Stomach Issues: Ulcers, Gastric Damage, and Digestive Health

Q: Stomach Issues: Ulcers, Gastric Damage, and Digestive Health

Hello： Regarding your symptoms, such as occasional stomach pain, indigestion, postprandial regurgitation, acid reflux, and severe abdominal bloating, it is first recommended that you seek medical attention to arrange for an endoscopy or upper gastrointestinal imaging to confirm o

Gastric ulcer? Gastric mucosal injury? (Additional!!!!!)

Hello Dr.
Chen,
Last July, I participated in a company trip to Taitung, where I experienced food poisoning due to unclean food.
During the first two days of illness, I vomited more than ten times and showed signs of dehydration, with diarrhea occurring only 3 to 4 times.
My blood pressure was 50/100 at that time.
However, since I went to the emergency room, received injections, and took medication, I recovered in about a week.
After that, I resumed my normal diet, thinking I was fine, and did not avoid fried or spicy foods.

However, it seems that the situation is not that simple.
I have been experiencing severe abdominal bloating and frequent flatulence, especially in the morning when I wake up; I often pass gas loudly.
Occasionally, I also have stomach pain and difficulty digesting food, often taking 2 to 3 hours to feel that I have digested my meal.
Sometimes, it takes 4 to 5 hours before I feel hungry because the food is not fully digested, and I also feel nauseous.
When I do vomit, it consists of very sour liquid and some food remnants.
After eating, my stomach feels heavy, and I often feel the urge to vomit, which only exacerbates the damage to my stomach.
Additionally, I now feel uncomfortable and have the urge to vomit immediately after eating spicy foods.
Doctor, how can I improve my gastrointestinal issues? Is this a gastric ulcer or an intestinal problem? Should I arrange for an endoscopy to check if I have a gastric ulcer or other issues?
P.S.
Due to irregular bowel movements, I suspect it may be because I eat less.
I have developed a habit of drinking a cup of coffee every morning to help with bowel movements.
Even though I don't eat much, if I don't have a bowel movement for a day, my stomach feels very bloated.
Is this habit of drinking coffee a long-term bad habit that has accumulated over time? I have previously tried drinking water in the morning or eating more fruits and vegetables, but it seems to have little effect on my bowel movements; drinking coffee seems to help more effectively.
Thank you, Doctor!
Sincerely,
Miss Peng

Miss Peng, 20~29 year old female. Ask Date: 2004/04/12

Dr. Chen Zhiping reply Gastroenterology and Hepatology

Hello: Regarding your symptoms, such as occasional stomach pain, indigestion, postprandial regurgitation, acid reflux, and severe abdominal bloating, it is first recommended that you seek medical attention to arrange for an endoscopy or upper gastrointestinal imaging to confirm or rule out conditions such as peptic ulcers, gastritis, or gastroesophageal reflux disease (GERD) that may be treatable with medication.
Additionally, it is advisable to adjust your dietary habits by avoiding spicy and irritating foods, eating slowly, chewing thoroughly, and avoiding talking or eating quickly, as this may lead to air swallowing and bloating.
It is also recommended to consume more fiber-rich foods, such as vegetables, to aid in bowel movements.
In summary, if there is no improvement or if the improvement is unsatisfactory after dietary adjustments, further examination at a hospital should be pursued.
Sincerely, Dr.
Chen Zhi-Ping, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2004/04/12

More Info

Dear Ms. Peng,
Thank you for sharing your concerns regarding your gastrointestinal issues. Based on your description, it appears that you are experiencing a range of symptoms that could be indicative of underlying gastrointestinal problems, including potential gastritis, ulcers, or functional gastrointestinal disorders.

Your history of food poisoning, characterized by severe vomiting and dehydration, could have disrupted your gastrointestinal tract significantly. Following such an event, it is not uncommon for individuals to experience lingering digestive issues, especially if dietary habits return to normal too quickly. The symptoms you describe—bloating, delayed gastric emptying, nausea, and the urge to vomit—suggest that your stomach may be struggling to process food effectively.

Possible Conditions
1. Gastritis: Inflammation of the stomach lining can result from various factors, including infection (such as Helicobacter pylori), excessive alcohol consumption, or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs). Symptoms often include stomach pain, nausea, and bloating.

2. Peptic Ulcers: These are sores that develop on the lining of the stomach or the first part of the small intestine (duodenum). They can cause similar symptoms, including pain, bloating, and nausea, particularly after eating. Your mention of discomfort after consuming spicy foods could suggest ulceration or irritation of the gastric lining.

3. Functional Dyspepsia: This condition is characterized by chronic or recurrent pain in the upper abdomen without an identifiable cause. Symptoms can include bloating, early satiety, and nausea.

Recommendations
1. Dietary Modifications: It is crucial to adopt a more gentle diet that avoids irritants. This includes steering clear of spicy, fried, or acidic foods, which can exacerbate symptoms. Instead, focus on bland foods that are easier to digest, such as bananas, rice, applesauce, and toast (the BRAT diet). Eating smaller, more frequent meals may also help reduce the burden on your digestive system.

2. Hydration: Ensure you are adequately hydrated, especially after episodes of vomiting or diarrhea. However, try to avoid excessive caffeine, as it can irritate the stomach lining and may contribute to dehydration.

3. Medical Evaluation: Given the persistence of your symptoms, it would be prudent to consult with a gastroenterologist. They may recommend diagnostic tests, including an upper endoscopy (gastroscopy), to visualize the stomach lining and check for ulcers or other abnormalities. A breath test for H. pylori may also be indicated, as this bacterium is a common cause of gastritis and peptic ulcers.

4. Medication: Depending on the findings, your doctor may prescribe medications such as proton pump inhibitors (PPIs) to reduce stomach acid, or antibiotics if H. pylori infection is confirmed. Antacids or medications that promote gastric motility may also be beneficial.

5. Lifestyle Changes: Consider incorporating stress-reduction techniques, as stress can exacerbate gastrointestinal symptoms. Regular physical activity, adequate sleep, and mindfulness practices can contribute positively to your overall digestive health.

Conclusion
In summary, your symptoms warrant a thorough evaluation to rule out gastritis, peptic ulcers, or functional dyspepsia. Dietary changes, medical evaluation, and possibly medication will be essential steps in managing your condition. Please consult with your healthcare provider to discuss your symptoms in detail and to develop a tailored treatment plan.

Wishing you a speedy recovery and improved digestive health.

Best regards,
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