Stimulants Of Fluid Secretion
Lubiprostone and linaclotide are novel agents recently approved by the USA Food and Drug Administration, that enhance fluid secretion into the gut lumen and accelerate intestinal transit. These properties are considered to play a role in treatment of constipation, thus a number of clinical trials focusing in the chronic constipation or IBS-C have been conducted . In 2 phase III trials, lubiprostone significantly improved the overall IBS symptoms including bloating in IBS-C.156,157 Several multicenter, randomized trials of linaclotide in chronic constipation or IBS-C also demonstrated the beneficial effect in relieving abdominal bloating.158,159 Thus so far, these 2 novel drugs offer a reasonable therapeutic approach for bloating mainly in IBS-C and functional constipation patients.
Bloating: Causes And Prevention Tips
How often do you hear yourself or friends complain about bloating? We often just say we’re bloated when we feel full, but for many women, the problem relates to a chronic underlying condition. If you feel bloated often, you may have a condition like irritable bowel syndrome , which affects up to 24 of women.
Here are some common causes of bloating and tips on preventing this uncomfortable condition.
What Is Abdominal Distension
A distended abdomen is measurably swollen beyond its normal size. Its often accompanied by the feeling of being bloated with trapped gas or digestive contents. However, abdominal distension isnt always from digestive processes. Healthcare providers diagnose a distended abdomen in terms of the five fs: flatus , fetus , feces , fluid or fat.
A distended abdomen may be very uncomfortable, or it may simply be a symptom that you and your healthcare provider observe visually. It may be acute a sudden, unusual occurrence or chronic something that occurs and resolves itself repeatedly in a predictable way. Chronic abdominal distension accompanied by an uncomfortable bloated feeling is often related to a digestive problem.
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When To Talk To Your Health Care Provider
Bloating can be normal, but it can also be a sign of serious conditions. Its important to keep track of what foods cause you to feel bloated, but also note if you experience other symptoms that have accompanied bloating.
If you notice a drastic change in weight or changes in your bowel movementssuch as changes in color or consistencyyou need to tell your provider that as well, as they can be signs of an underlying condition, Hoffman said. If you ate too much and are having trouble digesting your food, then you know that was the likely cause of your bloating and cramping, but if its come on suddenly with a healthy diet, you should err on the side of caution and visit your provider.
Media contact: Dee Dee Grays, , 979.436.0611
How Do You Fix A Distended Abdomen
If your distended abdomen has an organic cause, the treatment will be very specific to that cause. It might mean managing a disease, infection, growth, obstruction, or injury. An acute case will resolve when the underlying cause has been treated. A chronic case may be treated supplementally with diuretics , laxatives or activated charcoal capsules .
If you have functional abdominal distension and the cause is unknown, it might take some trial and error to manage it. Your healthcare provider may recommend a hydrogen breath test to help determine the cause of excess intestinal gas. They might also recommend you try dietary changes, probiotics or enzymes to improve digestive processes. If they suspect muscle weakness as a cause, they might suggest abdominal or pelvic floor exercises.
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Working With A Doctor
It is important to speak openly and honestly with your physician to express a clear picture of your experiences and symptoms. FGIDs present special challenges when communicating, specifically because of their vague symptoms and sensitive subject matter.
There isnt a diagnostic test for bloating or distension however your doctor may run some tests to rule out underlying problems or associated disorders.
For more information about GI tests and how to prepare for them, see our website www.aboutGIMotility.org or see IFFGD publications #111 or #510.
What Are The Symptoms Of Functional Dyspepsia
Dyspepsia symptoms are sporadic: They come and go without clear reasons, and its hard to tell if anything in particular makes them better or worse. While functional dyspepsia is chronic ongoing over a long period of time it may disappear for a while and then return for unknown reasons. To be diagnosed, you must have had symptoms within the last three months and persistently for at least six months. Youll also have more than one of the following symptoms:
- Epigastric pain. This is pain in the upper abdomen under the ribcage. This region, called the epigastrium, is home to your stomach, small intestine, pancreas and liver.
- Bloated stomach. Feelings of uncomfortable pressure or fullness in your belly, especially after eating.
- Early satiety or loss of appetite. Feeling full very quickly after or during eating.
- Heartburn. This is a burning pain in the region between the stomach and the esophagus, usually due to acid reflux.
- Acid reflux. Stomach acid comes up from your stomach through your esophagus, leading to a burning sensation and often a sour taste in your mouth.
- Nausea and vomiting. In severe cases, fullness and loss of appetite may develop into actual nausea or vomiting.
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Why Does My Stomach Hurt Common Causes And When To See A Doctor
Stomach pain has a number of potential causes, and it can also be a symptom of certain conditions.
Stomach pain is no fun. Theres never a convenient time to be bowled over with cramps, and some symptoms like gas or noisy rumblings can make you want to run and hide immediately.
The only thing worse than an upset stomach is not knowing exactly what caused it. Were those leftovers expired after all? Or do you perhaps have a food sensitivity or a GI condition?
Based on your symptoms and how frequently you experience them, you can nail down the most likely culprit behind your stomach pain which means you can treat and manage it more wisely. Below, we go over the most common reasons that your stomach hurts and what to do, including when its time to call the doctor.
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The Role Of Visceral Sensitivity
Changes in visceral sensitivity have been proposed as the hallmark of IBS.24 Patients frequently describe marked symptoms in the absence of significant physiologic changes, so altered visceral sensitivity provides a ready hypothesis to explain the frequency and severity of the bloating that they experience. Most commonly, rectal hypersensitivity is observed in patients with IBS. Rectal hyposensitivity is also common, particularly in patients with constipation,25 and is associated predominantly with increased abdominal distension. Almost 90% of patients with no-urge constipation, which is associated with elevated rectal sensory thresholds, describe distension and bloating.26 In contrast, hypersensitive patients, in whom diarrhea-predominant IBS is more common, have increased symptoms of bloating in the absence of distension.27
Alterations in visceral sensitivity may explain why symptoms of bloating and distension may be worse in women during the perimenstrual phase.28 Visceral sensitivity varies throughout the menstrual cycle and is generally most acute in the perimenstrual phase,29 the period when symptoms are usually worse. Visceral pain thresholds are also lower in the setting of psychological stress,30 perhaps explaining why patients commonly note exacerbations of symptoms during periods of stress.31
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A More Serious Condition Such As Irritable Bowel Syndrome
Irritable bowel syndrome, or IBS, is a common condition that causes abdominal pain with bloating, diarrhea or constipation. The cause of IBS is unknown, but it may be brought on by certain triggers, including:
- Bacterial infections
- Food sensitivity
- Stressful events
If you think you may have IBS, reach out to your doctor for an evaluation. Many times, lifestyle modifications and medicines can help ease symptoms. You may also try some at-home techniques to relieve your bloating.
Diet Eating Habits And Food Intolerances
Overeating can cause you to feel bloated, and some foods are much more likely to do this than others. Eating too much can cause bloating or expansion of the stomach. Swallowing air from eating too quickly or from chewing gum can also cause bloating.
Several types of foods can cause some people to have excessive gas. Fatty foods and a variety of healthy foods such as cruciferous vegetables , beans, some fruits , dairy products, alcohol, and carbonated beverages.
Abdominal bloating is a hallmark symptom of gluten intolerance, lactose intolerance, and celiac disease, an autoimmune disorder where gluten triggers an immune response that affects the small intestines.
For some people, gaining weight can lead to bloating and a sense that the stomach is always “full” or swollen. Often, weight gain causes previously comfortable clothes to feel tight on the abdomen. Being overweight or obese is also a risk factor for heartburn.
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Biofeedback And Neuromodulatory Techniques
Biofeedback Biofeedback and bowel retraining techniques have an established role in the management of functional hindgut disorders.110 Biofeedback involves a training program, usually led by a nurse or physiotherapist, in which instrument-based techniques are used to reinforce normal patterns of neuromuscular function.
Although no studies have assessed biofeedback for bloating in isolation, several small studies have shown that anorectal biofeedback relaxation techniques reduce symptoms of bloating in up to 70% of patients and concurrently reduce constipation, with the effect maintained for up to 12 months.20,111 This effect does not appear to be confined to those with slow transit or manometric abnormalities and is independent of the presence or absence of IBS.
Diaphragmatic breathing techniques are useful in aerophagia and rumination,112 and given the potential role of visceromotor reflexes in abdominal distension, they may confer benefit in the management of bloating. Unfortunately, no reliable studies have adequately explored this possible effect.
Neuromodulation Sacral nerve stimulation has been associated with a reduction in the frequency and severity of abdominal bloating and other symptoms of constipa-113,114 A study in patients with IBS also showed a significant reduction in bloating.115 However, sacral nerve stimulation is considered experimental, and as such, it cannot currently be recommended for the management of isolated bloating.
What Can I Do At Home To Prevent Abdominal Distension
Prevention is easier if you know the cause. If you notice that abdominal distension occurs after you eat, you may be able to change your eating habits to prevent it. For example:
- Identify food sensitivities and change your diet accordingly.
- Eat smaller amounts more slowly. Wait longer between meals.
- Drink more water and eat more fiber to prevent the accumulation of waste.
- Try digestive enzymes and probiotics before meals.
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Sudden Stomach Cramps With Diarrhoea
If your stomach cramps have started recently and you also have diarrhoea, the cause may be a tummy bug . This means you have a viral or bacterial infection of the stomach and bowel. It should get better without treatment after a few days.
Gastroenteritis may be caused by:
- coming into close contact with someone whos infected
- eating contaminated food
If you have repeated bouts of stomach cramps and diarrhoea, you may have a long-term condition, such as irritable bowel syndrome .
What Should I Do Before Starting The Low
Consult a reliable healthcare provider. Whether youve already been diagnosed with a gastrointestinal disease or you are just beginning to explore possible causes and cures for your symptoms, a registered dietitian or GI specialist can help set you in the right direction. They may have alternative ideas to test before you try the diet. They can also help guide you through the nuances of the diet, provide shopping and menu guides and troubleshoot when questions or problems arise. Theres a lot to keep track of with this diet, including different quantities and portion sizes for different foods. Its easier to follow successfully if you have a guide who knows the way around.
Plan ahead. This is a temporary diet, but its a significant investment of time and trouble in the meantime. Make sure you reserve a chunk of time to complete it when it wont conflict with other important events or obligations. You cant cheat on an elimination diet the whole experiment collapses if you do. Make an intentional commitment to yourself to complete the process before you start. Be deliberate about setting the stage. Clear your fridge and pantry of high-FODMAP foods and prepare some menu plans in advance. Make sure you have ingredients for a few simple standby meals that you know you can prepare and enjoy easily.
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How Do You Treat Functional Dyspepsia
If youve tested positive for a bacterial infection, youll be treated with antibiotics for the infection first. But if functional dyspepsia persists, and no other direct cause can be found, the remaining treatment options are focused on managing symptoms. This is a trial-and-error process. Medication might include:
These medications may help if they happen to target the factors contributing to your symptoms. But functional dyspepsia is often more complicated than that, and medications overall have only a moderate success rate in treating FD.
Some other therapies that people use to manage their symptoms include:
Does Drinking Water Help With Bloating
While it may seem counterintuitive, drinking water may help to reduce bloat by ridding the body of excess sodium, Fullenweider says. Another tip: Be sure to drink plenty of water before your meal too. This step offers the same bloat-minimizing effect and can also prevent overeating, according to the Mayo Clinic.
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How Can I Prevent Stomach Bloating
If your stomach bloating is caused by diet or alcohol, you can help prevent it by making some lifestyle changes. Some good general guidelines include:
If the cause of your bloated stomach is something more specific, such as specific food intolerance, perimenopause or a medical condition, you might need a little help with diagnosis, treatment and prevention. Some options include:
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How To Treat Stomach Pain And Bloating
Simple abdominal bloating without symptoms of concern may respond well to self-care at home. Some things you can try include:
- Drink more water. Increasing your fluid intake can flush your system and help with conditions such as constipation.
- Simplify your diet. Avoiding spicy foods in favor of more bland ones, like rice, applesauce, and toast, can alleviate stomach and GI troubles that cause bloating, like diarrhea, and minimize flares from conditions like Crohn’s disease. Avoid foods that you may not tolerate well, such as gluten or dairy.
- Consider medications. If gas is causing you to bloat, digestive enzymes or simethicone medicines , may help. If you have pain in. your abdomen, avoid non-steroidal anti-inflammatory drugs like ibuprofen or aspirin until your physician has ruled out a stomach condition like an ulcer. These drugs could increase bleeding.
Right Side Of The Abdomen
The upper right side of your abdomen contains the gallbladder, liver, and first part of the small intestine.
The gallbladder is a small sac that stores bile made by the liver. The duodenum, known as the first portion of the small intestine, is where food empties from the stomach into the small intestine.
The center right side of the abdomen contains the ascending colon and the transverse colon. Food then passes from the ascending colon to the transverse colon.
The cecum of the large intestine with the appendix and the small intestine are in the lower right side of the abdomen. The cecum is the first part of the large intestine that the end of the small intestine connects to.
Some experts believe the appendix plays a role in the immune system. Others think it has no purpose.
If your doctor performs a physical exam and then suspects a medical condition is causing your abdominal bloating or pain, theyll run various medical tests.
The types of tests they order will depend on your medical history and physical exam results.
Some common tests for abdominal problems include the following:
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What Does Abdominal Distension Indicate
A distended abdomen is either an organic or a functional problem. An organic problem can be explained by physical evidence, like a disease. Functional problems are observable but unexplained.
Organic causes of abdominal distension might include:
- Menstruation, which causes water retention.
- Significant recent weight gain, which tends to be stored as intra-abdominal fat and may restrict digestion.
- An obstruction of the small or large bowel, causing a build-up of gas and waste matter.
- Partial paralysis of the stomach causing a build-up of digestive contents.
- Inflammation of the abdominal lining .
- A build-up of fluid in the abdomen caused by liver disease .
- Organ enlargement from inflammation or a growth.
- Internal bleeding .
Functional reasons for a distended abdomen tend to involve digestive problems that cause gas and/or digestive contents to accumulate. Causes might include:
- Constipation causing a build-up of feces and back-up of digestive contents.
- Urinary retention causing a build-up of urine.
- A disorder of the muscle contractions involved in digestion , causing digestive contents to back up.
- Abdominal muscle weakness, which causes the abdominal contents to sag outwards and downwards .