomfort: The intermittent nature of your abdominal pain, especially if it's associated with bloating, could suggest a functional gastrointestinal disorder. Conditions like IBS often present with abdominal pain that correlates with bowel habits.

3. Changes in Bowel Movements: The fact that you are experiencing varying stool shapes and consistencies, along with urgency and frequency, is noteworthy. Long, thin stools can sometimes indicate a narrowing of the bowel, which could be due to several reasons, including inflammation or structural changes. Loose stools can indicate a variety of issues, including infections, dietary intolerances, or malabsorption syndromes.

4. Heartburn and Gastric Discomfort: The burning sensation in your stomach and the feeling of fullness after eating small amounts could indicate gastritis or gastroesophageal reflux disease (GERD). These conditions can coexist with other gastrointestinal issues.

Given these symptoms, it is advisable to consider further evaluation. While your previous endoscopy and stool tests were normal, the persistence and recurrence of your symptoms warrant a more thorough investigation. Here are some steps you might consider:
1. Consult a Gastroenterologist: A specialist can provide a more comprehensive evaluation of your symptoms. They may recommend additional tests, such as a repeat endoscopy, imaging studies (like an abdominal ultrasound or CT scan), or specialized tests for conditions like small intestinal bacterial overgrowth (SIBO) or food intolerances.

2. Dietary Review: Keeping a food diary can help identify any potential triggers for your symptoms. Consider working with a dietitian who specializes in gastrointestinal health to help you navigate dietary changes that may alleviate your symptoms.

3. Consider Probiotics: Since you mentioned that probiotics helped in the past, continuing or adjusting your probiotic regimen might be beneficial. Different strains of probiotics can have varying effects on gut health.

4. Symptom Management: Over-the-counter medications such as antacids, proton pump inhibitors, or medications specifically for IBS may provide symptomatic relief. However, these should be used under the guidance of a healthcare provider.

5. Follow-Up Testing: If your symptoms persist despite dietary changes and symptomatic treatment, further testing may be necessary. This could include imaging studies or even a colonoscopy if there are concerns about structural issues or polyps.

In summary, while your previous evaluations did not reveal any significant abnormalities, the recurrence of your symptoms suggests that further investigation is warranted. Engaging with a healthcare professional who can guide you through this process will be essential in managing your gastrointestinal health effectively. Remember, early intervention can often lead to better outcomes, so don't hesitate to seek further evaluation.

Similar Q&A

Persistent Gastrointestinal Issues: When to Seek Further Medical Help

Since my school years, I have often experienced diarrhea, but it would resolve quickly. However, after entering the workforce, my gastrointestinal discomfort has worsened. A few years ago, I had inexplicable nausea that made it difficult to eat. After undergoing an endoscopy, no ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
If there is continuous weight loss or a positive fecal occult blood test, further specialized examinations of the small intestine and other areas are necessary, and a visit to a medical center specializing in small intestine diseases is required.

Should You See a Doctor for Gastrointestinal Concerns?

Last Monday, I started experiencing the following abnormalities, suspecting a gastrointestinal issue: 1. After meals, I had abdominal rumbling, a sense of urgency to defecate, and flatulence (but no abdominal pain). 2. For one or two days, I had bowel movements, but afterward, ev...

Dr. Cai Jinji reply Gastroenterology and Hepatology
Hello Ms. Chen: I am not sure how long this situation has been going on, but I recommend that you see a physician to clarify your concerns. A stool test may be performed, and your doctor will make further assessments after your visit. Dr. Cai Jin-ji, Department of Hepatobiliary a...

Understanding Gastrointestinal Issues: When to Seek Medical Attention

Hello, doctor. For the past few months, my stools have often been loose and even unformed. I frequently feel the urge to have a bowel movement in the mornings during the week, but strangely, I don't feel the same urgency on weekends. I've also been passing gas a lot. Co...

Dr. Chen Shidian reply Gastroenterology and Hepatology
It is likely a case of general intestinal discomfort. Relax and avoid foods that may cause discomfort or are prone to gas production. You may continue to monitor the situation.

Understanding Digestive Issues: When to Seek Medical Advice

Since the start of last school year (September), I have been experiencing mild pain on the sides of my abdomen and in the four corners. At that time, my bowel movements were not very smooth, and the doctor diagnosed me with constipation, advising me to drink more water and eat ve...

Dr. Luo Yining reply Gastroenterology and Hepatology
If symptoms persist or worsen despite adjustments in lifestyle and dietary habits, it is recommended to consult a pediatrician or a pediatric gastroenterologist for further evaluation and treatment.