Persistent Stomach Bloating: Causes and Solutions

Persistent abdominal bloating?

Hello, doctor.
I've been experiencing bloating for the past month.
I've seen four or five doctors, and due to accompanying cold symptoms (nasal congestion, itchy throat, etc.), most diagnosed it as a gastroenteritis.
While the cold symptoms have improved, the bloating tends to subside after taking medication but recurs after a few days.
I feel excessively full after eating even a small amount, to the point where I can't eat much until the next meal.
In recent days, I've also experienced nausea and a desire to vomit, occasional mild headaches, and slightly increased burping frequency.
There has been no diarrhea, just soft stools about twice, while the rest of my bowel movements have been normal.
Additionally, I feel pain at the base of my skull when turning my head, and I occasionally experience sharp pain in my back.
I'm unsure if these symptoms are related.
I would appreciate your insights.
Thank you!

Xiao Liang, 10~19 year old female. Ask Date: 2021/07/03

Dr. Hong Yuanbin reply Internal Medicine

Based on the symptoms you described, it does appear to be a cold, which indicates a higher likelihood of an upper respiratory tract infection given the current community situation in Taiwan.
It is advisable to first rule out the possibility of a COVID-19 infection.
If the COVID-19 test is negative, it may be an infection caused by other viruses.
Symptoms such as headaches, back pain, and nausea can also be related.
It is recommended to rest and stay hydrated.
If you gradually improve, it should be less concerning; however, if the symptoms persist, be cautious of potential bacterial infections, and it is advisable to seek medical attention.
Thank you for your inquiry.

Reply Date: 2021/07/03

More Info

Persistent stomach bloating can be a frustrating and uncomfortable experience, and it often leads patients to seek medical advice multiple times, as you've done. Based on your description, it seems that your bloating is accompanied by other symptoms, including nausea, changes in appetite, and occasional headaches. Let's explore the potential causes and solutions for your condition.

Possible Causes of Stomach Bloating
1. Gastroenteritis: Since you mentioned experiencing cold-like symptoms alongside your bloating, it's possible that you may have had a viral gastroenteritis, commonly referred to as a stomach virus. This can lead to inflammation of the stomach and intestines, resulting in bloating, nausea, and changes in bowel habits.

2. Dietary Factors: If you've noticed that your bloating worsens after eating, it could be related to your diet. Certain foods, particularly those high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), can cause gas and bloating. Foods like beans, lentils, certain fruits (like apples and pears), and dairy products can be culprits, especially if you have lactose intolerance.

3. Gastric Motility Issues: If you're feeling excessively full after eating small amounts, it may indicate a problem with gastric emptying. Conditions such as gastroparesis (delayed gastric emptying) can lead to bloating and discomfort.

4. Stress and Anxiety: Psychological factors can significantly impact gastrointestinal function. Stress and anxiety can lead to increased sensitivity in the gut, causing bloating and discomfort. The connection between the brain and gut is well-documented, and emotional stress can exacerbate physical symptoms.

5. Food Intolerances or Allergies: In some cases, food intolerances (like lactose or gluten intolerance) can lead to bloating and gastrointestinal discomfort. Keeping a food diary may help identify any specific triggers.

6. Underlying Medical Conditions: Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even more serious issues like gastrointestinal obstructions can cause persistent bloating. Given your symptoms, it may be worth discussing these possibilities with your healthcare provider.

Solutions and Management Strategies
1. Dietary Modifications: Consider keeping a food diary to track what you eat and how it affects your bloating. You may want to try a low-FODMAP diet temporarily to see if it alleviates your symptoms. Focus on easily digestible foods and avoid known triggers.

2. Hydration: Ensure you are drinking enough water throughout the day. Staying hydrated can help with digestion and reduce bloating.

3. Smaller, More Frequent Meals: Instead of three large meals, try eating smaller portions more frequently. This can help reduce the feeling of fullness and discomfort.

4. Probiotics: Incorporating probiotics into your diet may help balance gut bacteria and improve digestion. Foods like yogurt, kefir, and fermented vegetables can be beneficial.

5. Stress Management: Since stress can exacerbate gastrointestinal symptoms, consider incorporating relaxation techniques such as mindfulness, yoga, or meditation into your routine.

6. Follow-Up with Your Doctor: Given the persistence of your symptoms, it’s essential to maintain communication with your healthcare provider. If your symptoms do not improve or worsen, further evaluation may be necessary, including imaging studies or referrals to a gastroenterologist.

7. Medication: If your doctor has prescribed medications for bloating or gastric motility, ensure you follow their instructions. Over-the-counter options like simethicone can also help relieve gas.

Conclusion
Persistent stomach bloating can arise from various factors, including dietary choices, stress, and underlying medical conditions. By identifying potential triggers and making appropriate lifestyle changes, you can work towards alleviating your symptoms. It’s crucial to maintain open communication with your healthcare provider to ensure a comprehensive approach to your health. If symptoms persist or worsen, further investigation may be warranted to rule out any serious underlying conditions.

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