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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29790
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My daughters stomach is so big and bloated. It looks like

Customer Question

My daughters stomach is so big and bloated. It looks like she is pregnant. She also has these bouts of burping spells. It is so embarrrasing for her. She is small built and her stomach does not look good. It's depressing her. She had a colonostoply and it was fine. She has visisted a gastroenterologist many times but they cannot tell her why her stomach always looks so big and bloated. They just tell her to try Activia. They have given medicine for stool softers. You name it she's had it. We would so much like to understand this. It's really depressing for her and me. I just want to try to see if I can find some help and answers for my daughter.

Many thanks.
Submitted: 3 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 3 years ago.

Greetings.

 

What is her age?

Did her blood work show anything abnormal?

Has she gas (more passing of flatus) and constipation?

Was a CT scan, barium meal with follow through done?

 

Dr. Arun

Customer: replied 3 years ago.
she is 43 and her blood work was good.
Customer: replied 3 years ago.

No she did not have a CT scan or Barium meal. Never heard of barium meal.

Expert:  Dr. Arun Phophalia replied 3 years ago.

Hello,

 

The reasons for excessive bloating can be;

 

1) excessive air swallowing.

 

Anxious people swallow air when they are stressed or anxiety supervenes.

 

2) increased intraluminal (inside the intestine) production from mal absorbed (improperly absorbed) nutrients,

 

3) decreased gas absorption due to some pathological condition of intestines like diverticulitis

 

4) expansion of intestinal gas due to changes in atmospheric pressure

A solitary reason or combination can be responsible for the excessive gas.

 

Following may help;

 

1) Avoid

 

a) Cabbage

b) Beer

c) Legumes

d) Cheese

e) Beans

 

2) This may help;

 

a) Bismuth subsalicylate

b) Activated charcoal

c) Simethicone; (Maalox, Mylanta); Simethicone causes gas bubbles to break up.

d) Beano; contains an enzyme (alpha-galactosidase), which helps to breakdown certain complex carbohydrates.

 

All are available without prescription.

 

Avoid foods that appear to aggravate symptoms. These may include milk and dairy products, certain fruits or vegetables, whole grains, artificial sweeteners etc. But this is based on the personal observation for the aggravating food.

 

3) Investigations by the physician specifically for it;

 

a) Healthy people pass gas up to 20 times per day. If the frequency of passage of flatus is more than 20 times per day, gas chromatographic analysis of flatus collected via a rectal tube can differentiate air swallowing (which is nitrogen predominantly) from intestinal production of gas (which is hydrogen and carbon dioxide).

b) Colonic transit time.

 

Discontinue the following if she does them;

 

1) gum chewing,

2) smoking,

3) drinking carbonated beverages, and

4) gulping food and liquids.

 

The gas formation and mild discomfort in her age would need to look for the following causes also;

 

 

 

1) Gallbladder disease (gallstones); HIDA scan and CT scan are needed for the diagnosis.

2) Irritable bowel syndrome

3) Diverticulitis; a barium meal with follow through is needed.

 

 

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 3 years ago.
She does not drink or hardly ever chews gum. She has tried just about all of the above you suggested. I will tell her to ask her Dr about the gallbladder, HIDA and CT scan along with the barium meal ?. The question still remains why is her stomack so big? I just don't get it. I will get back to you once I have discussed this with my daughter.
Expert:  Dr. Arun Phophalia replied 3 years ago.

Hello,

 

When there is a persistent problem which is not clear by the physical examination; further investigative work up is needed. As we discussed, colonic transit time and other investigation may be the key. A slow colon can be responsible for the bloating and big stomach. Intestines are the most bulky content of the abdomen and they are only structures which can change the size due to gas, fluid and other intestinal contents. So the direction of the investigative work up has to be for the whole of the gastrointestinal tract.

 

It is privilege assisting you.

 

Dr. Arun

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