Stomach Issues: Gas, Pain, and the Need for Endoscopy

Q: Stomach Issues: Gas, Pain, and the Need for Endoscopy

Hello： (1) Gastroesophageal reflux disease (GERD) primarily affects the lower esophagus, while gastric ulcers primarily affect the stomach. <br>One common cause of both conditions is gastric acid. <br>Theoretically, taking medications to reduce gastric acid can simultaneously tre

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Hello Dr.
Tsai,
I previously consulted you regarding issues related to my stomach, and I apologize for bothering you again.

1.
Over the past few days, I have been experiencing bloating and a feeling of pressure in my stomach.
I had a follow-up appointment two days ago and discussed this with my attending physician.
I asked if it would be possible to have another endoscopy next year if my condition remains the same.
The response was, "Yes, but it’s best to wait until the second half of the year." My question is: After experiencing gastroesophageal reflux and undergoing an endoscopy while regularly taking medication, is there a possibility that this could worsen into a gastric ulcer?
2.
Recently, I have been experiencing different types of pressure and pain, both in my stomach and diaphragm.
My attending physician attributed this to indigestion.
I would like to ask: When I press on my diaphragm (the edge of my stomach), I do indeed feel a pressure and pain.
Is this related to my stomach issues, or is it an independent event?
Thank you for your response.
I appreciate it.

Zhuang Xiansheng, 40~49 year old female. Ask Date: 2012/12/27

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: (1) Gastroesophageal reflux disease (GERD) primarily affects the lower esophagus, while gastric ulcers primarily affect the stomach.
One common cause of both conditions is gastric acid.
Theoretically, taking medications to reduce gastric acid can simultaneously treat both GERD and gastric ulcers.
However, there is still a possibility of developing a gastric ulcer during treatment.
In addition to medication, it is important to pay attention to dietary habits and avoid tea, coffee, smoking, alcohol, betel nut, fried foods, chocolate, and sweets, among others.
(2) During the course of medication, if symptoms do not appear most of the time and only occur occasionally, it should not be attributed to the ineffectiveness of the medication.
Instead, one should consider whether there have been any significant dietary changes or if it is simply an occurrence of acute gastroenteritis.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2012/12/27

More Info

Hello! Thank you for reaching out with your concerns regarding your stomach issues, including gas, pain, and the potential need for endoscopy. It sounds like you have been experiencing a range of gastrointestinal symptoms that have prompted you to seek medical advice. Let’s break down your questions and concerns.

1. Possibility of Worsening from GERD to Ulcer: You mentioned that you have been diagnosed with gastroesophageal reflux disease (GERD) and are on medication for it. While GERD can lead to complications if not managed properly, the transition from GERD to a gastric ulcer is not a direct progression. However, chronic inflammation of the stomach lining due to acid reflux can contribute to the development of gastritis, which in some cases can lead to ulcer formation. It’s important to adhere to your prescribed medication regimen and follow up with your healthcare provider regularly. If you continue to experience symptoms like persistent pain or changes in your condition, further evaluation, including an endoscopy, may be warranted. Your doctor’s suggestion to wait until the second half of the year for another endoscopy is reasonable, provided your symptoms remain stable and manageable.

2. Pain in the Diaphragm Area: The discomfort you are feeling in the diaphragm area, which is located just above the stomach, can indeed be related to your gastrointestinal issues. The diaphragm and the stomach are closely linked anatomically and functionally. Conditions such as gas buildup, bloating, or even muscle tension can cause referred pain in this area. Additionally, if you are experiencing significant gas or bloating, it can lead to pressure on the diaphragm, resulting in discomfort. However, if the pain is new or significantly different from your usual symptoms, it’s essential to communicate this to your healthcare provider. They may want to investigate further to rule out any other potential causes, such as musculoskeletal issues or even cardiac concerns, especially if the pain is severe or accompanied by other symptoms.

Additional Considerations
- Diet and Lifestyle Modifications: Since you are experiencing gas and bloating, consider evaluating your diet. Foods that are known to cause gas include beans, lentils, carbonated beverages, and certain vegetables like broccoli and cabbage. Keeping a food diary can help identify any triggers. Additionally, eating smaller, more frequent meals and avoiding eating too quickly can help reduce symptoms.

- Stress and Anxiety: Stress can significantly impact gastrointestinal health. If you are experiencing stress, whether from work or personal life, it may exacerbate your symptoms. Techniques such as mindfulness, yoga, or even talking to a mental health professional can be beneficial.

- Follow-Up Care: Regular follow-ups with your gastroenterologist are crucial. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention. It’s essential to keep an open line of communication with your healthcare provider about your symptoms and any changes you notice.

In summary, while the risk of GERD progressing to a gastric ulcer exists, it is not a guaranteed outcome, especially with proper management. The pain you are experiencing in the diaphragm area may be related to your gastrointestinal issues, but it’s important to monitor it and discuss it with your doctor. Regular follow-ups and lifestyle modifications can significantly improve your quality of life. Thank you for your questions, and I hope this information helps clarify your concerns!

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