Bloating and Constipation: Causes and Solutions - Gastroenterology and Hepatology

Abdominal bloating and constipation?

Hello, I have been experiencing frequent bloating and constipation, but in the past few months, the bloating has escalated to stomach pain, vomiting, and chest tightness.
Sometimes it feels like my gastrointestinal tract is completely inactive; food I eat in the morning comes back up at night.
Recently, my abdomen has become so distended that it looks like I am pregnant, and when I press on my lower abdomen, it feels hard and swollen.
My weight has also been steadily increasing, but I have been mindful of my diet and do not have issues with overeating.
I previously visited a gastroenterology clinic, where the doctor suggested that my symptoms might be related to anxiety, chronic insomnia, and occasional dizziness, leaning towards irritable bowel syndrome (IBS).
I have taken medication a few times, made dietary improvements, and I try to use the restroom regularly, but I still struggle to have a bowel movement, or only a small amount comes out.
I have tried many methods with little success, and my abdomen continues to grow larger each day.
I am unsure what might be causing my condition and whether I should undergo any specific tests at the hospital.
I would appreciate your response.
Thank you!

Lai, 20~29 year old female. Ask Date: 2022/09/04

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please cooperate with the gastroenterologist to manage your lifestyle and diet, as well as medication control.

Reply Date: 2022/09/04

More Info

Bloating and constipation can be quite uncomfortable and distressing, especially when they lead to symptoms like stomach pain, nausea, and a feeling of fullness that resembles pregnancy. Your experience of persistent bloating, along with the sensation of a hard abdomen and weight gain despite careful dietary habits, suggests that there may be underlying issues that need to be addressed.

Firstly, it’s important to understand that bloating and constipation can stem from a variety of causes, including dietary factors, gastrointestinal disorders, hormonal changes, and psychological stress. Given your description, it seems that stress and anxiety may be significant contributors to your symptoms. Stress can lead to gastrointestinal disturbances, including irritable bowel syndrome (IBS), which is characterized by symptoms such as bloating, abdominal pain, and altered bowel habits. The fact that you have experienced insomnia and occasional dizziness may further indicate that your mental health could be impacting your physical health.

Dietary habits play a crucial role in managing bloating and constipation. While you mentioned that you are mindful of your diet, it’s essential to ensure that you are consuming enough fiber, staying hydrated, and avoiding foods that can exacerbate bloating, such as those high in sugar, fat, or certain carbohydrates (like beans, lentils, and cruciferous vegetables). Keeping a food diary can help identify any specific foods that may trigger your symptoms.

In addition to dietary adjustments, regular physical activity can significantly improve gastrointestinal motility and help alleviate constipation. Even simple activities like walking can stimulate digestion and reduce bloating.
Since you have already consulted with a gastroenterologist who suggested that your symptoms might be related to anxiety and stress, it may be beneficial to explore stress management techniques. Practices such as mindfulness, yoga, or cognitive-behavioral therapy can help manage anxiety and may, in turn, alleviate some of your gastrointestinal symptoms.

If your symptoms persist despite these lifestyle changes, further medical evaluation may be warranted. Tests such as abdominal ultrasound, endoscopy, or colonoscopy could help rule out any structural abnormalities or gastrointestinal diseases, such as celiac disease or inflammatory bowel disease. Additionally, a comprehensive metabolic panel or thyroid function tests could provide insight into any hormonal imbalances that might be contributing to your symptoms.

In summary, while bloating and constipation can be caused by various factors, addressing dietary habits, managing stress, and seeking appropriate medical evaluation are essential steps in finding relief. If you continue to experience significant discomfort or if your symptoms worsen, it is advisable to follow up with your healthcare provider for further assessment and tailored treatment options. Remember, you are not alone in this, and there are effective strategies and treatments available to help you regain your comfort and well-being.

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