How do doctors investigate and treat persistent gastric discomfort?

Looking at the response to PPI (proton pump inhibitor) and antacid, your problem is likely related to gastric acid production since both medicine reduce the acid load in your stomach. Partial treatment response may mean too short a treatment duration. This is especially so if we are dealing with ulcers in your stomach or duodenum. Having said that, persistent gastric pain should not be taken too lightly.

A common test to investigate persistent gastric discomfort is endoscopy which involved inserting a flexible tube into your stomach to inspect the stomach lining. This test is mostly done under sedation to ensure comfort and con usually be completed in15 mins.

From the appearance of the inner stomach lining and tissue sampling, your doctor can detect inflammation, ulcers and HP (Helicobacter pylori) infection. This can help him organise an appropriate treatment for you including eradication of the HP infection. Sometimes, other diagnosis may be made at endoscopy.

Do get an advice from your family doctor if your symptoms do not resolve within the following 1-2 weeks.

- Dr Quan

The standard investigation for such a symptom is a gastroscopy. This involves passing a camera down the esophagus into the stomach and ends in the duodenum. The patient is comfortably sedated and does not feel any pain or distress. The whole procedure is about 10 min and is done as a day procedure. Any suspicious lesion can be biopsied and sent for reporting.

Should the gastroscopy turn out normal and the symptoms persist, the next step is an ultrasound of the gallbladder to exclude gallstones as a cause of the discomfort.

Appropriate treatment is directed at the diagnosis after the gastroscopy.