[26M] Experiencing abdominal pressure and anxiety

Patient Description

A 26-year-old male reports feeling pressure in the abdomen that seems to press on the lungs, particularly after consuming fried or fatty foods. This symptom has been occurring on and off for about six months and is most prominent in the upper abdomen, often soon after eating. The patient has a history of anxiety, which manifests as physical symptoms and is exacerbated by inactivity, crowded or loud spaces, and shortness of breath. Despite daily use of Lexapro and Xanax for anxiety, the patient still experiences these symptoms. Additionally, the patient reports frequent constipation or diarrhea, which has been a consistent issue for the past year. The patient has lost 17 pounds in the last two months due to dietary changes and cessation of alcohol consumption. There is no report of vomiting of blood, black tarry stools, severe unrelenting pain, or signs of internal bleeding. The last bowel movement was described as loose and rich brown in color. The patient's medical history includes occasional constipation but now reports regular diarrhea, indicating a sensitive stomach.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing discomfort or a feeling of a lump in your throat. It can also cause heartburn, a burning sensation in your chest. GERD can be exacerbated by certain foods, including fatty or fried foods.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Prescription medications or even surgery may be needed in severe cases.
  • Irritable Bowel Syndrome (IBS): This is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.

    • Treatment focuses on relieving symptoms so that you can live as normally as possible. Mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle.
  • Anxiety: Anxiety can cause a wide variety of physical symptoms, including stomach discomfort, diarrhea, and difficulty swallowing. It's also possible that your anxiety symptoms are being exacerbated by your physical symptoms.

    • Treatment typically involves a combination of psychotherapy, behavioral therapy, and medication.

Please remember that these are just possibilities and not a definitive diagnosis. Only a healthcare professional can provide a formal diagnosis.

What you can do

  1. Manage your diet: Try to identify any foods or drinks that seem to trigger your symptoms and avoid them. Common triggers include alcohol, caffeine, fatty foods, and certain types of fiber. Drinking plenty of water and eating smaller, more frequent meals can also help.

  2. Manage your stress: Stress and anxiety can exacerbate both GERD and IBS symptoms. Techniques such as deep breathing, meditation, and yoga may help reduce your anxiety and improve your gastrointestinal symptoms.

  3. Over-the-counter treatments: Antacids can provide quick relief from heartburn. For more severe symptoms, H2 blockers and proton pump inhibitors can reduce the amount of acid your stomach makes.

  4. Seek professional help: If your symptoms persist or worsen, make sure to seek medical attention. It's important to get a proper diagnosis and treatment plan.

What you should look out for

If you experience any of the following symptoms, seek medical attention immediately:

  • Severe, persistent abdominal pain
  • Bloody or black stools
  • Vomiting blood or black material
  • Unexplained weight loss
  • Difficulty swallowing
  • Signs of dehydration, such as dark urine, dry skin, fatigue, and lightheadedness

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What are common triggers for GERD and how can they be managed?

Common triggers for GERD include fatty or fried foods, alcohol, caffeine, and large meals. Managing these triggers involves avoiding these foods, eating smaller meals, and not lying down immediately after eating. Over-the-counter medications like antacids can also help manage symptoms.


How does anxiety contribute to gastrointestinal symptoms like IBS?

Anxiety can exacerbate gastrointestinal symptoms by increasing stomach acid production and altering gut motility, leading to symptoms like diarrhea or constipation. Managing anxiety through therapy, medication, and stress-reduction techniques can help alleviate these symptoms.


What lifestyle changes can help manage symptoms of IBS?

Lifestyle changes for managing IBS include identifying and avoiding trigger foods, eating a balanced diet with adequate fiber, staying hydrated, exercising regularly, and managing stress through techniques like meditation or yoga.


When should someone with abdominal discomfort seek immediate medical attention?

Immediate medical attention should be sought if there is severe, persistent abdominal pain, bloody or black stools, vomiting blood, unexplained weight loss, difficulty swallowing, or signs of dehydration such as dark urine and fatigue.


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