Severe gas and stomache pains after eating

  I am writing this for my fiance'.  She was in a car accident a month ago and suffered a 4 inh laceration in her liver.  She was hospitilized for 11 days.  The whole time whenever she ate anything of substance I.E. real food 4-8 hours later she suffers severe gas pains that can only be alieved by taking a laxitive.  Although her liver appears to be healing on its own she still cannot eat much besides a nutrition drink without this severe gas pain.  She has asked her doctor and he seems only to be concerened about her liver and not the constant pain she is in from gas pains.  It would seem that a month after the injury she should be able to digest something.  A pharmasyst heard her symptoms and thought that her colon should be checked out.  We are out the end of our rope.  It is 4:45 in the morning now and she woke up and hour ago with the pains again. Please help!!!
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Dear Jeff,
I assume from your letter that your fiance did not suffer from gas pains prior to her liver injury.  As we have discussed in this Forum previously, most cases of intestinal gas are related to swallowed air or eating foods/drinking liquids that cause gas.  
If these gas pains are new, persistent and disruptive to your lives, then work-up is warranted.  As an initial test, I would do an ultrasound of the liver and surrounding region or a CAT scan.  These tests will confirm that there is no additional injury.  If these tests are normal (and I would anticipate a normal result), the next step would be to x-ray the stomach and small intestine.  If this test is also normal, a barium enema could be ordered but this test would be very unlikely to provide an answer.  
While workup is ongoing, symptomatic treatment could be started.  Initially, I would choose a medication that will coalesce the gas and facilitate its movement e.g. simethicone. If symptoms persist and there is no structural abnormality, an empiric trial with a prokinetic agent such as Cisapride could be tried.  This drug promotes intestinal motility and would hasten the passage of gas through the gastrointestinal tract.
This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by your physician.
If you wish to be seen at our institution, Henry Ford Hospital, please call our PHYSICIAN REFERRAL LINE at(313) 876-2393 and request consultation with Dr Fogel, one of our experts in the diagnosis and treatment of abdominal pains.
HFHSM.D.-rf
*keywords: gas pains, constipation, abdominal trauma
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