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Dr. Andrew Rynne

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What do persistent bloating, fatigue and pain in stomach indicate?

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Dr. Rishi

General Surgeon

Practicing since :1999

Answered : 1312 Questions

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Posted on Mon, 26 Oct 2015 in Digestion and Bowels
Question: I have been suffering from all of these symptoms from last 16months. All the symptoms have been developed gradually.
(15/May/2014 – Present)
1.     Persistent Bloating/Fullness in “Upper Stomach” which becomes worse right after eating or drinking anything.
2.     Nervous stomach. Depressed? Anxious? Immediate reaction in “Upper Stomach”. I can feel nervousness, stress in my stomach.
3.     Problem in deep breathing. Feel like I am wearing a tight belt on “Upper Stomach”.
4.     Mild pain/discomfort in upper stomach when I lose my stomach (breath out).
5.     Mild pain/discomfort in upper stomach on pressing.
6.     Incomplete evacuation- not from rectum, I think my upper stomach has never emptied since last 16months, almost daily bowel movements, no constipation.
7.     Constant Burping from last 6 years. Burping becomes worse right after eating. I can burp on command. It’s like some air is always there (Just below the throat). That means I am always ready to burp as many times at any time of day.
8.     Sometimes Burning sensation in upper stomach: Rare
9.     Fatigue and feeling sleepy.
10.     Poor concentration due to discomfort.
11.     Feeling of food is not moving from stomach into intestines.
12.     Two big meal: 12pm -1am and 8pm- 9pm.
13.     I walk 5km daily.

- Pain/cramp/ache in stomach: Never
- Pain during bowel evacuation: Never
- Feces shape: Formed
- Hard Feces (Constipation): Possible
- Diarrhea: Never


Test (July/2015):
- Ultrasound: Nothing
- Stool & Urine Test: Nothing
- Diabetes: Negative
- CBC: Normal
- Thyroid Test: Normal
- Weight: No Change (Gained 3KG)
- Vitamin D3: Very poor
- IgE: Double than normal
- Appetite: Less than normal due to incomplete evacuation.

Treatment:
-     Treatment for GERD and Dyspepsia. April – July.

Question:
-     IBS: But I don’t have any discomfort in lower abdomen or anywhere. I don’t have constipation or diarrhea. Just bloating.
-     No feeling in lower stomach.
-     GERD: But I don’t have acid reflux and heartburn.
-     Dyspepsia?
-     Fecal Impaction? Lower is congested that’s why problem in upper?
-     Obstruction?
-     What it could be?

Current Treatment (2/September/2015 – Present):
1.     Suprial L
2.     Veloz 20
3.     Gush
4.     Lubowel 8

Kindly give anything for this persistent stress and anxiety to calm my stomach. I am very deeply stressed, depressed for my job and get anxious on very small things.
doctor
Answered by Dr. Rishi 3 hours later
Brief Answer:
It seems to be due to anxiety and increased air swallowing.

Detailed Answer:
Hi XXXXXXX
Thanks for the detailed and organized description of your problem.
You seem to be a very intelligent and meticulous person.
However, it is not nice to see that anxiety is getting the better of you.
I feel that there is nothing organically wrong with you - which can be clarified with an Upper GI Endoscopy. You will need to contact your GP or a Gastroenterologist for this investigation.
Your anxiety might be leading to increased air swallowing which can happen due to hyperventilation - also seen in anxiety episodes. Then the person gets used to a certain breathing pattern and unknowingly swallows more air into the stomach leading to bloating and repeated burping.
You should see a Psychiatrist or Psychologist who can help you with your anxiety and can help you relax from inside. That is extremely important.
As for the medicines you are on, you should stop Suprial, Gush and Lubowel. They will not do you any good.
You need only Veloz. That also I would advice change to Capsule Omeprazole 20mg twice a day half an hour before meals. It is similar to Veloz and I have found better results with this medicine.
Take care and do let me know if there are any other queries that I can help with.
Dr Rishi, New XXXXXXX XXXXXXX

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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