[38M] With lifelong all-over stomach bloating and history of pancreatitis

Patient Description

A 38-year-old male has been experiencing lifelong all-over stomach bloating that lasts all day. He has not found any relief from the bloating, and certain foods do not exacerbate it. He sometimes experiences intermittent abdominal pain on the left or right side and has infrequent constipation. There is no unexplained weight loss, nausea, vomiting, or jaundice. The patient has a history of pancreatitis, which was treated with antibiotics and resolved. Despite dietary changes, such as eliminating sugar and increasing fruit and vegetable intake, the bloating persists. The patient uses tobacco products in the form of vaping and has a family history of colon polyps. He is currently taking fiber supplements and has no other pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Chronic Pancreatitis: Given your history of pancreatitis, it's possible that you may have chronic pancreatitis. This condition can cause persistent bloating, abdominal pain, and occasional constipation. Chronic pancreatitis occurs when the pancreas becomes permanently damaged from inflammation and stops working properly.

    • Treatment: Management typically involves pain relief, enzyme supplements to aid digestion, and dietary changes. In some cases, surgery may be necessary.
  • Irritable Bowel Syndrome (IBS): IBS is a common condition that affects the digestive system and can cause symptoms like bloating, abdominal pain, and changes in bowel habits. Stress and certain foods can trigger symptoms.

    • Treatment: Treatment often includes dietary changes, stress management, and medications to relieve symptoms.
  • Small Intestinal Bacterial Overgrowth (SIBO): SIBO occurs when there is an abnormal increase in the number of bacteria in the small intestine, leading to bloating, abdominal pain, and changes in bowel habits.

    • Treatment: Treatment typically involves antibiotics to reduce bacterial overgrowth and dietary changes to manage symptoms.
  • Food Intolerances: Certain food intolerances, such as lactose intolerance or fructose malabsorption, can cause bloating and abdominal discomfort.

    • Treatment: Identifying and avoiding trigger foods can help manage symptoms.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to help manage your symptoms:

  1. Dietary Changes: Continue to monitor your diet and consider keeping a food diary to identify any potential triggers. You might want to try an elimination diet to see if specific foods are causing your symptoms.
  2. Hydration: Ensure you stay well-hydrated, especially if you experience constipation. Drinking plenty of water can help keep your digestive system functioning properly.
  3. Fiber Intake: Since you are already taking fiber supplements, make sure you are consuming the right type and amount of fiber. Sometimes, too much fiber can cause bloating, so you may need to adjust your intake.
  4. Probiotics: Consider taking probiotics to help balance the bacteria in your gut. Probiotics can sometimes help with bloating and other digestive issues.
  5. Stress Management: Stress can exacerbate digestive symptoms, so finding ways to manage stress, such as through exercise, meditation, or other relaxation techniques, can be beneficial.
  6. Use MDandMe: Utilize the MDandMe app to journal your symptoms, track your progress, get insights, and share your medical notes with your healthcare provider.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Severe Abdominal Pain: If your abdominal pain becomes severe or persistent, you should see a doctor.
  • Unexplained Weight Loss: If you start losing weight without trying, it could be a sign of a more serious condition.
  • Jaundice: If you notice yellowing of your skin or eyes, seek medical attention immediately.
  • Changes in Bowel Habits: If you experience significant changes in your bowel habits, such as persistent diarrhea or constipation, consult a healthcare provider.
  • Fever or Chills: If you develop a fever or chills, it could indicate an infection or other serious condition.

Remember, while these tips can help manage your symptoms, it's crucial to consult a healthcare provider for a formal diagnosis and appropriate treatment.

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3 mo ago


People Also Ask


What are the common symptoms of chronic pancreatitis?

Common symptoms of chronic pancreatitis include persistent abdominal pain, bloating, nausea, vomiting, and changes in bowel habits such as diarrhea or constipation. It can also lead to weight loss and malnutrition due to poor digestion.


How can Irritable Bowel Syndrome (IBS) be managed effectively?

IBS can be managed through dietary changes, such as following a low FODMAP diet, stress management techniques, regular exercise, and medications to relieve symptoms like antispasmodics or laxatives. Keeping a symptom diary can also help identify triggers.


What is Small Intestinal Bacterial Overgrowth (SIBO) and how is it treated?

SIBO is a condition where there is an excessive growth of bacteria in the small intestine, leading to symptoms like bloating, abdominal pain, and diarrhea. It is typically treated with antibiotics to reduce bacterial overgrowth and dietary changes to manage symptoms.


Can food intolerances cause persistent bloating and how can they be identified?

Yes, food intolerances can cause persistent bloating and abdominal discomfort. They can be identified by keeping a food diary to track symptoms and foods consumed, or through elimination diets where suspected foods are removed and then gradually reintroduced to observe reactions.


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