Bloating and Hunger: Gastrointestinal Issues Explained

Feeling bloated but still hungry?

Hello Dr.
Lin, I underwent a gastrointestinal endoscopy at the end of last year, and since then, I have frequently experienced diarrhea and bloating, along with increased acid reflux and sour belching.
During the procedure, the doctor removed a polyp from my stomach and mentioned that there was another small polyp that was not removed.
Additionally, I have a history of ulcers, having had them from my stomach to my throat.
I do not consume coffee or tea and rarely eat sweets.
Recently, I have been experiencing diarrhea more frequently, and I am unsure if it is due to my busy schedule and increased dining out.

My definition of diarrhea is having to use the restroom 3-4 times within about 3-4 hours, totaling around 4-6 times a day, with my stools varying from yellow-brown, semi-solid to watery.
The last episode of diarrhea occurred the day before yesterday, starting about 3 hours after a meal, with a frequency of approximately 3 times within 30 minutes, and it took two days to return to normal.

Additionally, I have noticed a peculiar phenomenon where I feel hungry easily but become very full after eating a small amount.
About 1-2 hours after a meal, I experience a sensation of fullness that makes me feel nauseous, yet I still feel hungry.
After about 2-3 hours, my stomach occasionally gurgles, and I sometimes burp.
I feel hunger, but at the same time, my stomach feels distended.

Today, I experienced the same issue.
For breakfast, I had: 1.
50 grams of fresh cranberry toast with milk (refined) 2.
About 80 grams of onion-basil cheese bread (a denser whole grain bread).
I feared that this might be a miscommunication from my brain, so I drank about 500cc of water, but I still felt both hungry and full.
In the fourth hour after eating, after using the restroom, I suddenly felt less hungry, but I still experienced mild burping.
Thank you for your assistance.

Joyce, 30~39 year old female. Ask Date: 2020/07/13

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
A 36-year-old female presents with frequent diarrhea and gastroesophageal reflux, with a history of peptic ulcer disease and gastric polyps.
Recently, she has been experiencing increased diarrhea, frequent hunger sensations, postprandial bloating, abdominal rumbling, and belching.

It is advised to pay attention to dietary hygiene due to the recent hot weather and to ensure adequate hydration.
However, she should avoid consuming large amounts of soup or liquids at once, as this may lead to bloating and regurgitation.
If symptoms persist, a follow-up consultation is recommended.

Wishing you safety and health!
Sincerely,
Dr.
Ming-Hui Lin
Attending Physician, Gastroenterology
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2020/07/13

More Info

Understanding gastrointestinal issues, particularly the sensations of bloating and hunger, can be quite complex, especially when there are underlying conditions such as a history of ulcers and polyps. Based on your description, it seems you are experiencing a combination of symptoms that could be attributed to several factors, including dietary habits, gastrointestinal motility issues, and possibly the aftermath of your previous endoscopic procedures.

Firstly, the sensation of bloating often arises from the accumulation of gas in the gastrointestinal tract. This can be exacerbated by certain foods, particularly those that are high in fiber or difficult to digest. Given that you mentioned an increase in your consumption of vegetables and fruits recently, it’s possible that your body is still adjusting to this dietary change. Foods that are high in fiber can lead to gas production as they are fermented by bacteria in the colon. Additionally, if you are eating quickly or consuming large amounts of food at once, this can also contribute to bloating.

The feeling of simultaneous hunger and fullness that you are experiencing is particularly intriguing. This phenomenon can occur due to several reasons. One possibility is that your stomach may be signaling hunger even when it is physically full, which can happen if the stomach is not emptying properly or if there are issues with gastric motility. This can be influenced by stress, which you mentioned might be a factor due to your busy lifestyle. Stress can significantly impact digestion and may lead to symptoms such as bloating, increased gastric acid production, and altered bowel habits.

Your history of ulcers and the presence of polyps could also play a role in your current symptoms. Ulcers can lead to changes in how your stomach processes food, potentially causing delayed gastric emptying or increased sensitivity to certain foods. If you have had any recent changes in your medication or if you have stopped taking any prescribed medications, this could also affect your gastrointestinal function.

Regarding your bowel habits, the frequency of diarrhea you described—4 to 6 times a day—along with the varying consistency of your stools, suggests a possible case of irritable bowel syndrome (IBS). IBS is characterized by a combination of symptoms including abdominal pain, bloating, and changes in bowel habits. It’s important to note that IBS can be triggered by dietary changes, stress, and even certain medications. If you have recently increased your intake of high-fiber foods, this could be a contributing factor.

To manage these symptoms, consider the following strategies:
1. Dietary Adjustments: Gradually reintroduce high-fiber foods to allow your digestive system to adapt. Focus on soluble fibers found in oats, bananas, and apples, which are generally easier to digest. Avoid excessive intake of gas-producing foods such as beans, lentils, and cruciferous vegetables (like broccoli and cauliflower) until your symptoms stabilize.

2. Eating Habits: Pay attention to how quickly you eat. Eating slowly and chewing your food thoroughly can help reduce the amount of air swallowed, which may decrease bloating.

3. Hydration: While staying hydrated is crucial, try to avoid drinking large amounts of water during meals, as this can contribute to a feeling of fullness and bloating.

4. Stress Management: Incorporate stress-reducing techniques such as mindfulness, yoga, or regular physical activity, which can help improve gastrointestinal function.

5. Medical Follow-Up: Given your history of ulcers and polyps, it’s essential to maintain regular follow-ups with your healthcare provider. If your symptoms persist or worsen, further evaluation may be necessary to rule out any complications.

In conclusion, the interplay between your dietary habits, stress levels, and gastrointestinal health is likely contributing to your current symptoms. By making mindful adjustments to your diet and lifestyle, along with regular medical check-ups, you can work towards alleviating these uncomfortable sensations. If symptoms persist, consider consulting a gastroenterologist for a more tailored approach to your gastrointestinal health.

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