Excessive Bloating

[KCQ]

I went to see my physician in October for abdominal pain, bloating, and naseau that I thought was related to my menstrual cramps.  After trying two different forms of birth control pills to help the symptoms my doctor finally decided I needed to have a laparoscopy to see if I had any tumors or endometriosis.  They couldn't find anything and finally took me off of the pill because it made my period very irregular.  After having my period for 50 days it finally went away but the bloating has still continued on a daily basis and the abdominal pain and naseau occur regualarily.  My dentist is even starting to question me about bulimia because the enamel is starting to come off the back of my teeth.  I'm sick of feeling this way and don't know what to do.  My physician thought I might have IBS, but my symptoms don't seem to match up with that.  I'm trying to get a referral to see a GI specialist, but in the meantime I thought I'd see if anyone else had any advice.  Thanks!!!

[kevinmd]

I gave the wrong link above.  It should be this:
http://answers.google.com/answers/main?cmd=threadview&id=119275

Sorry,
Kevin, M.D.

[kevinmd]

Hello - I have done some previous research on SOD.  You can read it here in this link if you are interested:
http://answers.google.com/answers/main?cmd=threadview&id=118761

Thanks,
Kevin, M.D.

[KCQ]

Thanks for all of your advice and support.  I just made an appointment with a GI specialist this morning for the end of the month.  So hopefully they will have some answers.

[Suziepie]

I lost faith in the GI specialist my daughter was seeing because when I asked him if the Hep B vaccination would cause her to get sick like this, his answer was no.  I hope you find someone that knows their stuff.  Now I am finding out a year later that people get very sick from this vaccination.  I will keep you posted because tomorrow I will get the hair analyst results from the Naturopathic doctor.

[Suziepie]

I would like to add some important elements to #1:
Delayed Gastric Emptying
Protein Digestion Impaired
Positive Gliadin Antibody
Leaky Gut Syndrome
Severe Constipation is also caused by parasites
Food Allergies


1) Constipation-predominant IBS:
Colon cancer
Hypothyroidism
Medication-induced constipation
Mechanical obstruction
Colonic inertia
Intestinal pseudo-obstruction
Pelvic floor dyssynergia
Descending perineum syndrome
Rectal prolapse
Depression

[5fan]

My suggestion is to get that referral as soon as possible.  Not necessarily because it may be a "major health issue", but because I have been trying since I had my gallbladder out in July to get some answers and everything takes so much time that it becomes extremely frustrating.  The earlier you get started the better.

My local gastroenterologist believes that I have some level of IBS, but referred me to a specialist because he also felt that with some of my symptoms I may also have SOD (Sphincter of Oddi Dysfunction).  The specialist I've been seeing doesn't want to do the testing for SOD yet because of the risk involved with pancreatitis (I had pancreatitis at the same time I had gallbladder problems).

He has run some blood work and found that I have pancreatic insufficiency and also did a repeat gastric emptying study which showed I have delayed emptying. (I had one done at the local hospital and it was normal but when I had one done at the hosptial where the specialist is it came back with delayed emptying).  I am now on Erythromycin four times a day.  There are four different dosages of this stuff and I have to try each dosage for two weeks before he will switch it.  I have to exhaust all the dosages before he moves on to the next test.

Don't get me wrong - I'm glad he has at least found something after having several doctors tell me they didn't know what it was, but felt like I really did have something wrong - but it does get frustrating.

Every time I eat my entire right side of my abdomen distends, I have severe pain that follows my rib cage up to the sternum area and I also have severe back pain (between the shoulders and up under the right shoulder blade).  I also battle nausea.  

Best wishes for a speedy diagnosis, but don't put it off!!!!

5FAN

[4gpact]

Ask your doctor about domperidone, also known by the brand name Motilium. Although it is not available in the US, except by a compounding pharmacy (they make it up for you), it is available all over the world, often without a prescription. I take it for a stomach motility problem, and it has helped enormously. It also does not wear off eventually, as does the erythromycin. It is a very safe drug, and is made by one of the major drug companies. It has been around for about 40 years, and its side effects are minimal.

[4gpact]

I did not see listed delayed stomach emptying, which can also cause those symptoms. Ask your doctor about a gastric emptying scan, to determine how much time it takes your food to digest. it is an easy test, and will give some answers.

[Kevin Pho, MD]

Hello, thanks for asking your question.  

I would definitely recommend seeing a physician, as there are many causes of your symptoms.  

IBS has broad diagnostic criteria.  Abdominal pain in IBS is usually described as a crampy sensation with variable intensity and periodic exacerbations. The pain is generally located in the lower abdomen, often on the left side; however, the location and character of the pain can vary widely. The severity of the pain may range from mildly annoying to debilitating. Several factors, such as emotional stress and eating, may exacerbate the pain, while defecation often provides some relief.  

By definition, patients with IBS complain of altered bowel habits. Patients with IBS complain of diarrhea, constipation, alternating diarrhea and constipation, or normal bowel habits alternating with either diarrhea and/or constipation.

Upper gastrointestinal symptoms, including gastroesophageal reflux, dysphagia, early satiety, intermittent dyspepsia, nausea, and non-cardiac chest pain, are common in patients with IBS.  Patients with IBS also frequently complain of abdominal bloating and increased gas production in the form of flatulence or belching.

Causes other than IBS can be found on these lists of differential diagnoses.  

1) Constipation-predominant IBS:
Colon cancer  
Hypothyroidism  
Medication-induced constipation  
Mechanical obstruction  
Colonic inertia  
Intestinal pseudo-obstruction  
Pelvic floor dyssynergia  
Descending perineum syndrome  
Rectal prolapse  
Depression  

2) Diarrhea-predominant IBS:
Inflammatory bowel disease  
Lactose intolerance  
Fructose or sorbitol intolerance  
Intestinal parasites  
Microscopic or collagenous colitis  
Bile-acid malabsorption  
Fat malabsorption  
Hyperthyroidism  
Anxiety disorder  
Medication-induced diarrhea  
Laxative abuse  

3) Bloating and distention:
Lactose intolerance  
Intestinal parasites  
Bacterial overgrowth  
Mechanical obstruction  
Intestinal pseudo-obstruction  
Intra-abdominal tumor  
Ascites  

As you can see, more tests are definitely needed to determine the cause of your symptoms.  Seeing a GI specialist is definitely the next step.

Thanks,
Kevin, M.D.