Bloating/Air in Stomach

[whalers679]

I'm new here. Over the last 3 months I have been dealing with some extreme bloating, feels like air is trapped in my stomach/intestines at all times plus diarrhea. I did have my gall bladder removed when I was 22 and symptoms were not nearly as bad and were always manageable. I do have anxiety which always makes everything worse, that I know. I'm in my early 40's now and was recently diagnosed with IBS although nothing my gastro has prescribed me is helping. Had both scopes done and only thing that came out was a slight Hiatal Hernia. It's to the point now that the gas/extreme burping/stomach discomfort/diarrhea/stomach noises is ruining my quality of life. The bloating/gas is so bad sometimes, it feels like I can't catch a breath her or there. It's constant and I know something is being missed. Any thoughts on what could be causing this would be much appreciated if you have experienced this. Thanks in advance!

[Maureen1958]

Hi, as you have had your gallbladder removed, you might want to check out Bile Acid Malabsortion (BAM). It sometimes happens after having your gallbladder removed. Link below. Check it out. Your doctor should have thought of this really!

gutscharity.org.uk/advice-a...

Hope this helps.

[xjrs]

I agree with Maureen about asking about BAM.

If you are tested for BAM and they still say it's IBS, here is some information about IBS that I have shared with others in this group in case any of these tips are of interest to you:

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as excess gas, pain or disordered bowel movements. There is an interesting infographic on this here:

gutmicrobiotaforhealth.com/....

This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app and Kings College fodmap apps, they will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[FRreedman]

I agree with Maureen1958, in respect of BAM, but wonder if you are following any special diet (like Fodmap) which is very helpful with a lot of your symptoms, (Ask your GP to refer you to a dietician). If you reduce alcohol and stop dinking fizzy drinks, also chew small mouthfuls of food very well before swallowing and avoid peanuts, sweetcorn and baked beans (all known antagonists of the bowel) Good luck, keep well and stay safe.

[Gardener]

I find Senocalm caps help with gas in stomach. I know what you mean by pressure and burping and a feeling of not being able to get a deep breath. Think it is probably the hiatus hernia is trapping wind high up. Awful symptom.

[Liz1234ty]

Hi - my symptoms are like this. For me it is caused by SIBO i.e excessive gas producing bacteria in small intestine but other possibilities would include food intolerance, your hernia, h pylori infection. Good luck