Extreme Bloating-No Pain-Feel Full

[Jeanie_301]

I am having extreme bloating - feel full most of the day.  I've had a few tests done, no gallstones, but my HIDA scan did show my gallbladder is slugish (18%).  Dr. said not to remove it because I am not having typical gallbladder symptoms.  I've had a hysterectomy/oopherectomy in the past.  I also had an endoscope of my stomach - everything looked good.  This sounds vain - but I just need to fit into my clothes,  I am not exaggerating, I look 4 months pregnant.  I am a small person and I cannot find clothes to fit me.  My GI thought I may have IBS - does anyone have that without bathroom problems?  I am very regular - no diarreha or constipation so I am confused about the IBS.  All I know is I am BLOATED!  

[Annie62]

You might want to read up on a condition called gastroparesis.  It is slowed emptying of the stomach (the causes are many including autoimmune disease or just post-viral/bacterial) and it can cause significant bloating (especially after meals), pain, nausea and vomiting.  You don't have to have all those symptoms to have it, though.  I've never vomited from it and only have occasional nausea and yet mine is severe on scan (I mainly have pain and bloating).  

The best test to diagnose it is a gastric emptying scan done in nuclear medicine.  You usually will be given an egg sandwich and milk with a radioactive tracer in it and you lie under a scanner that will track how quickly the food leaves your stomach.  There is medicine for it and change of diet can help (small meals often and low-fat food).  I have had pain/bloating ever since I had a bad GI bacterial infection 8 years ago and it wasn't until last year that I found out the cause it.  EGD showed food in my stomach after 17 hours (but it doesn't always pick it up) and later an emptying scan showed I had the condition.  Ask your gastroenterologist about the possibility.  Most internists don't know that much about it.  I used to say the same thing--that I would look 9 months pregnant by dinner time.  

[Jeanie_301]

Thanks Annie - I will mention it to my dr.  Do you still have the trouble now that you have found the cause or do you just manage it by eating small and low-fat?  I also notice it when I drink anything - it just sits in my stomach it seems.  I need to get up a couple of times during the night to urinate.  I only enjoy a flat stomach for about 1/2 hour in the morning - because as soon as I eat breakfast my belly begins to rise!

[Annie62]

You're welcome.  Yes, unfortunately I still have low-grade stomach/chest pain every day even on the medication, probably from chronic gastritis/esophagitis from all the reflux.  But I also get frank excruciating pain where I am doubled over once in a while.  My stomach will bloat out so far I can't even stand upright.  GP is almost always a chronic condition, especially if it is severe on scan.  I'm not sure if you would have it if you have no pain, but the bloating after eating is a definite sign of it.

Eating small meals often, eating low-fat and low-fiber are the dietary ways to help manage it, as fat slows digestion/emptying of the stomach and high-fiber food is harder to digest/grind up for a stomach that can't grind food properly.  So, yes, I definitely notice I have more problems if I eat too much in any one sitting, and if I eat veggies or fruits that are not cooked well or have the peels/skins on them.  I just won't go on a low-fiber diet, though, as it is overall unhealthy.  When people have mild gastroparesis they can usually manage their GP with diet alone, but if it is moderate or severe usually drugs to help the stomach empty faster are needed as well (Reglan, domperidone, etc.).

I don't know if you even have it, but you could try eating low-fat and eating small meals often (like 5 small meals instead of 3 bigger ones) and see if that helps at all with the bloating.  And if you don't want to eat low-fiber you could try cooking the foods down until they are soft or put them in the blender so it is pre-ground, and try that for a week to see if it helps with your bloating.  If it does, you might have GP.  If I can ever get myself to do it, I intend to spend a week eating only liquids and soft foods to see if I can get rid of the pain altogether.  Then I will know how much of a part diet plays into my symptoms.  

[Annie62]

One more thing.  I just read a post by you below.  Gastroparesis can be caused by gall bladder disease (don't know if it's linked to some kind of biliary obstruction or what) as well as abdominal surgery in which the vagus nerve is accidentally damaged.  I mention this because I think I read that your HIDA scan was abnormal and you had multiple abdominal surgeries in the past.  When my gastroent. suspected I had gastroparesis, he not only ordered a gastric emptying scan but an ultrasound of my gall bladder to see if I had stones/possible obstruction (?) as the cause of the GP.  Just thought I would mention it.  Most GP, though, is from damage to the nerves/vagus nerve or sometimes even muscles themselves in the stomach due to neuropathy/myopathy from autoimmune disease like diabetes, etc.  

[Jeanie_301]

Thanks  - a LOT of good advice/suggestions.  I did have an ultra sound of the gallbladder and it didn't have stones or anything - just the hida-scan was abnormal.  I also had a scope of my stomach about a month ago and although I have been having bloating for quite some time, it seemed to get worse after that - maybe it irritated my stomach.  The test results from that were good too.  I had it done by  a surgeon not a GI because I live in a small community and that who does them here.  I had the second opinion with a GI in a large city near me - but he really didn't take much time with me and said it was just IBS.  I will follow up with my family dr and ask about this GP you mentioned.  Thank-you Annie.