Abdominal Distension

[Barny12]

Hi all,

This is my first post on this forum but I've had symptoms for a few years now.

A quick summary of my medical/diet/symptom history:

2017. Found I had high cholesterol. Had been vegetarian for a few years with lots of dairy. Didn't want statins so went vegan. Felt much fitter & healthier within days. Cholesterol normalised within months.

2018. Noticed belly size increasing from 30" - 32" despite no increase in weight. Felt less fit generally. Atrial fibrillation diagnosed.

2019 - 2022 Belly size increased to 35", no weight gain. Lots of gurgling from tummy at bedtime but no other IBS type symptoms. Cholesterol back up again!

2023 Gastroscopy performed. Nothing found. Had other scans - osteoporosis diagnosed. Had private SIBO test which was positive for hydrogen. Took Rifaxamin - no improvement.

2024 Belly size up to 37". No weight gain.

So, apart from abdominal distension and much gurgling of tummy at night, and possible malabsorption (low calcium causing osteoporosis?) I have no other IBS type symptoms.

Only managed to speak to a gastroenterologist once on the phone (in four years) who recommended a pancreatic amylase test and more antibiotics to no avail.

Anyone any idea on a way forward for me or who recognises the problem?

Many thanks in advance.

[Luisa22]

A lot of people might not like me saying this, but it's possibly the vegan diet. I was vegan for years and well on it...until suddenly I wasn't, but only for a week, in 2018.

Then I carried on with my usual vegan diet, and in Spring 2020 my body just started rejecting it, unequivocally, and almost overnight.

I found all the vegan proteins too much for my tummy. My body had changed. I was in my late 60s then, and 71 now. I have not been able to eat much vegan food except steamed vegetables and rice, cous cous etc since Spring 2020. I can eat tiny amounts of vegan proteins, but not enough for my protein needs, and with my sensitive gut, I can't even eat those every day.

There is way too much roughage in that diet for my IBS D.

In 2020 I changed entirely, and included fish and eggs, and butter in my diet and that helped a lot. I don't think I would be here now if I hadn't let go of the vegan diet.

[Barny12 in reply to Luisa22]

Thanks for the reply. I should have said that I'm only about 90% plant based now as I started including a little chicken or fish once or twice a week, and some cheese and eggs occasionally. Trying for a more Mediterranean diet, really. I feel slightly better in myself for it but it's made no difference at all to the belly size!

[Misspomfrey]

I'm almost vegan, but occasionally eat a little white fish, but only occasionally. High Histamines prevent me eating tinned fish. I don't go overboard on special vegan foods, but do eat nuts and seeds. Cheese has to be Lactose Free and I can't seem to tolerate eggs. I can eat more fruit than vegetables and beans which I love are definitely out. I find too much protein starts a flare up but I do need fibre. I sometimes get the distended stomach but it's not there constantly, only during a flare up, and there's never any weight gain. A Mediterranean diet is a healthy diet, I just wish I could eat tomatoes. 😌

[Luisa22 in reply to Misspomfrey]

Yes... there's the thing...the wonderful Mediterranean diet we're all supposed to be on isn't necessarily so. I probably wouldn't live long if I had to eat that diet every day because there would be many things my gut couldn't eat. And unfortunately...it includes tomatoes,

The best idea is working out what foods are tolerable, and eating those, with a view to extending that whenever we can. That diet doesn't have a title. It's just a home made hotch- potch of whatever happens to be friendly to the tum!

I find green beans and most green veggies except cabbage really friendly but most people I know with IBS stay away from green veggies. I do not do well with fruits, yet keep trying.

It amazes me how different our requirements are for calm tummies.

[Misspomfrey in reply to Luisa22]

I don't believe any diet should have a title stamped on it, the same as I don't believe in the Fodmap diet. The Mediterranean diet is so called because it's just a collection of healthy foods which are good for us and include the nutrients and vitamins that we all need, such as fresh fish, fruits, vegetables, olive oil, nuts even a little red wine, they say..... In Mediterranean countries there is lower rate of Heart disease, High Choloesterol, High Blood Pressure, type 2 Diabetes etc, and is the only 'so called' diet that is back up by research.

Of course, people with IBS and other Gut related issues find some of the foods intolerable, I find Tomatoes, Citrus Fruits, Beans intolerable but try to eat healthy foods if I can and I also find I can eat some foods on a 'good day' which I couldn't eat on other days without detriment. I agree, it goes without saying that we all have to take an individualistic approach and work out what we can tolerate.

There's many people with gut and bowel issues to different degrees. At the end of the day it's not what we think we 'should' be eating but what we can get away with eating to stay alive and well.

I haven't eaten meat for well over 40 years, for health reasons but equally for animal welfare reasons. I won't resort to eating it now. In spite of having IBS, I'm still fitter and healthier than any other members of my family for my age who are now overweight and living with all kinds of ailments and illnesses, and who have eaten meat all their lives. I don't believe we 'need' meat, I've gotten to 67 without it. My gut issues steer towards anxiety related, not lack of meat. People don't understand if I tell them I have this frustrating, annoying IBS hanging over me, because to look at me, no one believes I have anything wrong so I keep it to myself mostly for fear of feeling foolish, and this doesn't help with anxiety, and so it goes on.

[Luisa22 in reply to Misspomfrey]

You do remind me of "me", Miss Pomfrey. I only tell someone I have IBS if it matters for some strategic reason. Otherwise I do look pretty well and live an active life, and don't think I look quite my age (71)

I do feel you're right; we all have to work out individually what foods do suit us, which we can have sometimes (when the gut is not so bad, and going through a calm phase), and which we can probably never have again (though never say "never", and I do keep trying a tiny bit of those, to see what happens. A few weeks ago I tried nuts seasoned with garlic and onion powder! Normally I wouldn't go near garlic and onion powder.

Gosh those were tasty, and I'd missed that flavour. I sprinkled some on my cous cous for dinner, and enjoyed that dinner so much.

And my gut was fine! So never say never. Though maybe not frequently-eh?

I was OK on some low FODMAP foods, but others were no good for me whereas some high FODMAPS were. So I couldn't stay on the low Fodmap diet. Some of those foods have become staples, but others upset my tum anyway.

So yes, I hear you about diet "titles". We have to work out our own foods which suit us. And if those don't come into the category of what we are told we SHOULD eat, then so be it. I'd rather feel well than sick and eating the "right diet".

[Misspomfrey in reply to Luisa22]

Your quite right Luisa22, I seem to eat to stay alive these days and if it happens to be healthy food I can eat, then that's a bonus 😆 Don't you find though, at times we can eat something we've not eaten for ages, and we think, Oh, that doesn't seem to have affected me. The next day I can feel fine, but I get kidded, Oh yes 😏 and it can be the second day when I suffer. I never get complacent with this thing and like you say, you can never say never. But Garlic & Onion Powder? 😲 I could never risk that so you've done well. Enjoy it while you can 😉

[Luisa22 in reply to Misspomfrey]

Oh yes, I know what you mean. I was given some lovely organic cherry tomatoes grown in a neighbour's garden. I had five of them, and even peeled them because I wasn't sure about the skins. Next day I was just fine, so fell for one of IBS's tricks.

The next dinnertime I had 5 more, sure they would be fine for me, and next morning found out they weren't. I tried again since then but each time it's a fail. I'd like to be able to eat tomatoes again! Yet I'm OK with cucumber in small amounts, say about 2" at a time,

Yes, garlic powder plus onion powder was a risk but worth taking for a flavour I so much missed. I wasn't conned that time though and didn't repeat it the next evening!

I sometimes get an odd feeling that if we swoop in low and fast just for one strike, IBS doesn't know we're there! haha!

[marthaalice]

I don’t have a solution as I do suffer with the dreaded bloat. I have tried everything and I mean everything. Including antibiotics for Sibo. I assume you have tried a low FoDmap diet which is first line treatment for bloating. The only thing that has helped a little is a course of Elixa Probiotics. I think you would need a few courses to try and sort out your gut but it may be worth a shot. Can’t do any harm to try and rebalance your gut as most bloating is caused by dysbiosis

[xjrs]

Distension alone may be trapped gas in the upper part of the small intestine. Abdominal muscles normally help this gas along and help it to evacuate. Weak abdominal muscles may not do this very well resulting in the pooling effect. Abdominal muscle function can be improved with core strengthening exercises for example from pilates.

[Meleber in reply to xjrs]

Maybe that's why I felt somewhat better in the past, when I practiced hatha yoga 🤔. Even it was only once a week, in a group.

[Trec]

As you were following a mainly vegan diet I assume you aren’t eating/drinking anything dairy so aren’t even consuming that much calcium so a diagnosis of Osteoporosis isn’t that surprising. I know calcium is found in other foodstuffs but not as well absorbed as dairy. Good to hear you are now eating some cheese but if also chicken and fish I take it the vegan diet wasn’t anything to do with animal welfare. I have been vegetarian (for animal welfare reasons) for over 40 years and thanks to dairy products my calcium levels are fine. I would second the suggestion of the Fodmap elimination diet but only carried out under the supervision of a qualified dietician and for a short time. It should help you find out which foods might be causing you a problem. Good luck.

[Barny12 in reply to Trec]

Thanks for the reply.

I was always supplementing with calcium from the word go, and according to nutrient app Cronometer I was fine regarding vits & minerals, so I don't really understand it. That is the reason I think one of the problems I have is malabsoption.

Tried Fodmap for 3 weeks without any noticeable changes.

[Lovemylippy]

I've had similar with bloating. Had loads of investigations. I've recently seen a hospital dietitian and she has suggested following a high fibre diet for constipation .. might be worth asking GP for a referral. Tried Fodmap before but so restrictive. Mostly common sense but a few things I was doing wrong. Here's my plan

Daily exercise

2L fluids daily

Pro-biotics (lots of different ones, try one for 4weeks, then change if no help, I'm trying bio-kalm)

Limit to 1 cafinated drink per day

No more than 2units alcohol

2tbsps Linseed on cereal

Oats for breakfast

5 a day fruit/veg

1-2 Kiwi daily

Eat 3 meals per day at regular times

No food before bed

Limit snacks

I'm feeling a little better (just started). Each person is different but worth a consultation and free with NHS 💖