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Anxiety, panic disorder, jumping sensation in abdomen, bloated, belching of air, causes. Treatment ?

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General & Family Physician
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Hi, I have sever anxiety panic disorder which I am currently on medication for. My question is I have a jumping sensation in my upper abdominal area. It almost feels like a hicup in my abdominal area just below my sternum. I often feel bloated when I am experiencing this sensation. It can happen when I am at rest or when I am exercising. This is followed by belching of air....No acid reflux just wind. I have no pain in my chest nor do I feel any numbness in my limbs. If I belch enough it finally subsides....But it scares me as if I am having heart palpatations. My wife is a nurse and when these symptoms are going on she listens to my heart and says there are no skip beats and that every thing is normal with my heart...Can you please help me...Thank you
Posted Sat, 28 Apr 2012 in General Health
Answered by Dr. Deepak Anvekar 4 hours later

From the history provided it seems that your symptoms might be due to irritation of the diaphragm caused by aerophagia (Ingestion of excess air).

The condition you may have is self-limiting and episodic and it may be useful to try to identify events, foods, drinks or drugs that precede the onset of an episode.

Belching is the expulsion of gas from the gut through the mouth (eructations). Bloating may occur due to gas trapped within the gastrointestinal tract and this is often relieved upon belching.

Belching and bloating may be due to food, eating habits, or disorders in the stomach, small intestine or gallbladder.

Causes of air swallowing that later result in belching: include -

1. Fast eating or drinking
2. Mouth breathing
3. Nasal blockage
4. Hyperventilation related to anxiety
5. Regular gum chewing
6. Poorly fitted dentures

Treatment is by removing the cause.

This in mild cases can be managed with dietary and lifestyle changes. Take the following steps to help manage your symptoms:

1. Increase the amount of fluid you drink, especially water. Avoid carbonated drinks and alcoholic beverages.

2. Avoid foods that cause gas, such as beans, broccoli, cabbage, and XXXXXXX The amount of gas that different foods cause varies from person to person.

3. Avoid swallowing air. Swallowing air may increase your symptoms.

4. Eat slowly. Avoid gulping food or beverages. When you rush through meals or eat on the run, you are more likely to swallow air.

5. Chew your food thoroughly before you swallow.

6. Avoid drinking through a straw.

7. Avoid chewing gum or eating hard candy.

8. Do not smoke or use other tobacco products.

9. If you wear dentures, check with a dentist to make sure they fit properly.

10. Keep calm. Tension and anxiety can cause you to swallow air.

Some foods to be avoided include certain fermentable short-chained carbohydrates that are degradable by intestinal bacteria yielding large amount of gases, like hydrogen or carbon dioxide, thus causing belching and bloating. Such food include

1. White bread, pasta, pastries, cookies, onions, and asparagus, leeks, garlic, chicory roots and chicory based coffee substitutes.

2. Legumes (soy, beans, chickpeas, lentils), cabbage and brussel sprouts.

3. Honey, dried fruits like prunes, figs, dates, or raisins, apples, pears, sweet cherries, peaches, agave syrup, watermelon, papaya.

The treatment in severe cases, where belching is lasting more than 2 days would be with prescription medications (Haloperidol, Reglan, chlor ) which can be provided by your primary care provider.

In the mean time, Use of OTC medications mentioned below can be used to have some relief.

1. Activated charcoal (Charcocaps) , will absorb the excess gas produced.

2. Antacids, such as Di-Gel, Maalox Anti-Gas, and Mylanta Gas, allow gas to be belched away more easily.

3. Food enzymes, such as Beano, which help break down the sugars found in vegetables and grains, can be added to foods that cause you to have gas.

I hope the suggestions given are helpful.

Please feel free to forward any doubts or questions, if you have.

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