Chronic Bloating: Causes and Solutions for Your Digestive Health

Abdominal bloating issues?

Hello, doctor.
I apologize for bothering you, but I would like to ask about my situation.
Since mid-September, after experiencing a cold with a sore throat and diarrhea (which resolved in a day or two), I have been experiencing daily bloating.
There has never been any pain, just bloating, and I have not had any other symptoms such as vomiting, fever, blood in stool, abdominal pain, loss of appetite, or stomach pain.
I consulted two doctors at clinics.
The first doctor I saw in early October spent about 1-2 minutes with me, just palpating my abdomen, and said I had a gastroenteritis-type illness, prescribing medication for gastroenteritis.
After two visits with no improvement (and no suggestion for further tests like endoscopy or ultrasound), I decided not to return.

Three days ago, I saw a second doctor.
I went in non-fasting, and they performed an abdominal ultrasound.
The doctor immediately noted that my abdomen was quite distended due to retained stool and gas.
I mentioned that my bowel habits seemed normal (once every 1-2 days), but he said this had accumulated over a long time due to poor habits.
He prescribed a 7-day course of medication, including sennosides as a laxative to take at bedtime, and advised me to return in 7 days.
He assured me that my stomach and liver appeared to be fine (I have been very concerned about potential issues with my stomach or liver, or something more serious).

However, after taking the medication for three days, I have been having larger, softer stools in the morning, but not as the doctor suggested, with constant gas and frequent trips to the bathroom.
My abdomen is less bloated in the morning, but after eating, the bloating returns until I wake up the next day (while continuing to take the medication).
I sincerely want to know what could be causing this persistent bloating (my abdomen sounds like a drum when I lie down) without any other symptoms.
I feel anxious every day, and there has been little improvement in the bloating.
I am unsure what to do!
P.S.
I have a busy work schedule, tend to sleep late (1-3 AM), and do not exercise often, but I have never experienced this before; it has only been happening for the past month.
Thank you!

penny, 20~29 year old female. Ask Date: 2016/10/22

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Dear Ms.
Penny, the possibility of a peptic ulcer cannot be ruled out based on your symptoms.
It is recommended that you see a gastroenterologist for evaluation and arrange for an endoscopy.
Changhua Hospital cares about your health.

Reply Date: 2016/10/22

More Info

Chronic bloating can be a frustrating and uncomfortable condition, and it sounds like you've been dealing with it for some time now. Based on your description, it appears that your bloating began after a mild illness, which may have disrupted your digestive system. While I cannot provide a diagnosis, I can offer some insights into potential causes and solutions for your digestive health.

Possible Causes of Chronic Bloating
1. Post-Infectious Gastroenteritis: After a gastrointestinal infection, some individuals may experience lingering symptoms such as bloating. This can occur due to changes in gut motility or alterations in the gut microbiome.

2. Dietary Factors: Certain foods can lead to bloating, especially those high in fiber, sugar alcohols, or certain carbohydrates that are poorly absorbed (like FODMAPs). Foods such as beans, lentils, cruciferous vegetables, and dairy products can contribute to gas production.

3. Constipation: You mentioned that your bowel habits have not changed significantly, but if you are experiencing any degree of constipation, this can lead to bloating. Even infrequent bowel movements can cause a buildup of gas and stool in the intestines.

4. Food Intolerances: Lactose intolerance or gluten sensitivity can also lead to bloating. If you suspect that certain foods may be causing your symptoms, it might be worth keeping a food diary to identify any correlations.

5. Stress and Lifestyle Factors: Stress can significantly impact digestion. Your busy schedule, late nights, and lack of exercise can contribute to digestive issues. Stress can alter gut motility and increase sensitivity to bloating.

6. Gut Dysbiosis: An imbalance in the gut microbiota can lead to digestive issues, including bloating. This can occur after antibiotic use or due to dietary changes.

Solutions and Recommendations
1. Dietary Modifications: Consider keeping a food diary to track what you eat and how it affects your bloating. You may want to try an elimination diet to identify any food intolerances. Reducing high-FODMAP foods may also help alleviate symptoms.

2. Increase Fiber Gradually: If you suspect constipation, gradually increasing your fiber intake can help. However, do this slowly to avoid exacerbating bloating.

3. Stay Hydrated: Drinking plenty of water can help with digestion and prevent constipation. Aim for at least 8 glasses of water a day.

4. Regular Exercise: Incorporating regular physical activity into your routine can help stimulate digestion and reduce bloating. Even simple activities like walking can be beneficial.

5. Manage Stress: Consider stress-reduction techniques such as mindfulness, meditation, or yoga. These practices can help improve your overall well-being and may positively impact your digestive health.

6. Follow-Up with Your Doctor: Since you have already seen two doctors, it may be beneficial to seek a third opinion or consult a gastroenterologist, especially if your symptoms persist. They may recommend further testing, such as a colonoscopy or breath tests for food intolerances.

7. Probiotics: Some studies suggest that probiotics may help restore gut balance and alleviate bloating. You might consider trying a high-quality probiotic supplement.

8. Medication Review: If you are taking any medications, discuss them with your doctor to see if they could be contributing to your bloating.

Conclusion
Chronic bloating can stem from various causes, and it often requires a multifaceted approach to manage effectively. By making dietary changes, increasing physical activity, managing stress, and seeking appropriate medical advice, you can work towards improving your digestive health. Remember, it's essential to listen to your body and consult healthcare professionals when necessary. If your symptoms persist or worsen, don't hesitate to seek further medical evaluation.

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