Managing GERD and Gastroenteritis: When to Seek Medical Attention

Gastroesophageal reflux disease (GERD) with gastroenteritis?

I have been taking antihypertensive medication and started experiencing gastroesophageal reflux disease (GERD) since September of last year.
After undergoing an endoscopy, the doctor diagnosed me with mild GERD, and at that time, Helicobacter pylori was not detected.
I have been using a proton pump inhibitor (PPI), Pantoprazole, since then, but my condition has not improved.
After the PPI expired, I switched to over-the-counter medications such as Aigui Reverse, Moshu Stomach Clear, and Yuenyi Stop.
Recently, I have been experiencing a poor appetite, and on the night of the 26th, I was very hungry and ate a tea egg.
I couldn't stop feeling hungry and was worried about reflux, which caused me anxiety (I have autonomic nervous system dysregulation).
The next morning, I felt somewhat better and ate rice, carrots, and cabbage.
By noon, I had rice, pumpkin, and cabbage, but after eating a small amount, I started feeling nauseous.
In the evening, I had rice, salmon, black fungus, and cabbage, and again, after eating a little, I began to feel nauseous.
An hour after dinner, I drank some water, but I started feeling nauseous even from drinking water.
Regarding bowel movements, I had three bowel movements during the day; the first was small, the second was somewhat loose, and the third was also a small amount of loose stool.
I would like to ask the doctor if it would be better to undergo another endoscopy to check my condition, or should I go to the emergency room for an examination?

Wen An, 20~29 year old female. Ask Date: 2016/01/27

Dr. Xu Kaixi reply Surgery

You have previously undergone an upper gastrointestinal endoscopy and were diagnosed with mild gastroesophageal reflux disease.
You have been taking the relevant medications, but your condition has not fully improved.
It is possible that a peptic ulcer has not healed completely.
It is recommended that you visit the outpatient department for further evaluation and to determine if another endoscopy is necessary.

Reply Date: 2016/01/27

More Info

Managing gastroesophageal reflux disease (GERD) and gastroenteritis can be challenging, especially when symptoms persist despite treatment. Based on your description, it seems you are experiencing a combination of GERD symptoms and gastrointestinal discomfort, which may be exacerbated by anxiety and dietary changes. Here’s a comprehensive approach to understanding your situation and when to seek medical attention.

Understanding Your Symptoms
1. GERD Symptoms: GERD is characterized by acid reflux, which can lead to symptoms such as heartburn, regurgitation, and difficulty swallowing. You mentioned that you have been on proton pump inhibitors (PPIs) and other medications, but your symptoms have not improved. This could indicate that your current treatment regimen is not adequately controlling your acid reflux.

2. Gastrointestinal Symptoms: The nausea and vomiting sensations you are experiencing, especially after eating, could be related to several factors:
- Dietary Choices: Eating foods that are difficult to digest or that trigger reflux can lead to discomfort. The tea egg you consumed may have been too rich or spicy, contributing to your symptoms.

- Medication Changes: Switching from PPIs to other gastric medications may have altered your stomach's acid production and motility, leading to increased reflux or gastrointestinal upset.

- Gastroenteritis: The presence of loose stools and abdominal discomfort could suggest a viral or bacterial infection, especially if you have had recent dietary indiscretions or exposure to contaminated food.

When to Seek Medical Attention
Given your ongoing symptoms, here are some guidelines on when to seek medical attention:
1. Persistent Symptoms: If your symptoms of nausea, vomiting, and abdominal pain persist for more than a few days despite dietary modifications and over-the-counter medications, it is advisable to consult a healthcare provider.

2. Severe Symptoms: If you experience severe abdominal pain, persistent vomiting, or signs of dehydration (such as decreased urination, dry mouth, or dizziness), you should seek immediate medical attention, possibly through an emergency department.

3. Change in Bowel Habits: The presence of diarrhea, especially if it is accompanied by fever, blood in the stool, or severe abdominal cramping, warrants a visit to the doctor.

4. Medication Review: Since you are on multiple medications for both hypertension and gastrointestinal issues, it may be beneficial to have a healthcare provider review your medications to ensure there are no interactions or side effects contributing to your symptoms.

5. Follow-Up on GERD: If you have not had a follow-up endoscopy since your initial diagnosis of mild GERD, and your symptoms are not improving, it may be appropriate to discuss this with your healthcare provider. An endoscopy can help assess the condition of your esophagus and stomach lining, and determine if there are any complications such as esophagitis or ulcers.

Recommendations
- Dietary Modifications: Consider keeping a food diary to identify any specific triggers that worsen your symptoms. Eating smaller, more frequent meals and avoiding known irritants (spicy, fatty, or acidic foods) may help.

- Medication Adherence: Ensure you are taking your medications as prescribed. If you have concerns about side effects or efficacy, discuss these with your healthcare provider rather than discontinuing them on your own.

- Stress Management: Since you mentioned anxiety and autonomic nervous system dysregulation, incorporating stress-reducing techniques such as mindfulness, yoga, or deep-breathing exercises may help alleviate some of your gastrointestinal symptoms.

- Hydration: Stay well-hydrated, especially if you are experiencing diarrhea. Electrolyte solutions can help maintain hydration levels.

In conclusion, while it is essential to monitor your symptoms closely, seeking medical attention is warranted if your condition does not improve or worsens. A healthcare provider can offer tailored advice and may recommend further diagnostic tests to ensure proper management of your GERD and any potential gastroenteritis.

Similar Q&A

Am I Suffering from Gastroenteritis or GERD? Understanding My Symptoms

Hello, doctor. Recently, I've been experiencing stomach pain after meals for the past week, along with a feeling of bloating and even nausea that sometimes leads to vomiting. Occasionally, I also have diarrhea. Every morning when I wake up, my throat feels very dry and sore,...

Dr. Lin Zhebin reply Family Medicine
Hello: Based on the symptoms you described, it seems more like gastroesophageal reflux disease (GERD), as abdominal pain and diarrhea from gastroenteritis typically resolve on their own within a few days to a week, unless there is persistent vomiting, watery diarrhea, or blood/bl...

Understanding Gastrointestinal Issues: When to Seek Medical Attention

Recently, I have been facing my master's thesis defense, and with the added stress of commuting, my stomach has been constantly churning, accompanied by bowel sounds. When I go to the bathroom, I only pass a small amount of stool, mostly just gas. Although I have experienced...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello, sir. You are likely experiencing typical irritable bowel syndrome (IBS) or motility disorder. Dietary adjustments and stress management can help, and if necessary (such as before an exam), medication to reduce motility can improve your condition. Wishing you success in you...

Understanding Gastrointestinal Issues: When to Seek Medical Help

Since last July, I suddenly started feeling nauseous, but I haven't actually vomited for several days. It might be due to fear or psychological factors. I have sought medical attention and was initially diagnosed with gastroesophageal reflux disease (GERD), which was treated...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Psychological factors, organ diseases, or gastrointestinal dysfunction (such as rapid or slow motility) are all possible causes. To rule out any organ-related issues, it is necessary to conduct examinations to check for ulcers or inflammation. If there are any other concer...

Understanding Gastrointestinal Concerns: When to Seek Medical Attention

Hello, doctor. I would like to ask about my habit of staying up late; I usually go to bed late and sleep until noon the next day, then I have lunch. I often eat at a buffet while working outside, and I usually include vegetables and fruits in almost every meal, but I don't e...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: I think you should consult a gastroenterologist, who will determine whether you need to undergo an endoscopy. Additionally, I recommend going to bed early, staying well-hydrated, and increasing your physical activity. Changhua Hospital cares about your health. Dr. Tsai An-...