Post-Meal Bloating and Digestive Issues After Rib Injury

After noon, I experienced bloating that made it difficult to eat or swallow in the evening?

Hello Doctor, I would like to inquire about my mother's condition.
Many doctors have suggested that she has poor gastrointestinal motility, but she did not have this issue before the following incident.
In April, someone forcefully lifted her from the right side of her ribcage.
My mother weighs only 42 kg, and after being lifted, she experienced severe pain in her ribs and was unable to move.
After seeing a doctor and getting an X-ray, it was determined that her ribs were not injured.
After two months of rest, she was finally able to walk more normally.
Although the pain from the lifting has subsided, she has started experiencing bloating.
The bloating sometimes occurs in the center of her abdomen and other times from her sides, under her armpits, down to her waist.
The bloating is so severe that she cannot eat anything.
Before noon, she does not experience these symptoms, but they begin after noon and continue until she goes to sleep, without any relief.
I have researched online and am concerned that there may be damage not only to her bones but also to her organs.
I consulted a doctor who performed an abdominal ultrasound and gastrointestinal X-ray, but found no abnormalities, suggesting that my mother might be overthinking her symptoms.
However, this is not simply a case of hypochondria.
The final conclusion from the doctor was that her gastrointestinal motility is too slow, but she had no bloating issues before the incident with her ribs.
I kindly ask for your assistance in identifying the underlying cause.
Below are some details about my mother's daily routine, which I hope will help in your assessment.
Thank you.
Diet: She eats a light diet with low oil and salt, preparing all her meals at home.
Breakfast mainly consists of cereal with milk, fried rice, or noodles, often accompanied by boiled eggs and steamed vegetables.
For lunch and dinner, she has rice, clear soup, fish, and at least two types of vegetables.
Her appetite is normal in the morning, but by noon and evening, she can only eat half a bowl of rice, one tablespoon of vegetables, and a few slices of fish.
She also consumes a few pieces of fruit daily.
Bowel Movements: She has a bowel movement once a day, but sometimes it is smooth, while other times it is somewhat constipated with hard stools.
Fluid Intake: Approximately 1500 to 1800 cc per day.
Exercise Habits: Before her injury, she exercised daily, walking over 10,000 steps.
She has started to resume exercise in the mornings.
Thank you very much for your patience in reading this.

Ms. S, 40~49 year old female. Ask Date: 2023/07/26

Dr. Hu Guozheng reply Gastroenterology and Hepatology

I apologize, but online consultations cannot replace in-person diagnoses.
It was mentioned that the patient has already sought medical attention, but the specific specialty was not stated.
If it is related to the hepatobiliary and gastrointestinal department, it is recommended to consult with a pulmonology clinic for further evaluation.
Additionally, it was noted that the attending physician suggested that the patient might be overthinking the situation; this is something the family can also consider further.
Thank you.

Reply Date: 2023/07/26

More Info

Post-meal bloating and digestive issues can be quite distressing, especially following a significant injury like the one your mother experienced. It’s understandable to be concerned about the potential for internal damage, particularly when the symptoms are new and disruptive to her daily life.

From your description, it seems that your mother experienced a traumatic event that caused significant pain in her rib area. Although X-rays did not reveal any fractures, the force of the injury could have led to soft tissue damage or even impacted the organs in the abdominal cavity. The fact that she is experiencing bloating, particularly after meals, suggests that her digestive system may be reacting to the trauma in a few ways.

Possible Causes of Bloating and Digestive Issues
1. Reduced Mobility and Activity: After the injury, your mother likely reduced her physical activity due to pain. This decrease in movement can slow down gastrointestinal motility, leading to bloating and constipation. The digestive system relies on physical activity to stimulate peristalsis, the wave-like muscle contractions that move food through the digestive tract.

2. Stress and Anxiety: The trauma of the injury can lead to psychological stress, which can significantly impact digestive health. Stress can alter gut motility and increase sensitivity to pain, potentially exacerbating feelings of bloating and discomfort.

3. Dietary Changes: While you mentioned that her diet is healthy and balanced, any changes in eating habits following the injury could also contribute to digestive issues. For instance, if she is eating less than usual or if her body is reacting differently to certain foods post-injury, this could lead to bloating.

4. Visceral Pain Sensitivity: Following an injury, the body can become more sensitive to pain, including visceral pain from the organs. This heightened sensitivity can make normal digestive processes feel uncomfortable or painful.

5. Potential Internal Injury: Although imaging studies did not show any abnormalities, it is still possible that there was some minor internal injury or inflammation that is affecting her digestive system. Conditions like splenic or liver contusions can sometimes occur without visible fractures.

Recommendations for Management
1. Gradual Return to Activity: Encourage your mother to gradually increase her physical activity as tolerated. Gentle walking can help stimulate digestion and reduce bloating.
2. Dietary Adjustments: Consider keeping a food diary to identify any specific foods that may trigger bloating. It may also be helpful to eat smaller, more frequent meals rather than larger ones, which can be easier to digest.

3. Hydration: Ensure she is adequately hydrated, as this can help with digestion and prevent constipation.
4. Stress Management: Techniques such as deep breathing, meditation, or gentle yoga can help manage stress and may improve digestive symptoms.

5. Follow-Up with Healthcare Providers: If symptoms persist or worsen, it may be necessary to follow up with a gastroenterologist. They may recommend additional tests, such as a CT scan or an endoscopy, to rule out any underlying issues that were not visible on initial imaging.

6. Physical Therapy: If her mobility is still limited, a physical therapist can provide exercises tailored to her recovery, which may help alleviate some of the digestive issues.

In conclusion, while the bloating and digestive issues your mother is experiencing may be related to her recent injury, they can often be managed with lifestyle adjustments and close monitoring. If symptoms do not improve, further evaluation may be warranted to ensure there are no underlying complications. It’s essential to maintain open communication with her healthcare providers to address any ongoing concerns.

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