Persistent Right Lower Abdominal Bloating: Causes and Solutions

Bloating in the lower right abdomen all day?

In early May, I started experiencing bloating in the lower right abdomen, which persisted throughout the day and was quite uncomfortable.
One evening, after eating fried food at 6 PM, I began to hear gurgling sounds in my stomach that lasted until 11 PM.
Since then, I have experienced abdominal bloating and gurgling sounds after eating every day.
Initially, I thought it was a stomach issue, so I underwent an upper gastrointestinal endoscopy, which revealed only mild inflammation.
However, the bloating and gurgling continued.
My bowel movements are normal, and my weight has decreased from 74 kg to 72 kg over the past two months.
I am unsure what to do now (I had a colonoscopy last year, which showed no abnormalities in the intestines, but I had a duodenal ulcer and Helicobacter pylori in my stomach, which were treated this year).
Thank you, doctor, for your response.

Mr. Li, 40~49 year old female. Ask Date: 2023/06/20

Dr. Hu Guozheng reply Gastroenterology and Hepatology

Hello, it is recommended to visit the gastroenterology and hepatology outpatient clinic for evaluation.
Thank you.

Reply Date: 2023/06/20

More Info

Persistent right lower abdominal bloating can be a frustrating and uncomfortable experience. Given your history of gastrointestinal issues, including a previous diagnosis of duodenal ulcers and Helicobacter pylori infection, it is essential to consider several potential causes and solutions for your current symptoms.

Possible Causes
1. Irritable Bowel Syndrome (IBS): One of the most common functional gastrointestinal disorders, IBS can lead to bloating, gas, and changes in bowel habits. Symptoms often worsen after eating, particularly with certain foods, which may explain the bloating and gurgling sounds you experience after meals.

2. Gastric Motility Disorders: Conditions that affect the movement of food through the digestive tract can lead to bloating and discomfort. Delayed gastric emptying or dysmotility can cause food to remain in the stomach longer than normal, leading to increased gas production and bloating.

3. Food Intolerances: Certain food intolerances, such as lactose intolerance or gluten sensitivity, can lead to bloating and gas. If you notice that your symptoms worsen after consuming specific foods, it may be worthwhile to keep a food diary and discuss potential intolerances with your healthcare provider.

4. Small Intestinal Bacterial Overgrowth (SIBO): An overgrowth of bacteria in the small intestine can lead to excessive gas production, bloating, and abdominal discomfort. SIBO can sometimes occur after gastrointestinal infections or surgeries.

5. Post-Infectious Gastroenteritis: If you had a gastrointestinal infection in the past, it could lead to lingering symptoms, including bloating and altered bowel habits, even after the infection has resolved.

6. Adhesions or Scar Tissue: If you have had previous abdominal surgeries, adhesions can form and may cause discomfort or bloating. These can sometimes lead to partial obstructions or changes in bowel function.

Solutions and Recommendations
1. Dietary Modifications: Consider adopting a low-FODMAP diet, which can help identify and eliminate foods that may be contributing to your bloating. Common high-FODMAP foods include certain fruits, vegetables, legumes, and dairy products. Gradually reintroducing these foods can help pinpoint specific triggers.

2. Probiotics: Incorporating probiotics into your diet may help restore a healthy balance of gut bacteria, potentially alleviating bloating and improving digestive health. Look for strains that have been shown to be effective for bloating, such as Lactobacillus and Bifidobacterium.

3. Regular Physical Activity: Engaging in regular exercise can help stimulate digestion and reduce bloating. Even light activities like walking can promote gastrointestinal motility.

4. Hydration: Ensure you are drinking enough water throughout the day, as proper hydration can aid digestion and help prevent constipation, which can contribute to bloating.

5. Stress Management: Stress can significantly impact gastrointestinal function. Techniques such as mindfulness, yoga, or meditation may help reduce stress and improve your symptoms.

6. Follow-Up with a Gastroenterologist: Given your history of gastrointestinal issues, it may be beneficial to follow up with a gastroenterologist. They may recommend further testing, such as breath tests for SIBO or additional imaging studies, to rule out any underlying conditions.

7. Medication: If dietary and lifestyle changes do not alleviate your symptoms, your healthcare provider may consider medications to help manage bloating and discomfort. This could include antispasmodics or medications that improve gut motility.

Conclusion
Persistent right lower abdominal bloating can stem from various causes, and addressing it often requires a multifaceted approach. By considering dietary changes, lifestyle modifications, and potential medical evaluations, you can work towards finding relief from your symptoms. It is essential to maintain open communication with your healthcare provider to tailor a management plan that suits your specific needs and health history.

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