Cause of diaphragm-area discomfort

On Dec. 9, 2003 I had colon resection surgery with approximately 10 inches of my colon removed. Following this successful surgery I was told that the cancer had metastasized to my liver and that it was stage four and was inoperable. I chose not to have any chemo treatments. On Feb. 23, 2004 the surgeon stated that he could not, from a routine examination, determine any growth in the tumor or any "hard spots".  I take no medications. I do take many vitamins and have completely altered my diet to a strictly vegetarian diet with no milk products,sugars, salt or fats. I energetically walk at least 2-3 miles daily, rest several times each day. Sleep very well. While I do have occasional "discomfort" in my liver it does not interfere with my daily lifestyle. ( I am 61 years of age and retired.) After changing my diet nearly five weeks ago I began experiencing much bloating in my diaphragm area which was quite uncomfortable. I attributed this to the higher fiber in my diet and began taking Beano. This alleviates the bloating, but does not eliminate it entirely. (I have NO symptoms which I believe are related to deterioration of the liver. Bowel movements, urine, eye color, etc. are all normal. I have had no weight loss. I weighed 145 lbs on Dec. 9 and now am at the same weight.) Is the likely cause of the diaphragm bloating discomfort attributable to my diet? I appreciate your input.

[Kevin Pho, MD]

It may be possible that the bloating can be caused by the diet.  Certainly eating "high-gas" foods can exacerbate the bloating.  Other causes would be irritable bowel disease, GERD, ulcers, or an upper GI mass.  

An upper endoscopy would be a reasonable place to start ruling out more serious causes of the symptoms.  Other tests to consider would be a 24-hr pH study (to evaluate for GERD), a gastric emptying scan (to evaluate for gastroparesis), or an ultrasound (to evaluate the liver and gallbladder).  

You may also want to consider a blood H Pylori test - this is a bacteria that is associated with ulcers or inflammation and can be treated with antibiotics.  

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.

Kevin, M.D.
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