I have constant bloating and excess gas production with normal endoscopy. Is this GERD?

Question

Hi doctor,

I have bloating and constant gas release by burping with heartburn that gives me a heart attack feeling before. I even had anxiety and panic attacks. Whenever I had bloating, I feel my heartbeat.

Now, I went into a keto diet and eating a super enzyme supplement, and it is going well. My weight dropped from 93 kg to 83 kg at the moment, and I am 168 cm high.

However, my concern is that I have high blood pressure, but I control my food with keto and do a regular workout to fix my health. I also notice that when I ate dark chocolate two days ago, severe gastritis occurred, and I felt my crunching in my stomach and heart crunching along with bleeding stool. So right now, I am staying away from all these until my stomach recovers.

Sometimes, I even felt weak, and when I do an intense workout, I can feel my heart beats fast with lightheadedness. But, my heart rate was not that high. Am I having other problems? It worries me as I had been anxious for the year due to this. I had an endoscope last month, and they state my stomach lining was good.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand you must be worried about your recent onset of stomach upset. If your endoscopy is normal, it is indeed reassuring that nothing wrong with the stomach structure. Meaning there is no ulcer, redness, which are otherwise common causes of this type of symptoms.

I understand your symptoms are predominantly gaseous. The common causes of these are the slowing of the stomach called gastroparesis. This slowing can occur in 10 different medical conditions like diabetes, cholesterol issues, thyroid, drugs, obesity, and in some idiopathic reasons (which means without identifiable cause). Weight reduction was a good attempt indeed. This will further help you to improve sugar and cholesterol control.

I am concerned about the bleeding in the stools. Were the dark stools are due to chocolate or any other diet changes or were they exact blood? Did your doctor suggest you some testing for it? If available, can you share a picture of it?

I would suggest you some investigations for this bleeding and others. But clarify me about this first. And do share the packaging label of that food super enzymes.

Answer 2

Hello,

Welcome back to icliniq.com.

No, your symptoms do not seem to be due to GERD (gastroesophageal reflux disease), and the treatment of GERD is not an acid replacement but acid supression.

Well, here are my recommendations. Keep doing a low carb diet. This will help your continued weight loss. This would be to your ultimate benefit. The supplements you take, if improve your symptom, you can continue with that. Otherwise, if no improvement, I suggest to stop it. It is pancreatic enzyme supplements that you do not need. So, I am asking you to justify its use. Otherwise, not required, given your symptoms and problem with gases within the gut.

Please test for the following things and let me know once reports are available.

1. CBC (complete blood count).

2. TSH (thyroid-stimulating hormone), FT4.

3. LFT (liver function test).

4. Lipid profile on fasting.

5. Fasting blood sugar plus fasting insulin level.

6. HBa1c (glycated hemoglobin).

7. Serum amylase.

8. Stool for H.pylori antigen.

And it would be best if you start capsule Esomeprazole 40 mg half an hour before breakfast for one week, and tablet Metoclopramide 10 mg half an hour before meals, twice daily for two weeks. Avoid foods with high FODMPAS value.

I have constant bloating and excess gas production with normal endoscopy. Is this GERD?

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