“Abdominal bloating every day doctor. I can’t find relief, I’ve done three diets and I don’t know what to eat. I’m afraid of having something wrong “
This surely sounds familiar to you if you suffer from this problem and that’s why I’m going to tell you today about bloating
What is abdominal bloating
Abdominal bloating is the feeling of bloating, fullness, or heaviness in the abdomen. It may or may not be accompanied by an increase in the diameter of the abdomen. Some patients tell me: I feel like a balloon or like I’m pregnant. For all people, the sensation or location may be different, but what is common is that it greatly affects the quality of life. Sometimes bloating comes alone but sometimes it accompanied by problems such as constipation or chronic diarrhea, bowel syndrome irritable or functional dyspepsia.
What causes abdominal bloating
There are many causes of bloating such as:
Small Intestinal Bacterial overgrowth SIBO:
It is the increase in the number of bacteria in the small intestine. When this happens, the carbohydrates that pass through this organ are fermented by these bacteria, producing more gas and distension of the intestine wall. See my post about SIBO
It may happen that carbohydrates are not absorbed properly in the small intestine or that, even if this is done well, they are not adequately tolerated. The most common is malabsorption or intolerance to lactose and fructose
Abnormal movement of the digestive tube:
Slower or abnormal movement of the walls of the digestive tract can cause abdominal distention. An example is these diseases: Gastroparesis, Diabetes, chronic constipation or use of medications
Malfunction of the pelvic floor:
When there is weakness or incoordination in these muscles, there may be an inability to expel gas or fecal matter and increase the sensation of distension.
Nerve endings in the small intestine can cause normal stimuli or activities to be perceived more intensely. May be related to changes in mood
Don’t panic but it could be due to abnormal fluid in the abdomen (Ascites) or other problems within your abdomen
Under normal conditions, our body accommodates the gas by relaxing the diaphragm (it takes it up) and contracting the muscles of the abdominal wall. In some people, this pattern is reversed and in this case the diaphragm contracts, that is, it goes down and the abdominal muscles relax, which causes obvious distension.
How to diagnose the cause of abdominal bloating
There are many tests that help me identify the source of bloating. Some of these are:
Carbohydrate malabsorption breath tests:
It safely and non-invasively measures whether a carbohydrate such as fructose or lactose is not properly digested. When these are not absorbed by the small intestine, they pass undigested to the colon and are degraded by the bacteria that exist there, increasing the amount of hydrogen gas which can be measured with the breath test.
SIBO Breath test:
The test is performed by administering lactulose and when it is positive it is necessary to study what is producing it. See my article on SIBO
Upper gastrointestinal endoscopy:
Useful to rule out obstruction to the passage of food through the stomach or to take biopsies in the intestine and thus know if there is inflammation that suggests celiac disease or other inflammatory problems of the small intestine.
It is necessary to rule out colon cancer or in the evaluation of constipation and chronic diarrhea. In this exam we can also evaluate the functioning of the pelvic floor.
Ultrasound of the abdomen:
It is used to rule out if there is fluid in the abdomen (Ascites), tumors or problems in the ovaries or liver.
According to the symptoms that predominate, I can also request a gastric emptying scintigraphy to rule out gastroparesis or laboratory tests such as calprotectin or tests for celiac disease, among others.
How am I going to help you?
The causes of abdominal distention are multiple and that is why there is no single intervention for all people. The treatment is aimed at improving the discomfort and, if possible, correcting the root of the problem.
I will help you find the solution to this problem in the following way:
I will listen to you and request the tests that I consider most appropriate to find out what is happening to you.
To improve your symptoms I will give you some special recommendations for you and if you need it you can start a medication. My idea is that you do not restrict yourself in food. You don’t have to stay on bread and water for your distension to improve
If you have abdominal distention I will help you find the solution to this problem. Schedule your appointment for Consultation / Endoscopy / Colonoscopy here: http://wa.me/573207571313
Learn more at http://endoscopyycolonoscopy.com
Mauricio González Hernández
Your Gastroenterologist in Medellín