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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4635
Experience:  MD Psychiatry
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I have been suffering from stomach problems two

Customer Question

hi I have been suffering from stomach problems for about two years now. My doctors say it is psychological. I was diagnosed with anxiety and depression when i was 14 years old. the medication normally controls all the anxiety symptoms but i cant get control of these stomach symptoms. It comes and goes. It first started when my daughter was ill and and I was really worried and then once I started feeling more relaxed my stomach started playing up. To start wit it was just a weird feeling in my stomach where I couldn't eat and felt like I was going to vomit for no reason even though I wasn't even nauseous, then it switched to real nausea right in the pit of my stomach every time I ate and a constant feeling of uneasiness in my stomach. The doctor gave me medication for acid and the symptoms eased after about 9 days. Then 3 weeks later I went through a spell of worry again. This time symptoms didn't ease with the medication and I stopped taking my antidepressant because I thought that may be the trigger. I went back on my medication after a couple of months because the stomach didn't feel better. My stomach issues still didn't ease until I went through a spell of severe ibs which turned my focus to that problem instead and then the upper gut issues disappeared. I had 4 months of feeling great after that. Then it came back for two days where I experienced nausea for a whole day and night. Then it was fine all the way through my pregnancy with my fourth child and I had a few flare ups which were very mild and short lived. I was fine apart from that and now its flared up again after my daughter was ill again and I was worrying a lot. it was fine while my daughter was ill but triggered off once I started feeling more relaxed again. if I feel a flare up coming on and then I find something else to worry about it goes away but once its in full swing nothing will stop it. At the moment it starts playing up a few hours after eating and lasts for quite some time after. My stomach feels uneasy like Im on a fairground ride. Is it possible that anxiety could be causing this or does it sound more physical?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 2 years ago.
Greetings.
Welcome to the site.
I am a psychiatrist and i believe i can help you with your query.
Well, after looking at your clinical scenario, one thing that stands out is that it is always the stress in form of worry about your own health or health of a near and dear one ( most cases it is your daughter's health) that triggers anxiety which then causes physical symptoms of nausea, vomiting, indigestion, sense of sickness / malaise, pain abdomen, etc. You see Anxiety disorder is very capabl;e of producing bodily/ physical symptoms like the ones known to you by now so in your case it is Situational Anxiety disorder ( where the situation being health scare acts as a trigger to a series of anxiety propelled events ) that is causing such symptoms. Had it been physical cause then your body by now must have deteriorated to a inferior level of health, but this is not the case and you tend to get affected by poor health only sporadically in episodes thanks to your health related anxiety.
However, you may discuss with your doctor about getting an endoscopic examination so as to rule out organic physical cause completely from this clinical picture of yours which thereby will remove all the doubt about this being physical.
As far as management of this condition is concerned, you can choose an anti depressant like amitriptyline at dose of 25-100 mg once a day at night time dose or duloxetine at dose of 60 mg at night time dose , since these two tend to work well in such psychosomatic and health related anxiety conditions.
Other than this you can seek prescription of either clonazepam or lorazepam at dose of 0.25-0.5 mg for PRN use that is as and when required based usage of this drug which means you take it only.when such a condition occurs.
Apart from the drug therapy mentioned above, it will really help you if you can seek CBT therapy from a clinical psychologist who will make you learn via this therapy how to control your mind at times of fear or threat and prevent it from loosing its battle against anxiety and stress, in other words this specialized therapy will make you learn special coping skills which you then can apply on a regular basis to prevent yourself from succumbing to similar or any other stress related situations.
I hope this helps.
Wish you all the best.
Please kindly leave a POSITIVE RATING if you are satisfied with the answer.
Regards
Customer: replied 2 years ago.
even when my stomach is ok I always feel my stomach is on stand by ready to flare up at any given moment. Are you a medical doctor aswell. I have had an endoscopy which was normal but I keep worrying I have gastroparesis which is probably adding to the problem and making it worse.My stomach is really depressing me. I am currently on seroxat 30mg
Customer: replied 2 years ago.
also flare ups can last between two days to six months. the shorter the length of the flare up, the more severe and constant it is but the less anxiety it causes and the longer it lasts, the more mild it is and I go through spells of it easing but it causes more anxiety for me and makes me feel really depressed.
Customer: replied 2 years ago.
just one more question. What is actually happening to my stomach to make it feel like this and why do flare ups last so long sometimes? If I understand what is actually going on, I might feel more reassured.
Expert:  Dr. Kaushik replied 2 years ago.
Thanks for the valuable inputs. I can understand that you want to get to the bottom of this and know exactly how anxiety can be related to your digestive problems and the answer to this in detail lies in the link below. Kindly go through it and know in detail what is happening to you.
http://www.health.harvard.edu/staying-healthy/anxiety_and_physical_illness
( Among the text in this link above the most important text to read is the text under the heading -- Anxiety and gastrointestinal disorders.
So the treatment plan above is a formidable one to counter this anxiety related gastrointestinal problem, in addition to the above mentioned regime, you may also take pre-biotic and pro-biotic supplements which come in the form of drinks also so as to correct the internal flora of your gut which thereby helps in resurrecting the problem that you are facing with gastric flare up.
I hope this helps.
Wish you all the best.
Please kindly leave a POSITIVE RATING if you are satisfied with the answer.
Regards

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