Abdominal Bloating and Incomplete Bowel Movements - Gastroenterology and Hepatology

Q: Abdominal Bloating and Incomplete Bowel Movements

Hello： If you feel bloated, you can consult a gastroenterologist and get an X-ray to objectively determine if there is indeed bloating or incomplete bowel evacuation. <br>Since you weigh only in the 30-kilogram range, you are quite thin, so a distended abdomen does not necessaril

Abdominal distension, feeling unclean?

Hello, doctor.
After 8 PM, my abdomen becomes very bloated, even if I eat very little at night.
This causes me to have a fear of food and prevents me from going out, significantly affecting my life.
This has been ongoing for about two years.
I am 159 cm tall and my weight has dropped from 47 kg to 35 kg.
Although I have daily bowel movements, I often feel that my bowels are not completely empty, leading to a sensation of incomplete evacuation.
I feel the need to strain to achieve a complete bowel movement.
My pelvic muscles have become tense, and some online users have suggested that I might have obsessive-compulsive disorder related to bowel movements.
I had an endoscopy in early December, which revealed a mild ulcer.
Could you please explain why my abdomen is bloated and what I can do about the feeling of incomplete evacuation?

Han, 30~39 year old female. Ask Date: 2020/12/13

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you feel bloated, you can consult a gastroenterologist and get an X-ray to objectively determine if there is indeed bloating or incomplete bowel evacuation.
Since you weigh only in the 30-kilogram range, you are quite thin, so a distended abdomen does not necessarily indicate intestinal bloating; it may simply appear distended due to being underweight.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2020/12/13

More Info

Abdominal bloating and the sensation of incomplete bowel movements can be distressing symptoms that significantly impact your quality of life. Based on your description, it seems you have been experiencing these issues for about two years, which is quite concerning. Let's break down the possible causes and management strategies for your symptoms.

Possible Causes of Abdominal Bloating
1. Functional Gastrointestinal Disorders: Conditions such as Irritable Bowel Syndrome (IBS) are common causes of bloating and altered bowel habits. IBS can lead to symptoms like abdominal pain, bloating, and changes in bowel movements (diarrhea or constipation). The sensation of incomplete evacuation is also a hallmark of this condition.

2. Dietary Factors: Certain foods can contribute to bloating, especially those high in fermentable carbohydrates (FODMAPs), such as beans, lentils, certain fruits, and dairy products. If you have developed food intolerances or sensitivities, these could exacerbate your symptoms.

3. Gastrointestinal Motility Disorders: Conditions that affect how well your intestines move can lead to bloating and a feeling of incomplete evacuation. Slow transit time can cause stool to remain in the colon longer than normal, leading to bloating and discomfort.

4. Psychological Factors: Anxiety and stress can significantly impact gastrointestinal function. The fear of eating due to bloating may create a cycle of avoidance that worsens your symptoms. The tightness in your pelvic muscles may also be a response to anxiety about bowel movements.

5. Underlying Conditions: Given your history of a mild ulcer, it’s essential to consider other gastrointestinal conditions such as gastritis, peptic ulcers, or even more serious conditions like inflammatory bowel disease (IBD).

Management Strategies
1. Dietary Modifications: Keeping a food diary can help identify any specific foods that trigger your bloating. Consider working with a dietitian to explore a low-FODMAP diet, which has been shown to alleviate symptoms in many individuals with IBS.

2. Regular Exercise: Physical activity can help stimulate bowel movements and reduce bloating. Even gentle activities like walking can be beneficial.

3. Stress Management: Techniques such as mindfulness, yoga, or cognitive-behavioral therapy can help manage anxiety and improve gastrointestinal symptoms. Relaxation techniques may help reduce muscle tension in the pelvic area.

4. Medications: Depending on your symptoms, medications such as antispasmodics, laxatives, or probiotics may be recommended. Probiotics can help balance gut flora and improve symptoms of bloating.

5. Follow-Up with Healthcare Providers: Since you have a history of gastrointestinal issues, it’s crucial to maintain regular follow-ups with your healthcare provider. If symptoms persist or worsen, further investigations such as imaging studies or additional endoscopic evaluations may be necessary to rule out other conditions.

6. Pelvic Floor Therapy: If you are experiencing tightness in your pelvic muscles, pelvic floor therapy may help. A physical therapist specializing in this area can provide exercises and techniques to relax these muscles.

Conclusion
Your symptoms of abdominal bloating and the sensation of incomplete bowel movements are multifactorial and may require a comprehensive approach to management. It’s essential to work closely with your healthcare provider to tailor a treatment plan that addresses both the physical and psychological aspects of your condition. Remember, you are not alone in this, and with the right strategies, you can improve your symptoms and quality of life.

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