Upper Abdominal Discomfort: Causes and Remedies - Gastroenterology and Hepatology

Discomfort in the upper abdomen?

Hello, doctor.
I would like to ask about my condition.
Around mid-January, I experienced stomach discomfort and went for an examination.
The doctor diagnosed me with gastritis.
I have been taking medication for about four times, and I feel that the symptoms of stomach heaviness and bloating have improved.
However, recently, since I ran out of medication and felt better, I did not continue to get more (I haven't taken any medication for the past two days).
This morning, I woke up feeling some discomfort in the area just above my stomach, around the lower left chest.
Sometimes, I feel a pulsing sensation in that area, similar to a heartbeat (this has happened more than once).
Additionally, I have experienced slight dizziness and a vague discomfort that is hard to describe—it's neither pain nor heaviness.
Pressing on that area does not cause pain, but the discomfort often makes me unconsciously press on that spot.
Recently, my stool has also been dark and watery.
I would like to know what improvements I can make.
Should I continue taking medication? What dietary changes should I consider? Are there any foods I should avoid? Could you provide some advice on this matter?

Alan, 20~29 year old female. Ask Date: 2012/02/11

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Alan! You mentioned experiencing discomfort in the upper abdomen.
This symptom should be considered in relation to gastroesophageal reflux disease or peptic ulcers.
If you have recently noticed black stools, it may indicate a bleeding phenomenon.
It is recommended that you visit a nearby hospital to arrange for an upper endoscopy and a stool occult blood test.
~~Changhua Hospital cares about your health~~

Reply Date: 2012/02/11

More Info

Upper abdominal discomfort can be a complex issue, often stemming from various underlying causes. Based on your description, it seems you have been experiencing symptoms consistent with gastritis, which is inflammation of the stomach lining. This condition can lead to discomfort, bloating, and even changes in bowel habits, such as the black, watery stools you mentioned, which could indicate the presence of blood in the gastrointestinal tract.

Possible Causes of Your Symptoms
1. Gastritis: As you noted, your doctor diagnosed you with gastritis. This condition can be caused by several factors, including excessive alcohol consumption, chronic stress, certain medications (especially non-steroidal anti-inflammatory drugs), and infections (like Helicobacter pylori).
2. Peptic Ulcers: If gastritis is left untreated, it can lead to the development of peptic ulcers, which can cause more severe symptoms, including pain and changes in stool color.

3. Esophageal Issues: The sensation of a heartbeat in the upper abdomen could also be related to esophageal spasms or gastroesophageal reflux disease (GERD), where stomach acid flows back into the esophagus, causing discomfort.

4. Cardiac Issues: Although less likely given your symptoms, it’s essential to rule out any cardiac issues, especially since you mentioned a sensation near your chest.

5. Dietary Factors: Certain foods can exacerbate gastritis symptoms, including spicy foods, acidic foods (like citrus and tomatoes), caffeine, and alcohol.

Recommendations for Management
1. Continue Medication: Since you have been on medication for gastritis, it is advisable to continue taking it as prescribed. If your symptoms have improved, consult your doctor about whether you should continue the medication or if a follow-up is necessary.

2. Dietary Modifications:
- Avoid Irritants: Stay away from spicy, acidic, and fried foods, as well as caffeine and alcohol, which can irritate the stomach lining.

- Eat Smaller Meals: Instead of three large meals, consider eating smaller, more frequent meals to reduce the burden on your stomach.

- Incorporate Soothing Foods: Foods like bananas, rice, applesauce, and toast (the BRAT diet) can be gentle on the stomach. Probiotics found in yogurt may also help restore gut health.

3. Hydration: Ensure you are drinking plenty of water, as dehydration can worsen gastrointestinal symptoms.

4. Monitor Symptoms: Keep a journal of your symptoms, noting when they occur and any potential triggers. This can help you and your healthcare provider identify patterns and adjust your treatment plan accordingly.

5. Seek Medical Attention: Given the presence of black, watery stools, it is crucial to consult a healthcare professional promptly. This could indicate bleeding in the gastrointestinal tract, which requires immediate evaluation.

6. Consider Further Testing: If your symptoms persist or worsen, further testing such as an endoscopy may be warranted to visualize the stomach lining and assess for ulcers or other abnormalities.

Conclusion
Upper abdominal discomfort can arise from various causes, and it is essential to approach this issue holistically. Continue your medications, make dietary adjustments, and monitor your symptoms closely. Given the potential seriousness of your symptoms, particularly the changes in stool color, do not hesitate to seek medical advice. Early intervention can prevent complications and lead to a more effective treatment plan.

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