Hi Dr. Samuel,

The symptoms started about 2 years ago. Initially I started to feel like “pressure” inside my stomach after waking up in the morning and had panic attacks as a result because I didn’t know what was wrong with me. During such panic attacks I used to feel nervous and nauseous, then lie down feeling very tired.
The reason why I had those panic attacks was because I always have phobia about cancer. After a few weeks of not eating (because of feeling of early satiety) and as a result losing some weight I started to feel better. I saw a doctor and told me there is nothing to worry about. I had full blood test and an ultrasound to check my bladder and it returned normal.
Since then, my main complaint has been belching a lot. I started to realize that I was not able to eat because of the belching problem and the problem got worse as my stomach shrank and got smaller because I was not eating.
The intensity of my symptoms seems cyclic. Some days/weeks I feel better and some other days/weeks I feel worse. There has been general trend towards getting better in the recent few months. But the problem of Belching a lot which I have never experienced in the past of my life still remains and sometimes makes me feel I cannot eat as much as I used to.
My symptoms also exclusively occur during the first half of the day and especially during the first three hours of the day as I always feel my stomach is heavy and that I cannot eat. Then I belch for several times in the morning until my stomach feels better and I can have my breakfast. My energy in the morning is also very low.
In 90% of the days I feel like an entirely different person during the second half of the day (from evening to night). Although belching continues throughout the whole day, my stomach does not seem to feel heavy and I can eat large meals especially at dinner. I also feel at night a dramatic increase in my energy (although this is still not like the explosive energy I used to have in my body in the past). But I can say I am normal at night and sometimes very bad in the morning.
I thought that perhaps my stomach is accumulating gas during the night while I am asleep, and once I release some gases in the morning I feel a little bit better. But my energy also increases in the night. The energy pattern reminds me of the “adrenal fatigue syndrome” which is associated with stress. In fact I am stressed most of the time because this low energy and heavy morning stomach sometimes prevents me from being productive at work.
I also had bad sleeping habits. I sleep at 3 AM and wake up 11 AM. I can only start to feel better at 1 AM when I have my “breakfast”. I have my lunch at 5 PM and dinner at 11 PM. Sometimes I cannot have that “breakfast” and have my lunch at 3-4 PM then dinner at 10 PM.
Sometimes (but rarely) I have acid reflux. It is not heartburn. I just feel some acid went up to my mouth. I do not have sternal pain etc. I don’t think I have GERD. Sometimes (also rarely) I feel like very brief and short burning sensation in the lower abdomen. I think the location is very low to be the stomach. My stools are normal most of the days but tend to be somewhat loose. The appearance of stools is normal. No blood, or mucus whatsoever. I don’t know if it is IBS but I don’t think so because I do not have a spasm in my colon.
I am aware that digestive problems can stem from stress. In fact I am a stressed person and I tend to worry about the smallest details. But I have always been like that since I was born.
I tried using Lanzoprazole for 4 months (last year from April to August 2012). I am not sure if it really helped because as I mentioned, my symptoms are cyclic. Some days/weeks I feel better. I have not been taking any medication since August 2012).
The most bothersome symptoms are morning fatigue and belching and morning heavy stomach (which prevents me from having my breakfast. I also have an important and persistent symptom which is odorless flatus. It seems a lot of this gas in my stomach passes to the lower end. Since It is odorless I believe it is CO2 or Nitrogen. I don’t think my problem is aerophobia because I don’t chew quickly I don’t chew gums etc. But antacids didn’t really help so I don’t think it is CO2 either.
Belching and the heavy stomach feelings are not associated with food because I sometimes belch immediately after I get up from bed after I wake up. On the bad days, I belch before, during and after meals. In fact I feel a little bit better after I have breakfast. It is like food promotes the expulsion of these large bubbles of gas inside my stomach. I also almost always belch after I drink little water in the morning (after I wake up).
It is noteworthy that two years ago (about the same time when my symptoms started) I used to work in a lab where a colleague of mine was doing research on multiple strains of H.Pylori. I don’t know if I got that one at the time. I had a urea breath test and the test strip turned somewhat yellow (indicating the presence of Urease) but the instrument showed a negative result. I understand that about 70% of people are infected though.
I just feel I am not what I used to be. I have just recently arrived to Austria after I won a PhD scholarship. I need my full energy and health in order to be productive and not let my supervisor and professor down. It makes me feel stressed when I feel I lack the energy required. I also want to eat freely whenever I want to and wherever I want as before. My symptoms might seem silly or trivial and I never had some alert symptoms as nausea or vomiting or blood etc, but the morning symptoms are very annoying and disturbing and they affect my academic performance and productivity.
As I said my symptoms are cyclic. For some periods (weeks) I belch 30 times during the day. Other periods I belch 10 times or less and never even notice it. But morning fatigue and the inability to eat breakfast in the morning is obvious on the bad days. It is also noteworthy that I feel much more energetic after I eat (perhaps because I am still underweight). But my weight never exceeded 80 Kg when I was healthy despite how much I used to eat.
I started to eat better recently (in the past few months). But this doesn’t seem to be a result of reduced bloating or gas but rather because my stomach got bigger and can now accommodate both food and gas. So I now eat more and my weight has in fact increased and I started to get used to it. But still I feel I am nothing close to what I used to be in the past. I used to have unbelievable amounts of energy. The low energy now is probably associated with the fact that I do not eat the quantities I used to eat. I used to eat 3-4 meals a day when I was healthy. Now I eat 2-3 meals a day. With the onset of symptoms (about two years ago) I was eating only 1 meal per day (in the evening).