Which Specialist to See for Unexplained Health Issues?

If you're experiencing health issues and are unsure which specialty to consult, it may be helpful to start with a primary care physician. They can evaluate your symptoms and refer you to the appropriate specialist based on your specific condition?

Hello Doctor, I previously went to the hospital for a gastric examination (gastroscopy), and the doctor mentioned that I have symptoms of gastritis.
I took medication but only twice.
Recently, I often feel fatigued, a bit disoriented (accompanied by mild dizziness), discomfort in my chest (tightness), a slight feeling of nausea, weakness, and sometimes my heart races, along with a sensation of something being stuck in my throat.
Additionally, my stomach has been cramping due to the inflammation.
I've also experienced some mild insomnia (I’m not sure if it’s because I tend to think a lot at night or if it’s related to this issue).
I’m confused about whether this is a liver problem (as I feel it started when I began to feel more fatigued, stayed up late, and experienced increased stress), a heart issue, hyperthyroidism, or if it’s all related to the gastritis.
If I go to the hospital, which department should I consult?
Moreover, I often have diarrhea (previously diagnosed as rapid intestinal motility), and when I have diarrhea, I don’t eat, which causes my stomach to hurt.
I would like to know if it’s advisable not to eat after having diarrhea, but this leads to my stomach being inflamed and painful! What should I do? Also, does gastritis increase the risk of stomach cancer, and how can I prevent it? How can I stop my stomach from being inflamed? I’m really troubled by this! Thank you for your response.

Ai yo wei ya, 20~29 year old female. Ask Date: 2008/04/21

Dr. Wang Zhengzhong reply Family Medicine

Hello, you have undergone a gastroscopy at the hospital, and the doctor mentioned that you have been feeling more fatigued and experiencing insomnia recently, along with symptoms of gastritis.
You often feel physically tired, somewhat disoriented (accompanied by mild dizziness), discomfort in the chest (chest tightness), a slight feeling of nausea, weakness, and sometimes experience a rapid heartbeat, as well as a sensation of something being stuck in your throat.
Based on the above statements, I recommend that you consult a gastroenterologist or a family medicine physician for further evaluation and medication treatment.

Reply Date: 2008/04/21

More Info

When dealing with unexplained health issues, especially those involving multiple symptoms like fatigue, dizziness, chest discomfort, nausea, and gastrointestinal problems, it's crucial to approach the situation methodically. Given your symptoms, it would be advisable to start by consulting a primary care physician or a general internist. They can perform a comprehensive evaluation, including a detailed medical history and physical examination, to help identify the underlying cause of your symptoms.

Your symptoms suggest a potential overlap between gastrointestinal issues and other systemic problems. For instance, chronic gastritis (inflammation of the stomach lining) can lead to discomfort and nausea, but it can also be exacerbated by stress, dietary choices, and lifestyle factors. The fatigue and dizziness you are experiencing could be related to several factors, including nutritional deficiencies, dehydration, or even anxiety and stress, which can manifest physically.

Given your history of gastritis and the recent onset of these additional symptoms, it would be prudent to see a gastroenterologist. They specialize in digestive system disorders and can conduct further tests, such as blood tests, imaging studies, or endoscopy, to assess the condition of your stomach and intestines more thoroughly. They can also evaluate whether your symptoms might be related to conditions like irritable bowel syndrome (IBS), which can cause rapid bowel movements and discomfort.

In addition to a gastroenterologist, if your symptoms persist or worsen, you might also consider consulting a cardiologist, especially since you mentioned experiencing a rapid heartbeat and chest discomfort. These could indicate cardiovascular issues that need to be ruled out.

Regarding your concerns about diet during episodes of diarrhea, it is generally advisable to avoid solid foods until your symptoms improve. However, staying hydrated is crucial. Clear fluids, such as broth, electrolyte solutions, or herbal teas, can help maintain hydration. Once your diarrhea subsides, you can gradually reintroduce bland foods that are easy on the stomach, such as bananas, rice, applesauce, and toast (the BRAT diet).

As for your worries about gastritis leading to stomach cancer, while chronic gastritis can increase the risk of gastric cancer, it is not a direct cause. The key to prevention lies in managing the inflammation effectively. This includes adhering to a diet that avoids irritants (like spicy foods, alcohol, and caffeine), managing stress, and following up with your healthcare provider for regular monitoring and treatment adjustments.

In summary, start with a visit to a primary care physician or a gastroenterologist to address your symptoms comprehensively. They can guide you through the necessary tests and referrals to specialists if needed. Additionally, focus on maintaining a balanced diet and managing stress, as these factors can significantly impact your gastrointestinal health. Always consult your healthcare provider before making any significant changes to your diet or treatment plan.

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