Chronic Abdominal Bloating: Causes and Concerns - Gastroenterology and Hepatology

Chronic abdominal bloating

Hello, doctor.
I have been suffering from bloating for a long time.
Since childhood, I have been prone to gastric bloating, which occurs when I eat too much, eat too late, or consume fatty foods.
However, it was only gastric bloating.
In the past year, I have started experiencing bloating in my entire abdomen, especially in the lower abdomen.
I have visited the clinic multiple times and have not yet undergone a gastroscopy, but I have had an ultrasound and taken gas relief medications.
During my first hospital visit, the doctor mentioned that it was due to decreased gastrointestinal motility.
At that time, my bowel movements and gas expulsion were relatively normal, but I was just prone to bloating.
However, in the past two months, the bloating has become very severe and seems to be affecting my bowel movements.
Concerned about decreased gastrointestinal motility, I have been taking enzymes and health supplements like Ruo Yuan tablets daily, but this has not improved my situation, as I only go to the bathroom once every three days.
Additionally, I have started experiencing difficulty in passing gas.
I have always had trouble burping and can only wait for the gas to escape through my esophagus when it builds up too much.
I rely on passing gas to relieve the bloating, but recently, I occasionally experience an inability to pass gas, leading to abdominal distension that feels like I am four to five months pregnant, along with dizziness and insomnia.
Could you please tell me what this might be? Is it possible that these are symptoms of intestinal obstruction?

Miss Zhang, 20~29 year old female. Ask Date: 2016/09/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.

1.
Your symptoms are likely related to peristaltic digestive issues.
Eating smaller, more frequent meals, along with exercise and medication, may help improve your symptoms.

2.
It is recommended to at least check for occult blood in your stool and monitor for any weight loss to rule out other underlying causes.

Changhua Hospital cares about your health.

Chen Shidian

Reply Date: 2016/09/23

More Info

Chronic abdominal bloating can be a distressing condition, and it sounds like you have been experiencing significant discomfort for quite some time. Given your symptoms and the history you've provided, let's explore some potential causes and concerns related to your condition.

Potential Causes of Chronic Abdominal Bloating
1. Functional Gastrointestinal Disorders: Conditions like Irritable Bowel Syndrome (IBS) are common causes of bloating. IBS can lead to symptoms such as abdominal pain, bloating, and changes in bowel habits (diarrhea or constipation). Stress and anxiety can exacerbate these symptoms, even if you feel you manage stress well.

2. Gastrointestinal Motility Disorders: You mentioned that a doctor suggested your intestines might not be moving properly. Conditions like gastroparesis (delayed gastric emptying) or intestinal pseudo-obstruction can lead to bloating and discomfort. These conditions can be challenging to diagnose and may require specialized tests.

3. Dietary Factors: Certain foods can contribute to bloating, especially those high in fermentable carbohydrates (FODMAPs), such as beans, lentils, certain fruits, and dairy products. It may be helpful to keep a food diary to identify any potential triggers.

4. Constipation: You noted that your bowel movements have become less frequent. Constipation can lead to significant bloating and discomfort. If stool is retained in the intestines, it can cause a buildup of gas and lead to bloating.

5. Intestinal Obstruction: While you are concerned about the possibility of an intestinal blockage, it is essential to consider that this condition typically presents with more severe symptoms, such as intense pain, vomiting, and inability to pass gas or stool. However, partial obstructions can lead to bloating and discomfort, so it is worth discussing with your healthcare provider.

6. Food Intolerances: Lactose intolerance or gluten sensitivity can also lead to bloating. If you suspect a food intolerance, consider an elimination diet under the guidance of a healthcare professional.

7. Psychological Factors: Anxiety and stress can manifest physically, leading to gastrointestinal symptoms. If you have a history of anxiety, it may be worth exploring this aspect with a mental health professional.

Recommended Actions
1. Consult a Gastroenterologist: Given the persistence and severity of your symptoms, it is advisable to consult a gastroenterologist if you haven't already. They may recommend further testing, such as an endoscopy or colonoscopy, to rule out any underlying conditions.

2. Dietary Modifications: Consider working with a dietitian to explore a low-FODMAP diet or other dietary changes that may alleviate your symptoms. Keeping a food diary can help identify specific triggers.

3. Regular Exercise: Engaging in regular physical activity can help stimulate bowel function and reduce bloating.

4. Hydration: Ensure you are drinking enough water, as dehydration can worsen constipation.

5. Over-the-Counter Remedies: While you mentioned using enzymes and gas relief medications, it may be worth discussing with your doctor which specific products are most effective for your symptoms.

6. Monitor Symptoms: Keep track of your symptoms, including when they occur and any associated factors (like food intake or stress levels). This information can be valuable for your healthcare provider.

Conclusion
Chronic abdominal bloating can stem from various causes, and it often requires a comprehensive approach to diagnosis and management. While it is essential to rule out serious conditions like intestinal obstruction, many cases can be attributed to functional disorders, dietary factors, or motility issues. Engaging with a healthcare provider who can guide you through the diagnostic process and treatment options is crucial. Remember, you are not alone in this, and with the right support, you can find relief from your symptoms.

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