<s>[INST] At the beginning of December 2013, I began feeling like my stomach was unsettled and bloated. I also had difficulty completely emptying my bowel. Around mid-December, after running a 5K, I had pain in on the right side in my pelvic area which lasted for a week. I also had pain and pressure under my right rib cage. The pain in the pelvic area increased and I had abdominal swelling (a pelvic MRI showed nothing). When the swelling and pain did not subside, I ended up going to the ER in January of 2104 . All they found after a CAT scan was excess abdominal fluid; they said this was possibly from an ovarian cyst that had ruptured. My GI woes continued and I felt like I was emptying too much from my bowels whenever I went in the morning. The stools would often stick to the toilet bowl. I also continued to have incomplete evacuation. This continued on and off for months. In April and May, I had two days where my stomach felt so bloated and full that I had to throw up to relieve the pressure. In May, I ran the Broad Street run and had stomach pain the entire race. All throughout the summer, I still had problems with emptying my bowels and emptying what looked like too much. In August, I took my migraine meds (Immitrex, which always gave me abdominal pain, but I continued to take it as it took away my migraines) one night and went for a 16 mile run the next day. When I finished, I had bad pain under my right ribcage and the pain descended down to my stomach. I ate chili that night and this worsened my pain to the point where I considered going to the ER. This triggered two months of my stomach feeling unsettled and my stools looked like sludge (again, I was emptying too much and still could not completely empty my bowel). After this “GI attack” I lost 7 pounds. I finally went to a GI doctor in October who discovered after doing an endoscopy that I had severe esophogitis (even though I never had any symptoms of GERD—no acid reflux, esophageal burning, etc). There was also a small, benign nodule that had formed under my right rib cage (where I had the pain). After this diagnosis, I changed my diet (I eliminated acidic foods) and my stomach settled down, even though I still had stomach discomfort off and on. I also continued to have pressure under my right rib cage. In December of 2014, I had a hysterectomy (I had multiple issues with my uterus). I recovered well and I felt like my GI tract was “back on track.” I was on a good routine where my system emptied at the same time every day and it was emptying what seemed to be a normal amount and it looked like “healthy” stool. I had also put on the weight I had lost from the previous GI attack. In February of 2015, after reading about the dangers of esophogitis, I decided to take the PPI my doctor prescribed in October of 2014. I then started having acid reflux—burning in my esophagus, burps that were stuck in my throat, etc. So, I returned to my GI doc who then told me to take 60 mg of Dexilant. I did so for a week and 4 days and then I developed severe abdominal pain. I immediately went off of the Dexilant and what ensued was two months of GI hell—I had cramping pain in stomach that was relieved somewhat with taking different laxatives to empty my system. I also was not able to eat most evenings because of the pain in my stomach. As a result, I lost 9 pounds. One doctor said that stopping the acid production in my stomach caused bad bacteria to grow/caused a leaky gut and this seems like a likely theory as different foods that I ate seemed to worsen the pain. Mid April I also ate salmon and asparagus one day and this resulted in awful pain in my stomach in the middle of the night and into the next day. I had to throw up to try and relieve the pain—what came out was full pieces of the asparagus that I had eaten. I had an abdominal MRI to rule out anything going on in my stomach. It came back negative. Now in May, the abdominal pain has stopped, but I have abdominal discomfort most evenings—my stomach feels full and bloated and my gas feels trapped. The pressure is not relieved until I go to the bathroom the next day. I am back to not being able to completely empty my bowels—there seems to always be a little more that I need to strain to get out (what comes out is normally flat and/or thin or a small “nugget” when the “extra” does come out). To rule out anything serious going on with my colon, I had a colonoscopy on May 4; I also had a repeat endoscopy. My colon looked great, but I still have a little scarring on my esophagus. I don’t know if the PPI incident reveals that I may have low stomach acid and not high stomach acidity. Or, did it exacerbate an existing condition with SIBO. Do I have motility issues where food is either moving too quickly or not quickly enough through my system? If so, what creates this problem? Is it possible my gallbladder is not working correctly and breaking down my food even though the abdominal MRI did not show anything? If you are able to lend any insight as to what my going on with my GI track, I would greatly appreciate it! [/INST] Hi,Welcome to health care magic,I have read all your long query and understand the concern.Your main problem is stomach bloating and delayed emptying or fullness in stomach.This all symptoms could be due to dyspepsia, constipation,gastroenteritis,IBS orinflammatory bowel disease,parasitic infestation(giardiasis) etc.You should undergo certain routine blood investigations with urine and stool examination for R/M and ova or ultrasound of abdomen or upper GI scopy if required.Treatment is mainly depend on the underlying cause but symptomatic treatment can be given.You may require antibiotics (quinolones, antiprotozoals or amoxycillin derivatives)and anti helminthic (albendazole) with proton pump inhibitors and prebiotics and probiotics.You must consult your gastroenterologist for detailed medical history and thoroughly clinical examination and get it diagnosed first.Regards, </s>