Nicole Asked :
I have suffered from severe bloating and burping upon waking every morning for one year. The bloating and burping gets worse after meals but is present even without eating. I also suffered from diarrhea and abdominal pain, which was diagnosed as severe IBS and I am on a medication that controls the diarrhea and pain, but the bloating and belching will not go away.
I have been seeing a GI specialist for one year as well and have been tested for everything under the sun and has tried numerous medications such as pamine forte, antidepressants, H2 blockers, pancreatic enzymes and probiotics. I have also had multiple stool tests run, lactose breath test, colonoscopy an abdominal ultrasound and CT. All came back negative.
I forgot to mention I was also tested for celiac disease multiple times. I have also tried many different diets such as an elimination diet, gluten and wheat-free diets as well with no success. It does not matter what I eat. I bloat as big as a pregnant lady or even if I don’t eat I am still bloated.
I am also a marathon runner and lead an extremely healthy lifestyle. I eat a very clean diet consisting of lean meats, veggies, fruit and low fat dairy and occasionally nuts. I have gained 10lbs during this whole thing as well.
This question was posted under the Excessive Belching and Bloating article.
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Dr. Chris Answered :
Firstly it would be important to identify whether the bloating and burping are related. While it may be taken for granted that intestinal gas build up may result in bloating, this is not be the only reason for abdominal distension, especially in your case where it is very pronounced despite your active lifestyle. If your bloating correlates with your burping in that both arise at the same time, then some of your bloating should be eased by passing out gas, either as a belch or flatus.
I have stressed this point because severe bloating to this extent can be due to other serious causes and may not be entirely related to intestinal gas.
Bloating and belching could possibly be related to IBS but there are also many other possible causes. Refer to the article on Causes of Bloating and Gas.
If you have not experienced any relief thus far then it may be time to seek a second opinion from another gastroenterologist. The lack of other gastrointestinal symptoms may have limited your current doctor in a number of other tests and given your previous history of IBS, this may have been the main focus thus far.
Ensure that the probiotics you used contained Saccharomyces boulardii before you write off probiotics as a possible solution. Your weight gain despite your active lifestyle should also prompt further tests and investigations for other conditions like hypothyroidism. These other conditions may be contributing to your gastrointestinal symptoms although the primary cause is not due to a gastrointestinal condition.
Also speak to your doctor about tests for H.pylori infection of the stomach as well as small intestine bacterial overgrowth (SIBO). These conditions will require antibiotics.
Lastly, it is important to take not of the tendency to breathe through the mouth. This may be noticed as snoring during the night. Any form of nasal congestion will also contribute to mouth breathing and you are may be likely to swallow air (aerophagia) while sleeping and when eating. It may be air that you are belching and causing the abdominal bloating.
There may be many other contributing factors which you may not be aware of and it is essential that you speak to a doctor or gastroenterologist about the diagnosis and management.
Article reviewed by Dr. Greg. Last updated on April 19, 2010