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Gastroenterology  (Expert Forum)
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MORE QUESTIONS ABOUT SERVERE ABDOMINAL BLOATING
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

MORE QUESTIONS ABOUT SERVERE ABDOMINAL BLOATING

by kgandas, Jul 10, 2003 12:00AM
HELLO, I AM WRITING FOR MY WIFE. WE POSTED A QUESTION RECENTLY ABOUT THE ABDOMINAL DISTENTION SHE GETS ALL THE TIME. A QUICK RECAP. SHE STARTED "BLOATING UP" THE DAY SHE CAME HOME FROM A PAP SMEAR AND OTHER ASSOCIATED TESTS. SHE WENT TO HER REGULAR DR. WHO HAD NEVER SEEN A CASE LIKE HERS, WHERE YOU COULD PUSH YOUR FINGERS INTO HER ABDOMIN (abdomen) AND SHE WOULD BLOAT TO THE SIZE OF LOOKING 6 MONTHS PREGNANT.THE DR REFERRED HER TO A GYN. WHO DID A PELVIC ULTRASOUND AND NOTED CYSTS ON BOTH OVARIES THAT "APPEAR FUNCTIONAL AND NORMAL, ALTHOUGH THEY MAY BE SYMPTOMATIC". HE ALSO NOTED, THERE IS NO FREE FLUID SEEN.ALSO THAT THE DISTENSION WAS IN THE BOWEL. NEXT CAME THE GASTRO DR, WHO AFTER A 15 MINUTE APPT. DIAGNOSED HER WITH IBS. NONE OF THE PRESCIPTIONS HAVE HELPED. THIS IS THE ONLY TIME SHE HAS SEEN THIS DR., ALL OTHER COMMUNICATION HAS BEEN THROUGH HIS NURSE. THEY ORDERED A BARIUM ENEMA AND A ABDOMAN CT. THEY TOLD HER ALL WAS GOOD. SHE TALKED TO THE NURSE AGAIN LAST WEEK AND WAS TOLD THAT THERE IS NOTHING THEY CAN DO AND ARE REFERING HER BACK TO HER REGULAR DR. WE GOT A CD-ROM OF THE TESTS FROM THE HOSPITAL AND THE DIAGNOSTIC IMAGING REPORTS. ON THE BARIUM ENEMA REPORT THEY NOTE THAT THERE IS "NO SIGNIFICANT REFLUX THOUGH INTO THE TERMINAL ILEUM AND THE APPENDIX IS NON-VISUALIZED.""PATIENT PROBABLY HAS HAD A APPENDECTOMY. SHE HAS NEVER HAD HER APPENDIX TAKEN OUT UNLESS THEY TOOK IT WHEN THEY DID GALLBLADDER SURGERY. SHE DOES NOT REMEMBER THIS BEING THE CASE. SO I GUESS THE QUESTIONS ARE. 1. IS IT STANDARD PROCEDURE TO REMOVE THE APPENDIX DURING GALLBLADDER SURGERY?(OLD STYLE SURGERY, NOT LASER) 2. COULD THE APPENDIX BE CAUSING A PROBLEM IF IT IS STILL THERE, BUT NON-VISUAL? ALSO THE DOG JUMPED UP ON HER STOMACH THE OTHER DAY AND SHE SAID IT FELT LIKE SOMETHING STRETCH OR RIPPED INSIDE. SINCE THEN SHE HAS HAD A "BURNING" SENSATION IN HER SIDE AND STRONG "PINCHING" PAINS AND NOW SHE BLOATS UP FROM SIMPLY RIDING 20 MILES IN THE TRUCK. SHE IS STILL TAKING THE DRUGS FOR THE IBS AND GAS-X, BUT SHE STILL MUST LAY DOWN FOR A COUPLE OF HOURS TO GET THE BLOATING TO START GOING DOWN. WE ARE GETTING DESPERATE TO GET THIS SOLVED, BUT DON'T BELIEVE THE DOCS SHE HAS BEEN GOING TO ARE THE SOLUTION. A RECOMMENDATION ON WHAT TYPE OF DR. TO SEE NEXT WOULD BE GREATLY APPRECIATED.

by Kevin Pho, MD, Jul 11, 2003 12:00AM
Hello - thanks for asking your question.

Known as "incidental appendectomy", it is the removal of the appendix during other surgery to remove future episodes of appendicitis.  It is possible this occured, however I would assume that your surgeon made you aware of what happened during the procedure.

If the barium enema was not able to see the appendix, it should be able to be visualized with the abdominal CT scan.

Before attributing all the symptoms to IBS, I would suggest a colonoscopy first to make sure that other organic disease such as a mass or inflammatory bowel disease is not causing your symptoms.

Malabsorption is also a cause of gas and bloating.  If not done already, tests for celiac disease, fat or lactose intolerance should be performed.

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.

Thanks,
Kevin, M.D.
Member Comments (6)

by MyBellyHurts, Jul 10, 2003 12:00AM
Hi there
Obviously not the doctor, but I suffer the same way as your wife. I am 5'5" 112 lbs., and I look 6 months pregnant if I don't stick to my low fat eating. Had my gallbladder out 1-1/2 yrs. ago, and have been lactose intolerant, IBS, and extreme bloating and gas pains. I also develop ovarian cysts, which make everything worse because if you have a cyst on the right ovary, it oftentimes hits the bowel (showed on ultrasound). She may have scar tissue on the bowel, or the ovary may have fused itself to the bowel, which would cause her symptoms. Ovarian cysts often cause the same symptoms, bloating, burning, and pain with gas. You can write me at
***@****
I'll let you know how I control the gas and bloating.
Good Luck

by angelgal, Jul 13, 2003 12:00AM
I had my gallbladder out (laser) on 5/22/2003.  I have been having the same symtoms as both of you ever since.  Mine actually start about 10 minutes after eating.  I need to take Reglan before meals or I am also nauseous all day.  I was diagnosed with Celiac last August and have been maintaining a strict gluten-free diet so I do not think that has anything to do with the bloating.  My surgeon finally agreed at my last visit that something isn't right and I am having an endoscopy this coming Wednesday to see if this is a complication from the surgery or if there is something else wrong to go with it.  I definitely feel your pain and frustration.  Prior to being diagnosed with Celiac, I was told I might have IBS (simply because they couldn't figure out what was wrong) or that maybe it was all "in my head" and a phsychiatrist could help.  I'm hoping I don't have the same run-around this time!

by yoshi, Jul 13, 2003 12:00AM
i have a question on endoscopy .
my gastro doc wants me to do it in the hospital but i have heard that some doc have the setup in their own office,what is the difference??
thanks

by tessa0825, Jul 14, 2003 12:00AM
To: yoshi
In my GIs office there are 7 Drs. and they have their own "Surgery and Endoscopy center" however some pts. insurance won't cover procedures being done there...Those pts. have to be done at the hosp......Tessa

by Tammy2, Jul 25, 2003 12:00AM
To: angelgal
I too have the abdominal bloating and look six months pregnant.  I suffer from reflux, hiatel(sp) hernia, IBS and just an irritated stomach.

I was curious how you were diagnosed with celiac?  When my blood tests showed me anemic, that was he first thing he suspected, but wanted to rule out other problems, colon cancer.  He did another blood test and I tested positive for one of the protein (?) things or something, that also led to his suspicion.  So he wanted to do a colonoscomy and wanted to do a biopsy of the celia in my lower intenstine.

Well like usual it was the same - irritated stomach and no problems in the colon.  I had had an endoscopy 5 months prior and it showed the irritated stomach and some erosion from the reflux.  Did you go through all of this before it was definitely diagnosed as celiac?  I've done a lot of research on celiac and I really do have a lot of the symptoms.  The last real bad flare up I had was about four days and I was quite nauseated.  This too led my doctor to think celiac.

I'd appreciate any info you can offer.  I have a horrible diet because so much bothers my stomach, I just eat stuff like cereal and a lot of junk.  Amazingly it doesn't bother me as much as "good" food.

Thanks for taking the time to read this lengthy message and for any info you have.

by dd_dee, Jul 30, 2003 12:00AM
I am 26/f and I have been suffering for at least 13 years. I have had all of the upper gi series. On all the acid reflux meds and ultrasound and so on. I have yet to get the bottom part check. I am very scared of the out come. One doctor touched the right side of my upper stomcah and said I have diverticuloios (spelling not sure of)
I have tried keeping many food journals and nothing clicks so i was wondering if anyone has and foods or drinks that they know that hurts them? I am really really happy to find people that have the same problem because everyone including doctors that I tell about my stomach expanding look at me like I am crazy. I know beer blows my stomach up very fast and itseems things with sugar tend to do it also.

I was also wondering if how ya'll bowel movements are?
mine are mainly pasty and I never seen to empty my colon.

I would like to go one day without the stomach pains.

pls let me know about the foods and drinks.
Thanks
dd_dee
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