Stomach Issues: Causes, Symptoms, and Alternative Tests - Gastroenterology and Hepatology

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Since entering high school, my stomach has been in poor condition for over five years.
At first, I would always feel nauseous in the morning and vomit stomach acid.
A relative suggested I get an endoscopy, and it seemed like there was mention of Helicobacter pylori.
After not taking medication for nearly two years, my symptoms have recently returned.
I'm not sure if I'm just less sensitive to the pain because I don't feel significant stomach pain, but whenever I feel uncomfortable, I lose my appetite.
In the morning, I still feel nauseous, often vomiting stomach acid, which makes me uncomfortable and reluctant to eat.
I always feel like if I eat, I will vomit again.
I have no appetite; even when I'm very hungry at noon, I can't eat much.
At that point, I feel stomach pain, and eating a little makes me feel nauseous.
Sometimes, when I wake up in the morning, I feel a tightness in my chest and want to cough but can't.
After having undergone an endoscopy before, I have a fear of it and am hesitant to return to that clinic.
(1) What could be the possible causes of these symptoms?
(2) If I don't want to undergo an endoscopy, what other methods are available to check my stomach? Will they be very expensive?

Meimei, 20~29 year old female. Ask Date: 2008/10/29

Dr. Zhang Siyuan reply Gastroenterology and Hepatology


To my sister: Don't worry too much, because among the patients in the gastroenterology clinic, there are indeed many who have symptoms resembling both peptic ulcers and gastroesophageal reflux disease.
However, it is really difficult to distinguish between them without an endoscopy.
It might be better to switch to another clinic or, if possible, to go to a hospital for a thorough examination.
Otherwise, the symptoms you described may not receive effective relief, which can severely impact your quality of life and academic or work performance.
The losses incurred are not worth it.
Hang in there! Dr.
Chang, Gastroenterology Department, Lesheng Rehabilitation Hospital.

Reply Date: 2008/10/29

More Info


Understanding stomach issues can be quite complex, especially when symptoms persist over a long period. Based on your description, it seems you are experiencing a combination of nausea, loss of appetite, and discomfort that may be linked to a previous diagnosis of a Helicobacter pylori infection. This bacterium is known to cause gastritis and peptic ulcers, which can lead to the symptoms you are experiencing.

1. Possible Causes of Your Symptoms:
- Helicobacter pylori Infection: If you were diagnosed with this infection in the past, it could still be a contributing factor to your current symptoms. H. pylori can cause chronic gastritis, leading to nausea, vomiting, and discomfort.

- Gastritis or Peptic Ulcer Disease: Chronic inflammation of the stomach lining (gastritis) or the presence of ulcers can cause similar symptoms. These conditions can be exacerbated by stress, diet, and lifestyle choices.

- Functional Dyspepsia: This is a common condition characterized by chronic or recurrent pain or discomfort in the upper abdomen without any identifiable cause. It can be related to stress and anxiety, which may be heightened during your high school years.

- Gastroesophageal Reflux Disease (GERD): If you are experiencing acid reflux, it can lead to symptoms such as nausea and a feeling of fullness, which may discourage you from eating.

- Psychological Factors: Anxiety and stress can significantly impact gastrointestinal function, leading to symptoms like nausea and loss of appetite. The psychological aspect of your symptoms should not be overlooked, especially if they coincide with stressful periods in your life.

2. Alternative Testing Methods:
If you are hesitant to undergo another endoscopy (gastroscopy), there are several non-invasive tests and evaluations that can help assess your stomach health:
- Breath Test for H. pylori: This test can determine if you still have an H. pylori infection without the need for invasive procedures. It involves drinking a solution and then measuring the breath for specific markers.

- Ultrasound: An abdominal ultrasound can help visualize the organs in your abdomen, including the stomach, and can identify any abnormalities.

- Blood Tests: These can check for signs of infection, anemia, or other underlying conditions that may be contributing to your symptoms.

- Stool Tests: These can be used to check for blood in the stool or for the presence of H. pylori.

- Dietary and Lifestyle Assessment: Consulting with a nutritionist or dietitian can help identify any dietary triggers that may be exacerbating your symptoms.

3. Cost Considerations:
The cost of these tests can vary widely depending on your location, the healthcare facility, and whether you have insurance coverage. Generally, breath tests and blood tests are less expensive than endoscopic procedures. It’s advisable to check with your healthcare provider or insurance company for specific pricing and coverage options.

In conclusion, your symptoms could stem from a variety of gastrointestinal issues, including a possible recurrence of H. pylori infection, gastritis, or functional dyspepsia. While endoscopy is a valuable diagnostic tool, there are alternative methods available that can provide insights into your condition without the need for invasive procedures. It’s essential to communicate openly with your healthcare provider about your symptoms and concerns, as they can guide you toward the most appropriate tests and treatments tailored to your situation. Additionally, addressing any psychological factors, such as stress and anxiety, may also play a crucial role in managing your symptoms effectively.

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