Digestive Disorders / Gastroenterology Expert Forum
Chronic bloating
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Chronic bloating

Hi.  I'm a 31 yr old woman suffering from chronic bloating. It started about 6 yrs ago, I noticed that after eating my stomach would bulge out, making me look pregnant.   I had a gastroscopy, colonoscopy, and xray of the small intestine, all normal.  My doctor said I have IBS and must be stressed at work or at home.  We tried medication such as Motilium, Zelnorm, and anti-depressants, but nothing really worked.
Today: I have a steady job that is not overly stressful (note that I have the same symptoms whether I'm working or on vacation).  I do not have much stress in the homelife (no relationship drama).  I exercise regularly (walk the dogs briskly twice a day and do at least some cardio or strength training about 5-6 days a week).  I sleep well.  I eat healthy - lots of fruits and vegetables, lean meats and fish, legumes, whole grains, limited caffeine and alcohol. I constipate easily so I need to eat fiber.  I am bloated regardless of whether I eat 'gassy foods' like cabagge or beans.  I am not lactose intolerant, and I don't believe I have celiac's disease.  I have tried including probiotics such as activia yogurt and bio-k in my diet but with no success.  I try to eat slowly and not swallow air but it doesn't help.  I've tried to eat smaller but more frequent meals but this doesn't help either.  I tend to have more severe bloating the more the day progresses.  Sometimes I'll be fine until the afternoon when I'll eat a handful of nuts or a plum (ie something small) and bam!  onset of bloating!  

I am sick of always looking pregnant and would like to know what is wrong with me.  I can't function after dinner when I'm bloated and I have having to limit activity in the evenings.  Can you help me here?  Is there something that I have not been tested for that could be a likely culprit - am I lacking some kind of enzyme to breakdown something common that is found in most foods?  
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You have had a comprehensive evaluation, and I agree with the workup thus far.  The gastroscopy and colonoscopy would exclude many of the major causes.

More specialized tests, such as stool tests for malabsorption, breath tests for lactose deficiency, or blood tests for celiac disease can all be considered.  Each of these disorders can lead to increased gas perception and bloating.

Another consideration would be imaging the abdomen.  Sometimes, there are rare cases of ovarian cancer that can lead to unexplained bloating.  A CT scan or ultrasound would be helpful to exclude this possibility.

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.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd
9 Comments
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Avatar_f_tn
I suffer the same! I have had the tests you have had and even a biopsy of the colon, no abnormalities :S I am very slender, which makes the bloating look so much worse. It also fills me with wind and i won't go out for meals etc in case it gets embarrassing! I really feel this is impacting my quality of life severely and has done since i was in my early 20's, i am now almst 35. Wheta makes it heaps worse, but i bloat with only a mouthful of food it seems. I am at the end of my tether with what to try and feel like my Dr feels i am a hypochondriac. I don't know where to turn next.

XX
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Avatar_f_tn
I have the same sypmtoms gas, large swollen abdomen, & I am a small woman 115 pounds, 30 yrs. old also I am having heartburn ,chronic fatigue, no appatite. My doctor sent me for a cat scan of my abdomen & it showed that the duct going to my gallbladder is dilated I believe the bile duct & this problem can cause these symptoms. Let me just say when your doctor thinks you are a hypochondriac it's time to find a new doctor.You may have a gallbladder problem, I would nicely demand a cat scan it is my understanding some gallbladder diseases can cause liver cancer as your gallbladder is right below your liver. Colonostopy' don't show your gallbladder & x-ray's are not going to show nearly as much detail as a cat scan. Even if you don't have a gallbladder problem you should have a ct to show what the problem is. Thanks, Denise444
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Avatar_f_tn
Dear blotedinmt
I'm having this self same condition for a year now, there's no at test I haven't done and no cure I haven't tried, including hypnotherapy, dieting, OTC medication - to no avail. I read in an article that the condition is chronic and that the causes are unknown. It'not food related and it progresses during the day and subsides partially in the morning. It's a horrible ordeal, it makes me feel so helpless and out of control but apparently I'll have to learn to live with it and hope that someday, as suddenly as it came it will go away.
Agnes
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Avatar_f_tn
I understand your frustration.  I, too, have a similar story.  Currently going through more diagnostics to "rule out".  I have the same chronic problems(eating causes gas, bloat, pain, constipation), but I've also had "attacks".  Where the situation gets much worse for a few weeks, then seems to settle down.  I have found accupuncture and some chinese herbs to be helpful.  The problem is knowing if I've found a real good homeopathic doctor.  I'd advise seeking a professional versed in natural healing. My hometown is not very open to the natural relm of healing, but you may live in a more "open minded" community.  I am a nurse of 15 years and I'm not sure that everything in western medicine is good for the patient. Good luck. Sheila
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Avatar_m_tn
I can relate to your situation. It sounds like what I've been dealing with since I was in my twenties. I took a course of tetracycline back then for a urine tract infection. I don't know if there is a connection. My doc. has suggested lac. intol. and lack of fiber. I eat a healthy diet and exercise regularly. Dairy has never been a problem for me. I'm under the impression at this point that it is a bacterial problem, that is primarily in the small intestine. I've read that this can be exacerbated by a compromised immune system. I experimented a one point with eliminating sweets from my diet and found this to provide considerable relief. It hasn't cured me but the problems are considerably less. I know what thinking, give up sweet, no way? Well it may be worth trying. One more thing if I start the sweets again the problem will come right back. Good luck too you. Oh yea, also, you might want to do some reading about things such as diet that can bolster your immune system.
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Avatar_m_tn
Well, we all have this problem, and none of us can find a complete answer.

One thing I experience that is not mentioned above is that the bloating will build up in one spot in my colon, and then if I eat or drink the right thing it will gurgle and spasm a bit and I can feel the gas start to move along and then RELIEF, but just temporarily, until it builds up again or in another area.

   Oddly, it is things like coffee, and unfortunately cigarettes, that starts things moving, and then relief. And what a relief it is - even though the pain is not a sharp pain it is very distressing.

  Mostly, that area where the gurgling happens is at the ilium, or appendix - the start of the large colon I guess, at the lower right side of my abdomen. It is very obvious, like something crawling inside me when it gurgles, but looking in a mirror it appears that the whole abdomen is bloated.

  This bloating causes my a certain kind of ANXIETY, and not just because I am in pain... it seems more like gagging or pressure on my stomach.

   To me it seems like a type of diverticulitis, but large pouches instead of the small pouches I see in the medical info. ; my doc says that poor motility might be an issue, but I have good regular BMs, so it is more like "poor motility of the gasses in the colon.

  
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Avatar_n_tn
hi there, several months ago i started feeling my intestines grumbling and ever since it doesnt seem to stop,so i went to gp and he reffered me to do an xtray,results came in  and some calcified phleboliths were noted ,can u please explain to me what is this condition,and if it something i should worry about.....thnxx
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Avatar_f_tn
Check the information for Fructose Malabsorption.  I have experienced excrutiating pain sometimes, and in the past they dismissed it to IBS.  But recently took a fructose test and it was positive.  Then, after reading about this disorder, the symptoms based on food consumption began to "click".  It also goes hand and hand with my SIBO that reoccurs.
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