Bloating and Gas

I suffer from anxiety and I had a real difficult period about 8 months ago that led to changing medications and ever since that time I have had GI problems.  It started out as increased gas an bloated and then I was having more frequent bowel movements.  l saw my internist and he did a blood test and stool sample test that found nothing so he put me on an antispasmatic for possible IBS.  Since that time the gas and bloating continues and became more and more frequent.  I changed my anti-anxiety medication to see if that was the cause and it made no differernce.  I then saw a Gastroenterologist who did an upper GI that came back normal.  He decided to start me on Xifaxin for possible small intestinal bacterial over-grouth and after 5 days the gas was out of control every evening!  He told me to stop the Xifaxin but now the uncontrolable gas in the evening persists and is worse.  He said it's probably just IBS and to take some simethicone and probiotics but I don't buy it.  The simethicone does nothing and the excessive gas continues.  The bouts of gas are constant and foul smlling.  It just keeps coming.  I usually have a few bouts of strong gas in the morning and then I'm fine until about 5 or 6pm and then the gas doesn't stop!  Although cetain foods and drinks make it worse I have the gas no matter what I eat.  What could possibly be going on here?  Should I ask my Gastroenterologist to run additional tests?  I've had anxiety and stress issues for years with medication changes yet I've never had any problems like this my whole life and I am baffled.  Please help!!

[Kevin Pho, MD]

I agree with the workup thus far.  IBS is certainly possible, but you may want to exclude more serious GI causes first.  

A more comprehensive test of the upper GI tract would be an upper endoscopy.  This can evaluate for ulcers or inflammation of the stomach or esophagus.  

Specialized tests like a 24-hr pH study can be done to evaluate for GERD.  This can be combined with an esophageal motility study to exclude motility disorders.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com