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Gastroenterology (Expert Forum)
liver worries and 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.
liver worries and bloating
by jersy, Mar 30, 2005 12:00AM
18 months ago I took some anabolic steroids, have used them twice before in pervious years without any problem. 4-5 days later I started to feel nauseas so I stopped taking them and the nausea stopped after about 2 weeks. I then went on holiday and drank rather heavily and the nausea returned after a week of my first drinking. I was then very unwell for about 2 weeks. Following this I didn’t take anything for about a month until I had a bad cold and took some paracetamol, which in turn made me feel nauseas after about 4 days. I realised that perhaps I had done some damage to my liver and should cease to take anything else which might affect it. Unfortunately by now I had started to be unable to digest fats and a vicious cycle started where I would eat some fat, cheese, milk, chocolate bar and would feel very unwell with a very upset stomach and would be waken in the middle of the night with acute nausea, white speckles would appear in my stools. It would normally take me about 2 weeks to get over such an incidence for it to happen all over again. This lasted for about 5 months, each time my stomach becoming more and more upset. These cycles then suddenly stopped (whether by my better understanding of avoiding fatty foods or my some other means I don’t know) and I felt good for about 2 weeks with a very careful low fat diet.
Then it went all wrong again when I had a strawberry and banana milk shake and some carrot cake on an empty stomach. Within 30 minutes my stomach massively expanded and then went down again. This then started a second cycle of symptoms which would be my stomach blowing up after eating, each time it happened the more lightly it was to happen again, I would feel sick for 3-4 days afterwards. I became so desperate to know how to stop this that I stared to eat very little except white rice (I had discovered that bulking my food around rice was the best way of stopping a flare up). This made my gut completely slow down to the point where I felt pain as it moved through my gut and I was drinking loads of water to try and help this. I realised this diet was making me worse so I tried to eat other low fat foods again. This now seemed possible, the earlier flaring up of my stomach with the following nausea and stomach soreness had stopped but now I was becoming very bloated. At night I would be very bloated and look as if I was pregnant (if that were possible!). I had an x-ray, which revealed that I was constipated, and the doctor thought that was the course of the bloating. He told me to take some bran and it should start moving again, this did not work. He then said use some Epsom salts, which gave me diarrhoea and the bloating, reduced a little but not much. This last episode brings me up to date.
My current symptoms are bloating which gets steadily worse throughout the day, at night very distended. I don’t know whether I am constipated or not, I am moving my bowels twice a day, but doesn’t feel normal. I cannot tolerate carbohydrate in wheat based products or potatoes, I am eating brown rice most f the time. I feel nauseas when eating anything, which is fatty, e.g. chocolate, & coconut milk. After eating fat my stool seems paler and float more (but I could be imagining this). I have no energy and feel achy and generally unwell. My weight is normal as is my skin colour and I did have a liver function test and some blood tests done which are normal (not sure what the test were for precisely though). It was discovered that I had large amounts of undigested food in my stool, I took some digestive enzymes, which dramatically reduced my bloating, but the bloating then returned after 4 days. I am still using digestive enzymes.
Has my liver or pancreas been damaged, if so how can I treat this, will they recover?
What’s causing the bloating, could it be bacterial over growth or even an invasion of my small intestine?
Then it went all wrong again when I had a strawberry and banana milk shake and some carrot cake on an empty stomach. Within 30 minutes my stomach massively expanded and then went down again. This then started a second cycle of symptoms which would be my stomach blowing up after eating, each time it happened the more lightly it was to happen again, I would feel sick for 3-4 days afterwards. I became so desperate to know how to stop this that I stared to eat very little except white rice (I had discovered that bulking my food around rice was the best way of stopping a flare up). This made my gut completely slow down to the point where I felt pain as it moved through my gut and I was drinking loads of water to try and help this. I realised this diet was making me worse so I tried to eat other low fat foods again. This now seemed possible, the earlier flaring up of my stomach with the following nausea and stomach soreness had stopped but now I was becoming very bloated. At night I would be very bloated and look as if I was pregnant (if that were possible!). I had an x-ray, which revealed that I was constipated, and the doctor thought that was the course of the bloating. He told me to take some bran and it should start moving again, this did not work. He then said use some Epsom salts, which gave me diarrhoea and the bloating, reduced a little but not much. This last episode brings me up to date.
My current symptoms are bloating which gets steadily worse throughout the day, at night very distended. I don’t know whether I am constipated or not, I am moving my bowels twice a day, but doesn’t feel normal. I cannot tolerate carbohydrate in wheat based products or potatoes, I am eating brown rice most f the time. I feel nauseas when eating anything, which is fatty, e.g. chocolate, & coconut milk. After eating fat my stool seems paler and float more (but I could be imagining this). I have no energy and feel achy and generally unwell. My weight is normal as is my skin colour and I did have a liver function test and some blood tests done which are normal (not sure what the test were for precisely though). It was discovered that I had large amounts of undigested food in my stool, I took some digestive enzymes, which dramatically reduced my bloating, but the bloating then returned after 4 days. I am still using digestive enzymes.
Has my liver or pancreas been damaged, if so how can I treat this, will they recover?
What’s causing the bloating, could it be bacterial over growth or even an invasion of my small intestine?
Doctor's Answer
by Kevin Pho, MD, Mar 30, 2005 12:00AM
, Mar 30, 2005 12:00AM
Tough to say without examination. If the blood tests for the liver and the amylase/lipase are normal, it would be less likely there is a problem with the liver and pancreas. You can consider an ultrasound or CT scan to further image these organs.
Given the fact that you cannot tolerate carbohydrates and the stool seems to float more, this would indicate some sort of malabsporption syndrome. Taking pancreatic digestive enzymes are a start, but I would also test the stool itself for fecal fat malabsorption, as well as blood tests looking for celiac disease.
Bacterial overgrowth is also a possibility. This can be diagnosed with a breath analysis test, or via an analysis of a jejeunal aspirate (which can be performed during an upper endoscopy).
Other possible causes would be irritable bowel disease, but before settling on this diagnosis, I would ensure there are no further organic abnormality first. An upper and lower endoscopy can be considered for a more thorough evaluating of the bowel tract.
These options can be discussed with your personal physician or in conjunction with a gastroenterology evaluation.
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.
Medical Weblog:
kevinmd_b
Given the fact that you cannot tolerate carbohydrates and the stool seems to float more, this would indicate some sort of malabsporption syndrome. Taking pancreatic digestive enzymes are a start, but I would also test the stool itself for fecal fat malabsorption, as well as blood tests looking for celiac disease.
Bacterial overgrowth is also a possibility. This can be diagnosed with a breath analysis test, or via an analysis of a jejeunal aspirate (which can be performed during an upper endoscopy).
Other possible causes would be irritable bowel disease, but before settling on this diagnosis, I would ensure there are no further organic abnormality first. An upper and lower endoscopy can be considered for a more thorough evaluating of the bowel tract.
These options can be discussed with your personal physician or in conjunction with a gastroenterology evaluation.
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.
Medical Weblog:
kevinmd_b
chocolate,peppermint,caffeine,citric food,soda,grease,fried food,dairy products,spice are all bad news.
try rice and white bread.