Persistent Stomach Discomfort: Causes and Solutions

Severe stomach discomfort?

Previously, I experienced frequent gastric contractions, so I went to the outpatient clinic for an endoscopy.
The doctor said I had only mild inflammation.
An abdominal ultrasound was also performed, which showed no other abnormalities.
The doctor prescribed me gastric medication for 1-2 months, but my discomfort has not improved.
Now, when my stomach is empty, I feel most comfortable, except for a slight hunger, and I can't tell if I'm truly hungry because after eating just a little, it seems like I have indigestion.
I constantly feel gas in my stomach and have to burp to release it.
Sometimes, I can't distinguish between hunger and pain.
Currently, my food intake is only about one-third of normal, yet after eating, it feels as if I've overeaten at an all-you-can-eat restaurant; my stomach becomes bloated and painful, even though I've only eaten a small amount.
I have to burp vigorously to expel the gas, and it takes 2-3 hours after eating to feel somewhat better.
In short, I don't experience much pain when I don't eat, but sometimes if I skip breakfast, I still burp a lot.
I'm unsure if this indicates severe indigestion or if there are other underlying causes.
Should I undergo another endoscopy or other tests? Additionally, could my long-term gastric discomfort lead to more serious gastric diseases? I would appreciate a diagnosis and advice on what I should do now, as it has been two months.
Thank you.

Xiao Lin Zi, 30~39 year old female. Ask Date: 2009/06/11

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, delayed gastric emptying is currently the issue.
As for the potential causes, conditions such as gastritis, ulcers, gastroparesis, and gastric cancer are all possible.
If symptoms persist, it is recommended to undergo further examination with an endoscopy, and possibly an abdominal ultrasound.
Best regards, Dr.
Chi-Feng Chen, Taoyuan Hospital, Department of Health.

Reply Date: 2009/06/11

More Info

Understanding persistent stomach discomfort can be quite complex, as it often involves a combination of physiological and psychological factors. Based on your description, it seems you are experiencing symptoms that could be attributed to several potential causes, including functional gastrointestinal disorders, anxiety-related issues, or even dietary intolerances.

Possible Causes of Your Symptoms
1. Functional Dyspepsia: This is a common condition characterized by chronic or recurrent pain or discomfort in the upper abdomen. Symptoms can include bloating, early satiety (feeling full after eating only a small amount), and belching. Your description of feeling discomfort after eating small amounts of food aligns with this diagnosis.

2. Gastritis: Although your previous endoscopy indicated only mild inflammation, gastritis can sometimes be persistent and cause ongoing discomfort. It can be exacerbated by stress, certain medications, or dietary choices.

3. Gastroesophageal Reflux Disease (GERD): If you are experiencing frequent belching and discomfort, it could be related to acid reflux, where stomach acid flows back into the esophagus, causing irritation.

4. Anxiety and Stress: Psychological factors can significantly impact gastrointestinal function. Stress and anxiety can lead to increased gastric motility or sensitivity, resulting in symptoms like bloating, gas, and discomfort.

5. Dietary Factors: Certain foods can exacerbate gastrointestinal symptoms. Common culprits include spicy foods, caffeine, alcohol, and high-fat meals. Additionally, food intolerances (like lactose or gluten intolerance) could also be contributing to your symptoms.

Recommendations for Management
1. Dietary Modifications: Keep a food diary to identify any potential triggers. Consider eliminating common irritants such as caffeine, alcohol, and spicy foods. Eating smaller, more frequent meals may also help reduce discomfort.

2. Stress Management: Since you mentioned that your symptoms may have worsened with stress, incorporating stress-reduction techniques such as mindfulness, yoga, or cognitive-behavioral therapy could be beneficial.

3. Medication Review: If you have been prescribed medications for your symptoms, discuss with your doctor whether they are appropriate or if adjustments are needed. Sometimes, medications like proton pump inhibitors (PPIs) or H2 blockers can help manage gastritis or GERD symptoms.

4. Further Evaluation: Given that your symptoms have persisted for two months without improvement, it may be wise to consider further evaluation. A repeat endoscopy could be warranted to reassess the state of your stomach lining and rule out any other underlying conditions. Additionally, tests for H. pylori infection or other gastrointestinal disorders may be beneficial.

5. Consultation with a Specialist: If your symptoms continue to be bothersome, consider consulting a gastroenterologist for a more comprehensive evaluation. They may recommend additional tests such as an abdominal ultrasound or gastric emptying study to assess for other potential issues.

Conclusion
Persistent stomach discomfort can stem from various causes, and it is essential to take a holistic approach to management. By addressing dietary habits, managing stress, and possibly seeking further medical evaluation, you can work towards alleviating your symptoms. It is crucial to maintain open communication with your healthcare provider to ensure that you receive the appropriate care tailored to your specific needs. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention.

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