Gastrointestinal Issues: A Comprehensive Guide for Young Adults

A long-standing issue?

At 21 years old, with a height of 170 cm and a weight of 65 kg, I seem to be experiencing a trend of weight gain.

1.
Constipation: This symptom started intermittently at the beginning of last year and became severe in March of this year, often resulting in more than three to four days without a bowel movement.
Sometimes I feel the urge to defecate but cannot do so.
I often feel a sensation of fullness in my abdomen, which sometimes radiates to the anal area and the lower back near the buttocks.
I rarely use laxatives because, although they help with bowel movements, they make the experience very uncomfortable.
The shape of my stools frequently changes, but they are not hard as rocks; sometimes, there are white specks mixed in with the stools.
2.
Nausea: This symptom is the most prominent and has been present intermittently since middle school for several years.
Since February of this year, the nausea sometimes accompanies the urge to defecate, and it tends to ease after a bowel movement.
Recently, it has occurred without the urge to defecate and comes at irregular intervals.
However, I have not experienced any vomiting.
3.
Burning sensation: For the past few days, I have felt a slight burning sensation near the left side of my gastrointestinal tract.
4.
Pain: There are two areas that often hurt without pressure; one is on the left side of my lower abdomen, which feels achy; the other is located between my navel and the left rib cage, which is accompanied by nausea and a dull pain.
5.
Insomnia: I feel groggy in the morning but very alert at night, often taking more than two to three hours to fall asleep.
6.
Belching: I have always had mild belching, but since February of this year, it has become quite intense, and the symptoms of nausea and pain can be relieved through belching.
In mid-February, while I was in New York and had a layover in San Francisco, I began to feel extremely nauseous and uncomfortable on the plane, needing to defecate to relieve the symptoms.
I experienced sensations of burning, cramping, and bloating in my stomach (though I'm not sure if it is indeed my stomach).
After disembarking, I was unable to eat for several days due to severe nausea and could only manage to drink some warm liquids.
I visited two hospitals at that time; the first one diagnosed me with stomach flu, while the second one said I had an ulcer.
After taking medication, my symptoms only slightly improved.
After returning to Taiwan in early March, I gradually resumed normal eating.
I first went to Chang Gung Memorial Hospital for an endoscopy, which showed mild inflammation in my stomach and small white spots in my duodenum (the doctor suspected an ulcer, but it likely wasn't one).
Later, I switched to Cathay Medical Center, where the doctor diagnosed me with an intestinal issue, likely irritable bowel syndrome.
The doctor arranged for an abdominal X-ray, which showed significant fecal accumulation; stool tests were normal.
However, despite medication, my condition fluctuated, with unstable bowel movements, intermittent nausea, persistent belching, and occasional pain in the affected areas.
In early July, I consulted with my doctor, who indicated that it was likely a functional issue and advised me to maintain a regular schedule, exercise more, and increase my fiber intake, which is why no medication was prescribed.
Last week, I sought treatment from a traditional Chinese medicine practitioner, which improved my constipation but did not alleviate the other symptoms.
In terms of lifestyle, I tend to be a night owl, usually going to bed around 2 AM, but due to insomnia, I often fall asleep around 4 or 5 AM.
I do not exercise regularly.
Regarding my diet, I have a relatively small appetite for a male, enjoy sweets and beverages, and do not drink water frequently.
My fiber intake seems adequate.
I am uncertain if I have any food intolerances; however, I enjoy drinking Uni-President's iced green milk tea, which sometimes makes me feel nauseous.
I am unsure if this is due to lactose intolerance or sensitivity to green tea (as I have previously experienced intolerance to black tea).
Additionally, I am a carrier of hepatitis B and have the E antigen.
I also have a history of allergies, including allergic asthma and allergic rhinitis.

yiwen, 20~29 year old female. Ask Date: 2002/07/31

Dr. Yang Peizhen reply Gastroenterology and Hepatology

(1) Based on the symptoms you described, your issue appears to be related to gastrointestinal dysfunction, commonly referred to as dyspepsia.
The fundamental approach to resolving this should involve several aspects.
Firstly, dietary changes are essential; you must avoid irritant foods (such as acidic, spicy, and sweet items), foods that can cause bloating (like bread and legumes), as well as coffee or tea (including milk tea).
It is important to eat at regular intervals and in appropriate portions, while also refraining from smoking and drinking alcohol.
Additionally, try to minimize stress or emotional fluctuations and avoid staying up late.
Furthermore, a cold or the use of pain-relieving and fever-reducing medications during a cold can also lead to gastrointestinal discomfort.
By paying attention to these points, your gastrointestinal discomfort symptoms should naturally improve.
Incorporating more fiber-rich foods such as vegetables and fruits, along with regular exercise, can also enhance bowel function.
(2) You are a carrier of Hepatitis B and have the E antigen, indicating that the virus still has replicative capability, which means there is a potential risk of developing hepatitis at any time.
Therefore, it is crucial to undergo regular follow-up tests (including GOT, GPT, alpha-fetoprotein, and abdominal ultrasound).
Antiviral medications should be administered at appropriate times to reduce the risk of progressing to cirrhosis and developing liver cancer.
Literature reports indicate that individuals who are E antigen positive have a 62-fold increased risk of liver cancer compared to the general population, so it is vital to remain cautious and vigilant.

Reply Date: 2002/07/31

More Info

Gastrointestinal issues are increasingly common among young adults, often exacerbated by lifestyle factors such as diet, sleep patterns, and stress. Based on the symptoms you've described, it appears you are experiencing a combination of constipation, nausea, abdominal pain, and sleep disturbances, which can significantly impact your quality of life. Let’s delve into these issues and explore potential solutions.

Understanding Your Symptoms
1. Constipation: This is characterized by infrequent bowel movements or difficulty passing stools. You mentioned experiencing constipation for over a year, with intervals of several days without a bowel movement. This can lead to discomfort and a feeling of fullness in the abdomen. The presence of white specks in your stool may indicate undigested food or mucus, which can be a sign of irritation in the gastrointestinal tract.

2. Nausea: This symptom can be particularly distressing, especially when it occurs frequently. Nausea can be linked to various factors, including gastrointestinal disorders, dietary choices, and even anxiety or stress. The fact that your nausea sometimes alleviates after a bowel movement suggests a possible connection to your constipation.

3. Abdominal Pain: The pain you describe, especially in the left side of your abdomen, could be related to several issues, including gastrointestinal inflammation, constipation, or even referred pain from other organs. The discomfort you feel may also be exacerbated by your eating habits or stress levels.

4. Sleep Disturbances: Poor sleep can have a profound effect on gastrointestinal health. Late nights and irregular sleep patterns can lead to increased stress and anxiety, which can, in turn, worsen gastrointestinal symptoms.

5. Bloating and Gas: The increased belching and bloating you experience may be due to dietary choices, particularly if you consume a lot of sugary or carbonated beverages. These can lead to increased gas production in the intestines.

Recommendations for Management
1. Dietary Adjustments:
- Increase Fiber Intake: Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stool and can alleviate constipation. However, increase fiber gradually to avoid exacerbating gas and bloating.

- Stay Hydrated: Drink plenty of water throughout the day. Dehydration can worsen constipation, so aim for at least 8-10 cups of water daily.

- Limit Trigger Foods: Since you suspect that certain foods, like dairy or specific teas, may be causing discomfort, consider keeping a food diary to identify potential triggers. If you suspect lactose intolerance, try eliminating dairy products for a period to see if symptoms improve.

2. Regular Exercise: Incorporate physical activity into your routine. Exercise can help stimulate bowel movements and reduce stress, which may alleviate some of your gastrointestinal symptoms.

3. Sleep Hygiene: Establish a regular sleep schedule. Aim to go to bed and wake up at the same time each day. Create a relaxing bedtime routine to help signal to your body that it’s time to wind down.

4. Stress Management: Consider techniques such as mindfulness, meditation, or yoga to help manage stress levels. Stress can significantly impact gastrointestinal health, so finding effective coping strategies is crucial.

5. Medical Follow-Up: Given your history of gastrointestinal issues and the complexity of your symptoms, it’s essential to maintain regular follow-ups with healthcare providers. If symptoms persist or worsen, further investigations, such as imaging studies or endoscopy, may be warranted to rule out any underlying conditions.

Conclusion
Your symptoms are multifaceted and may require a comprehensive approach to management. By making dietary changes, increasing physical activity, improving sleep hygiene, and managing stress, you may find significant relief from your gastrointestinal issues. Additionally, maintaining open communication with your healthcare providers will ensure that you receive the appropriate care and monitoring for your condition. Remember, it’s essential to listen to your body and seek help when needed.

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