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Gastroenterology (Expert Forum)
MORE QUESTIONS ABOUT SERVERE ABDOMINAL BLOATING
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
MORE QUESTIONS ABOUT SERVERE ABDOMINAL BLOATING
by kgandas, Jul 10, 2003 12:00AM
HELLO, I AM WRITING FOR MY WIFE. WE POSTED A QUESTION RECENTLY ABOUT THE ABDOMINAL DISTENTION SHE GETS ALL THE TIME. A QUICK RECAP. SHE STARTED "BLOATING UP" THE DAY SHE CAME HOME FROM A PAP SMEAR AND OTHER ASSOCIATED TESTS. SHE WENT TO HER REGULAR DR. WHO HAD NEVER SEEN A CASE LIKE HERS, WHERE YOU COULD PUSH YOUR FINGERS INTO HER ABDOMIN AND SHE WOULD BLOAT TO THE SIZE OF LOOKING 6 MONTHS PREGNANT.THE DR REFERRED HER TO A GYN. WHO DID A PELVIC ULTRASOUND AND NOTED CYSTS ON BOTH OVARIES THAT "APPEAR FUNCTIONAL AND NORMAL, ALTHOUGH THEY MAY BE SYMPTOMATIC". HE ALSO NOTED, THERE IS NO FREE FLUID SEEN.ALSO THAT THE DISTENSION WAS IN THE BOWEL. NEXT CAME THE GASTRO DR, WHO AFTER A 15 MINUTE APPT. DIAGNOSED HER WITH IBS. NONE OF THE PRESCIPTIONS HAVE HELPED. THIS IS THE ONLY TIME SHE HAS SEEN THIS DR., ALL OTHER COMMUNICATION HAS BEEN THROUGH HIS NURSE. THEY ORDERED A BARIUM ENEMA AND A ABDOMAN CT. THEY TOLD HER ALL WAS GOOD. SHE TALKED TO THE NURSE AGAIN LAST WEEK AND WAS TOLD THAT THERE IS NOTHING THEY CAN DO AND ARE REFERING HER BACK TO HER REGULAR DR. WE GOT A CD-ROM OF THE TESTS FROM THE HOSPITAL AND THE DIAGNOSTIC IMAGING REPORTS. ON THE BARIUM ENEMA REPORT THEY NOTE THAT THERE IS "NO SIGNIFICANT REFLUX THOUGH INTO THE TERMINAL ILEUM AND THE APPENDIX IS NON-VISUALIZED.""PATIENT PROBABLY HAS HAD A APPENDECTOMY. SHE HAS NEVER HAD HER APPENDIX TAKEN OUT UNLESS THEY TOOK IT WHEN THEY DID GALLBLADDER SURGERY. SHE DOES NOT REMEMBER THIS BEING THE CASE. SO I GUESS THE QUESTIONS ARE. 1. IS IT STANDARD PROCEDURE TO REMOVE THE APPENDIX DURING GALLBLADDER SURGERY?(OLD STYLE SURGERY, NOT LASER) 2. COULD THE APPENDIX BE CAUSING A PROBLEM IF IT IS STILL THERE, BUT NON-VISUAL? ALSO THE DOG JUMPED UP ON HER STOMACH THE OTHER DAY AND SHE SAID IT FELT LIKE SOMETHING STRETCH OR RIPPED INSIDE. SINCE THEN SHE HAS HAD A "BURNING" SENSATION IN HER SIDE AND STRONG "PINCHING" PAINS AND NOW SHE BLOATS UP FROM SIMPLY RIDING 20 MILES IN THE TRUCK. SHE IS STILL TAKING THE DRUGS FOR THE IBS AND GAS-X, BUT SHE STILL MUST LAY DOWN FOR A COUPLE OF HOURS TO GET THE BLOATING TO START GOING DOWN. WE ARE GETTING DESPERATE TO GET THIS SOLVED, BUT DON'T BELIEVE THE DOCS SHE HAS BEEN GOING TO ARE THE SOLUTION. A RECOMMENDATION ON WHAT TYPE OF DR. TO SEE NEXT WOULD BE GREATLY APPRECIATED.
Doctor's Answer
by Kevin Pho, MD, Jul 11, 2003 12:00AM
, Jul 11, 2003 12:00AM
Hello - thanks for asking your question.
Known as "incidental appendectomy", it is the removal of the appendix during other surgery to remove future episodes of appendicitis. It is possible this occured, however I would assume that your surgeon made you aware of what happened during the procedure.
If the barium enema was not able to see the appendix, it should be able to be visualized with the abdominal CT scan.
Before attributing all the symptoms to IBS, I would suggest a colonoscopy first to make sure that other organic disease such as a mass or inflammatory bowel disease is not causing your symptoms.
Malabsorption is also a cause of gas and bloating. If not done already, tests for celiac disease, fat or lactose intolerance should be performed.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Known as "incidental appendectomy", it is the removal of the appendix during other surgery to remove future episodes of appendicitis. It is possible this occured, however I would assume that your surgeon made you aware of what happened during the procedure.
If the barium enema was not able to see the appendix, it should be able to be visualized with the abdominal CT scan.
Before attributing all the symptoms to IBS, I would suggest a colonoscopy first to make sure that other organic disease such as a mass or inflammatory bowel disease is not causing your symptoms.
Malabsorption is also a cause of gas and bloating. If not done already, tests for celiac disease, fat or lactose intolerance should be performed.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Obviously not the doctor, but I suffer the same way as your wife. I am 5'5" 112 lbs., and I look 6 months pregnant if I don't stick to my low fat eating. Had my gallbladder out 1-1/2 yrs. ago, and have been lactose intolerant, IBS, and extreme bloating and gas pains. I also develop ovarian cysts, which make everything worse because if you have a cyst on the right ovary, it oftentimes hits the bowel (showed on ultrasound). She may have scar tissue on the bowel, or the ovary may have fused itself to the bowel, which would cause her symptoms. Ovarian cysts often cause the same symptoms, bloating, burning, and pain with gas. You can write me at
***@****
I'll let you know how I control the gas and bloating.
Good Luck
my gastro doc wants me to do it in the hospital but i have heard that some doc have the setup in their own office,what is the difference??
thanks
I was curious how you were diagnosed with celiac? When my blood tests showed me anemic, that was he first thing he suspected, but wanted to rule out other problems, colon cancer. He did another blood test and I tested positive for one of the protein (?) things or something, that also led to his suspicion. So he wanted to do a colonoscomy and wanted to do a biopsy