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How do doctors investigate and treat persistent gastric discomfort?

Gastroenterology Health & Fitness Colorectal Surgery

I'm a 22 year old female. I've been experiencing gastric discomfort for 2 weeks now. It's best described as a burning feeling around my upper abdomen, with bloating as I feel trapped wind in my stomach throughout the entire day. I modified my diet to avoid acidic food, and have been taking PPI for 2 weeks, and antacids for 1 week. The medications seemed to help, as the frequency of gastric discomfort has reduced. However, I have now completed my medications, and am still experiencing gastric discomfort. I would like to know whether I should visit the doctor for further investigation and treatment for my gastric discomfort, and what tests are done? Thank you and have a good day.

DOCTOR’S ANSWER (2)
Dr Quan Wai Leong
"A specialist in Digestive Health and Advanced Endoscopy"
(4 Reviews)

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


Dr Quan Wai Leong
MBBS, MRCP, FRCP, FAMS

Gastroenterology and Hepatology, GI Endoscopy and Liver Centre @Royal Square
101 IRRAWADDY ROAD
ROYAL SQUARE
#15 - 01 Singapore 329565

623 views 20 Nov 2018

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.


Dr Wong Nan Yaw
MBBS (S’pore), FRCS (Edin), FAMS (General Surgery)

NY WONG SURGERY
3 MOUNT ELIZABETH
MOUNT ELIZABETH MEDICAL CENTRE
Singapore 228510

570 views 21 Nov 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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