What steps should I take to manage indigestion and obesity?

Question

Hello doctor,

For the past five to six years, I have been experiencing random periodic episodes of indigestion at night. Usually, between 2 am and 5 am, I wake up from deep sleep due to upper abdominal pain, followed by foul-smelling, egg-like burps, and then diarrhea with watery stools. In the last two episodes, I have also experienced vomiting. After vomiting and diarrhea, the burps and pain go away as if nothing had happened. Typically, all of this resolves within five to six hours.

I use a hot water bottle for pain relief, which helps alleviate the discomfort. However, whenever the eggy burps start, I know the next few hours will be very painful for me. I am obese. My weight was 299 pounds, and I am now trying my best to lose weight. Currently, I weigh 227 pounds. I am married and plan to start a family, so I need to lose much more weight. These episodes also tend to occur around my menstrual cycle, but sometimes they happen without any clear pattern. My diet is rich in protein and fats. During vomiting, the meals I ate earlier in the day are expelled. What steps should I take to manage this?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

From your description, it appears that you may be experiencing a gut infection, dyspepsia, or a gallbladder issue, such as cholelithiasis (gallbladder stones). Sometimes, food intolerance can also cause these kinds of symptoms, especially since your diet is rich in fats. Additionally, obesity itself is a risk factor for gastroesophageal reflux disease (GERD) as it may cause hiatus hernia and weaken the lower esophageal sphincter, leading to acid reflux and acidity.

I suggest doing basic blood tests such as

Complete blood count (CBC).
Liver function test (LFT).
Lipid profile.

Along with routine stool examination and an abdominal ultrasound. Avoid spicy or oily food and continue weight reduction efforts.

Regarding medications, you may take Omeprazole 20 milligrams (before food) for acid suppression, a Bifidobacterium-based probiotic, and Dicyclomine to relieve spasmodic abdominal pain. If a gut infection is present, you may also need an antibiotic such as Metronidazole. I recommend seeing a gastroenterologist, especially since you are planning a pregnancy. It is important to confirm the diagnosis and receive appropriate treatment.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.