Upper Abdominal Bloating: Causes and Solutions - Gastroenterology and Hepatology

Q: Upper Abdominal Bloating: Causes and Solutions

Hello： Psychiatric medications should be gradually tapered under the supervision of a psychiatrist, rather than abruptly discontinued. <br>As for whether further examinations are necessary, this should be determined after an evaluation by a gastroenterologist. <br>Changhua Hospit

Upper abdominal bloating and pain?

Hello Dr.
Tsai, I have been experiencing bloating and pain in my upper abdomen (just above the navel) for over a week.
Over the past six months, I have intentionally lost about 20 kilograms through exercise without taking any medication.
Due to dieting, my food intake has been relatively small until recently when I started to return to a normal diet.
I suspect that my gastrointestinal system may not be able to adapt, leading to indigestion.
The bloating sensation is almost constant, becoming more pronounced after meals, and I even experience intermittent sharp pains.
I can hear my intestines moving, which is quite uncomfortable, and sitting or holding my abdomen provides some relief.

Previously, I felt very bloated, so I went to the emergency room.
The doctor ordered blood tests, a urinalysis, X-rays, and an abdominal ultrasound, concluding that I seem to have gastric bloating, with normal liver and gallbladder function and no abnormalities in other tests.
Later, I visited Chang Gung Memorial Hospital in Kaohsiung, where I underwent an endoscopy.
The doctor stated that my esophagus, stomach, and duodenum appeared completely normal.
I also asked if a colonoscopy was necessary, but he believed it wasn't urgent since I am young, have no symptoms of diarrhea or bloody stools, and no family history of colorectal cancer.
He prescribed me an anti-bloating medication (Nidolium) and advised me to relax and exercise more, suggesting I return for follow-up if issues persist.
I have been taking the medication for a few days, but my symptoms still fluctuate (I feel somewhat better in the morning, but the bloating and pain become more noticeable after eating).
I am very worried about what is happening to my body.
I previously took psychiatric medication for about a year, and I would like to ask Dr.
Tsai if you think I need to see a psychiatrist.
My family believes that I am overly sensitive, which amplifies my pain perception.
Should I consider further examination by a gastroenterologist? Thank you for your patience in reading and responding.

ning, 20~29 year old female. Ask Date: 2014/05/10

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Psychiatric medications should be gradually tapered under the supervision of a psychiatrist, rather than abruptly discontinued.
As for whether further examinations are necessary, this should be determined after an evaluation by a gastroenterologist.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2014/05/10

More Info

Upper abdominal bloating can be a distressing symptom, and understanding its potential causes and solutions is essential for effective management. Based on your description, it seems that you have been experiencing persistent bloating and discomfort in the upper abdomen for over a week, particularly after meals. You mentioned a significant weight loss over the past six months due to dieting, which may have contributed to changes in your digestive system.

Possible Causes of Upper Abdominal Bloating
1. Dietary Changes: Rapid weight loss and changes in eating habits can lead to digestive issues. If you have recently increased your food intake after a period of restriction, your digestive system may struggle to adapt, leading to bloating and discomfort.

2. Gastrointestinal Motility: The sensation of your intestines moving and the accompanying bloating could indicate altered gastrointestinal motility. This can occur due to changes in diet, stress, or even the effects of previous medications.

3. Food Intolerances: Sometimes, reintroducing certain foods can trigger bloating, especially if you have developed an intolerance to specific ingredients (like lactose or gluten) during your dieting phase.

4. Functional Gastrointestinal Disorders: Conditions such as Irritable Bowel Syndrome (IBS) can cause bloating and abdominal pain without any structural abnormalities. Stress and anxiety can exacerbate these symptoms.

5. Psychological Factors: As you mentioned having taken psychiatric medications in the past, it’s worth considering that anxiety or stress could be amplifying your perception of pain and discomfort. Psychological factors can significantly influence gastrointestinal symptoms.

Recommended Solutions
1. Dietary Adjustments: Keep a food diary to identify any potential triggers. Gradually reintroduce foods and monitor your body's response. Eating smaller, more frequent meals may help reduce bloating.

2. Hydration and Fiber: Ensure you are drinking enough water and consuming adequate fiber to promote healthy digestion. However, be cautious with fiber intake if you are not used to it, as it can initially cause bloating.

3. Probiotics: Consider incorporating probiotics into your diet, as they can help balance gut flora and improve digestive health.

4. Physical Activity: Regular exercise can help stimulate digestion and reduce bloating. Even simple activities like walking can be beneficial.

5. Stress Management: If you suspect that anxiety may be contributing to your symptoms, consider stress-reduction techniques such as mindfulness, yoga, or therapy.

6. Follow-Up with Healthcare Providers: Since you have already undergone several tests that returned normal results, it may be beneficial to follow up with a gastroenterologist if symptoms persist. They may recommend further evaluations, such as a colonoscopy, if deemed necessary based on your symptoms and history.

7. Mental Health Consultation: If you feel that anxiety or stress is significantly impacting your physical health, consulting with a mental health professional could provide additional support and coping strategies.

Conclusion
While your symptoms are concerning, the fact that multiple tests have returned normal results is reassuring. It’s essential to continue monitoring your symptoms and maintain open communication with your healthcare providers. If your symptoms worsen or new symptoms arise, seek medical attention promptly. Remember that digestive health can be complex, and sometimes a multidisciplinary approach involving both gastrointestinal and mental health professionals is necessary for comprehensive care.

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