Why, stomach, why?
November 18, 2017 1:05 PM   Subscribe

Sometimes if I walk after eating I become increasingly bloated and eventually throw up. This is obviously inconvenient and now happening more frequently. Anyone ever have this issue?

I first recall this happening to me a few years ago, and it was just something that happened once in a great while. Now it happens more often than not when I eat out. It's like this: A friend and I will get food, then we'll hit a museum, stroll around a park afterwards, or walk through the city to our next activity. Not strenuous walking but often a period of extended standing/walking. I'll start to feel bloated not long after starting the walk and then get more and more bloated such that about three hours later I (1.) look pregnant, except the bloating is all above my waist, and (2.) feel Thanksgiving level full, often much more full than I did at the end of my meal. Nausea also rises with the bloating and if I don't sit down within a few hours, I'll eventually throw up. The nausea is not new, but actually throwing up is. I also often develop a weird lethargy as time goes on as well - foggy headed and physically tired.

I'm under the care of a good gastroenterologist, but I can't get an endoscopy for a few more weeks and he really had no ideas about what this might be. He said maybe just "getting older" but I'm only in my mid-30s, dude. I had an abdominal ultrasound that showed nothing. Spring of this year I had a couple transvaginal ultrasounds to monitor an ovarian cyst, which went away, so all is well there. This has been hard to search for online because walking is apparently a way to alleviate bloating after meals.

More details than you could ever want:
- Throwing up helps make me feel better, but not immediately. Sitting helps me from getting sicker but if I walk again it starts up again. Pepto kind of helps. Acid reducer did nothing when I tried it. Usually when I wake up the next morning I feel better.
- Over the past couple months I've developed severe and chronic heartburn (sometimes with belching) whereas I never had heartburn in my life before this. Things that have triggered it are rice pudding, tomato sauce, and peanut butter. I never experience the two problems at the same time though.
- I can't pinpoint any particular food or cuisine, but I eat a wide variety of foods so that would be hard to do. A couple times it has happened at people's homes so this isn't exclusive to restaurants (though I recall eating store bought foods). I usually don't go for long walks after eating at home or work, so I'm not sure if this has something to do with restaurant food or not.
- I asked the gastro about an elimination diet, but he didn't think it was worthwhile. Honestly, I think it would be hard for me to stick to this anyway. He said food allergy testing is fraught with problems and didn't recommend it.
- Never any problems below the waist when this happens or in general. Always have been and continue to be regular.
- I've always eaten too much and too fast. I've worked on curbing both of these with mixed success, but the last time this happened all I'd had was a sandwich that I munched on slowly. I often go long stretches between meals (just my preference).
- My diet isn't great. It used to be waaaay worse years ago, and I never had problems. I don't eat crap like Taco Bell anymore or any HFCS, but I definitely don't eat enough fresh fruits and vegetables. I eat too many Trader Joe's/organic frozen meals, and a lot of carbs, meat, dairy, and sugar. I drink a lot of water.
- I don't drink a ton of alcohol, much less than I used to. Some weeks more than others depending on how often I go out, but sometimes I go weeks without drinking. Beer feels more filling lately than it used to, so I usually go for wine or liquor.
- I've been drinking a lot of probiotic stuff after a course of heavy antibiotics a few weeks ago, and that has not helped anything. In fact, it's happened twice since then.

Any ideas? Thanks.
posted by unannihilated to Health & Fitness (31 answers total) 6 users marked this as a favorite
about three hours later I... look pregnant, except the bloating is all above my waist

This is what stands out to me. It's not just that you feel internally uncomfortable, it's also a large externally-visible swelling?
posted by LobsterMitten at 1:15 PM on November 18, 2017

Oh yes. I won't post pictures but highly distended. Last time I couldn't zipper my coat.
posted by unannihilated at 1:23 PM on November 18, 2017

If you've been having a lot of probiotics after rarely having any, it can be a shock to your system and some can create gas. It wouldn't surprise me if all of this is related. If I were you I would drastically cut back on them, have say a teaspoon of kefir (or whatever) to start with instead of a glass and gradually increase it. You may just have gone overboard and it will all settle down.
posted by Jubey at 1:24 PM on November 18, 2017 [2 favorites]

posted by PorcineWithMe at 1:26 PM on November 18, 2017

Just to clarify so people don't get hung up on this -
I actually made the gastro appointment prior to taking the probiotics because the issue had started to become more frequent over the past 6 months or so. The probiotics was just in the past few weeks.
posted by unannihilated at 1:30 PM on November 18, 2017

Trying not to threadsit, but looking at the symptoms of SIBO I want to add:
No unintentional weight loss. In fact, I'm actually trying to lose weight right now and feel like my body is being stubborn.
posted by unannihilated at 1:34 PM on November 18, 2017

From the story you've told I think it is possible you might have gastroparesis. Has anyone ever mentioned this to you?
posted by telegraph at 1:39 PM on November 18, 2017 [3 favorites]

I've always eaten too much and too fast.

Sounds like it could be air swallowing (aerophagia), given this.
posted by capricorn at 1:40 PM on November 18, 2017

Sibo does not necessarily cause weight loss. My son has it- symptoms can vary quite a bit.
posted by PorcineWithMe at 1:44 PM on November 18, 2017 [2 favorites]

I had a similar problem. My problem was from not burping. Due to some childhood-developed complex of some sort, I find bodily functions very gross -- to the point that I basically don't burp or belch. In my life, that doesn't affect me except when flying; I got sick multiple times when flying in a similar way to what you describe. I eventually figured it out and let myself burp before getting all nauseated, and the problems went away.

However, if that does not help, consider a fecal transplant from someone close to you without your symptoms. Yeah, gross, but the answer to basically every digestive problem that isn't physical is "your gut flora is out of whack". You could take lots of drugs with bad side effects and undergo lots of expensive testing, or you can just get a balanced arrangement of bacteria back in there.
posted by flimflam at 1:54 PM on November 18, 2017

If the endoscopy comes up empty, try asking about a gastric emptying test to see if your stomach is emptying unusually slowly for reasons that can't be seen on an endoscopy?
posted by flibbertigibbet at 1:56 PM on November 18, 2017 [1 favorite]

posted by Coaticass at 2:02 PM on November 18, 2017

Your gastro also seems dismissive (elimination diet and allergy testing can yield very helpful info) and incurious (mid-30's is "older"as an explanation for a highly unusual set of symptoms?!). I'd also get a second opinion or another GI doc. This isn't normal. Demand answers and find a doctor who takes this seriously. Good luck!
posted by quince at 2:16 PM on November 18, 2017 [13 favorites]

I would also suggest a second opinion. You’ve already noted that certain foods trigger the heartburn. Food sensitivities can be tricky to sort out, and your doctor doesn’t seem interested. An elimination diet won’t harm you and might help.

I would also be really concerned about this being attributed to getting older at your age. That seems dismissive to me. Good luck.
posted by FencingGal at 2:29 PM on November 18, 2017 [3 favorites]

Okay, so... I'm the queen of stomach problems (points to crown on head.)

1) YES do an elimination diet. Just take out some main problematic foods for a 3 or so weeks, dairy, wheat, acids, and see what helps. This literally could be as simple as lactose intolerance. (Any doctor that doesn't advice literally seeing if it's a food is bullshit. I've had my share of bullshit doctors.)

2) Gallbladder. Personally, this is where my moneys at. It seems you're female and you're the right age for this shit. Does it hurt in your shoulder, back, or chest? Does it hurt in your side?

My gallbladder tested normally - along with all other stomach tests, and I had to push and ended up in surgery 2 weeks after being told my results were "normal". I was in excruciating pain, stomach acid, bloating, indigestion for over a year. Once they sent it to pathology they saw it was fucked up.

3) Stomach disorders. This could be anything from IBS to GERD to IBD etc. Again, MANY treatments for stuff like this is avoiding food triggers with medication. I personally take peppermint leaf capsules and it's been almost a miracle. That paired with Priolosec, as needed IBS meds, nausea meds, and tracking food triggers has helped.

4) Bacterial overgrowths. I personally had a candida overgrowth, but these are RARE!! It's highly unlikely that you have something like Candida or SIBO. And the treatment for those is an EXTREME diet. And it won't help you if that's not your problem. Which, it likely isn't. (And I for sure had a candida overgrowth, after the diet I stopped getting constant yeast infections, severe pain and bloating, and skin problems.)

I personally get sick from SOME probiotics. It's not one-size-fits-all. It depends on your gut environment.

5) Other: I also have endo and POTS which both affect my stomach, in addition to the GERD and IBS. So it's not just all one thing sometimes. I also had endo surgery where they took out my appendix that showed signs of acute appendicitis, and all that helped tremendously.

But find a doctor that believes you, personally most GIs are total shit. Find a good GP that can help you.

I found an amazing GI and his advice literally is elimination diet, avoiding trigger foods, take peppermint all day every day (the peppermint leaf doesn't give me heartburn) take my meds, etc.

And seriously. I have dealt with this stuff for years. There is a TON of misinformation and I've probably spent hundreds of hours easily researching, experimenting, seeing doctors, tests, surgeries etc. Everyone is different but you HAVE to see what is bothering YOUR body, be that food or illness.

Good luck, feel free to message me.
posted by Crystalinne at 2:38 PM on November 18, 2017 [14 favorites]

I would also suggest going back to your gynecologist, since issues with your ovaries can cause bloating. Even if one ovarian cyst went away, that doesn’t mean you don’t have another one or other problems.

BTW, doctors in general can be really dismissive of women’s problems and just really wrong. I had completely different symptoms from yours (like shortness of breath and frequent severe infections, so we do not have the same thing) and four different doctors missed my cancer. I saved my life by deciding they were all wrong and seeking a fifth opinion. Now I’m in remission and doing well. But it’s because I didn’t just trust what the doctors told me.
posted by FencingGal at 2:57 PM on November 18, 2017 [1 favorite]

Have you tried taking something like Prilosec and seeing if it still happens? That's what I would start with. Take it in the morning on an empty stomach, on any day you think you might do this. It may not help but it's the thing I'd try and I'm surprised your gastro didn't try this.
posted by ch1x0r at 3:15 PM on November 18, 2017 [2 favorites]

Seconding gynecologist. I just ended up with super huge fibroids and while this exact thing didn’t happen to me, it could have. I had heartburn, burping - bloating and distended belly. For me the fibroids were so big, my uterus was huge and poking into everything. Now that it’s all gone I’m noticing I never feel full the way I did and my belly doesn’t ever look like it did. Just something to consider. It does sound triggered by food so I may be way off, but had to mention it incase it’s helpful. Good luck!
posted by jdl at 3:24 PM on November 18, 2017

It sounds like you like your gastroenterologist, but a doctor who suggests that a regular occurrence of a painful distended stomach plus nausea severe enough to throw up after eating a normal amount of food could be a normal part of getting older (in your 30s!!) is not a good doctor. A good doctor might not know what the problem is, and might not be sure how to find out, but suggesting that it’s just because you’re getting older is incredibly dismissive. I’d switch doctors if that’s feasible or at least seek a second opinion.
posted by insectosaurus at 4:14 PM on November 18, 2017 [4 favorites]

I'm not sure if this is helpful, but anecdotally - something similar often happens to me, without the throwing up because I am severely emetophobic and would sooner die than vomit. But if I have to walk around much after eating - ESPECIALLY after eating breakfast, but other meals too - I get very belchy, bloated, way overly full feeling (like the food expands in my stomach), and nauseated. I also get crampy and waves of pain like I need to evacuate my bowels (but rarely actually do) AND the weird foggy lethargy. I'm actually somewhat excited to read this because maybe I'm not such a freak?

However, I also have inflammatory bowel disease (specifically Crohn's). I don't really know if the two are related, because I'm pretty sure I'm in remission right now, and this problem has been going on since before I was diagnosed and continues even while treating my disease. I've just assumed that the Crohn's makes my system extra sensitive.

I would also add that one I experienced this once or twice, my anxiety about it happening again definitely makes the problem worse. For example, I had a terrible experience going for a hike after eating a campfire dinner and even 5 years later, I get major anxiety while hiking even if my stomach is empty, and I feel sick and gaggy. Could that be going on with you?
posted by raspberrE at 7:49 PM on November 18, 2017

Hiatal hernia is a distinct and serious possibility, especially with the bloating and acid reflux. Your stomach may have reduced in size due to strangulation, causing the symptoms you describe. I had a family member have this problem and it was nearly life-ending before diagnosis. Please get a second opinion and bring up this possibility. It shows up clearly if present, and I'd say you need to rule it out, as it is both crystal clear to diagnose with a test, and can potentially be very serious.
posted by Miko at 8:00 PM on November 18, 2017 [2 favorites]

The fatigue with walking makes me think POTS. Obviously IANYD but just something to keep on your radar.
posted by shalom at 8:36 PM on November 18, 2017

Four things that help me when I feel bloated (which is often):

1. Wheat makes me bloat. Rice, couscous, or potatoes don't. Try cutting wheat (and beer) for a week? Much easier than a full elimination diet.

2. A sour green apple helps when I feel bloated. Drinking hot water does too.

3. Teach yourself to fake-burp. When you feel bloated, fake-burp about 10 times and usually a HUGE and very relieving real burp will follow.

4. Take simethecone. Ovol or Gas-X. It's a chemical that breaks the surface tension of water, so it breaks any foamy bubbles in your stomach and lets you burp.
posted by pseudostrabismus at 8:48 PM on November 18, 2017

You certainly could have a hiatal hernia, which unfortunately can't be diagnosed until you can get that endoscopy. Taking a daily dose of something like omeprazole or pantoprazole (ask your doc but you probably need to take a prescription strength dose of these, which would mean doubling the OTC versions) until you can get an endoscopy should improve your symptoms.

You mention that your diet is "not great." If this means that you are overweight and carry extra weight in your midsection, this can also contribute to GERD. Even in the absence of a hernia, increased abdominal fat creates additional pressure on the lower esophageal sphincter.

Source: nurse, long-time GERD sufferer, apple-shaped, endoscopy veteran.
posted by little mouth at 8:54 PM on November 18, 2017 [1 favorite]

I am not sure how helpful this will be, but I'll throw it out there anyway.

For a long time I thought I was vaguely intolerant to all sorts of foods because frequently after eating, I'd get extremely bloated and experience a significant amount of gas pain in my gut and sometimes a bit of heartburn (no nausea though). Unfortunately, I don't have a lot of money so wasn't in a position to shun some of the foods that I thought were making me sick, so I dealt with it (and probably farted a lot in my sleep). Recently, I decided to cut my sugar intake way down because I recognised that I was definitely eating too much of it. Not many other changes, I don't eat takeout-style food anyway, and my diet is otherwise pretty solid.

In as little as two weeks, I noticed that I wasn't getting bloated or pain in my gut after meals, and things I thought didn't agree with me (cauliflower, legumes, dairy products etc.) didn't make me feel like shit anymore. I still eat a bit of sugar but nowhere near what I was. Elimination diets are definitely a PITA but sugar is a relatively simple one to cut out for a fortnight to see if it helps. I am not saying sugar is the cause of your issues, but maybe it is contributing to the general misery. I've yet to experience any of the other positive side effects that are supposed to happen when you give up sugar, but not looking 4 months pregnant after dinner is enough for me.
posted by BeeJiddy at 9:06 PM on November 18, 2017 [1 favorite]

I swear I could have written this post. I'm currently seeking an answer and am in the middle of testing. I was diagnosed with IBS-C YEARS ago, but am not convinced that was a real diagnosis. I'm currently working with a clinical nutritionist. Again, no firm answers here yet, but here are thoughts:

- I also get the above waist bloated. What helps me is to eat reallllly slowly and only to 80% full. I avoid any type of peppers, tomatoes, tomato sauce, peanuts, peanut butter, broccoli, Brussels sprouts and only eat cooked onions. I cannot do hemp powder or stevia and avoid probiotics because they kill me. Dairy is fine as long as it's high quality (one Greek yogurt a day).

- I recently had the results of my first round of testing come back and I'm mineral deficient and a slow oxidizer so I'm addressing this with the clinical nutritionist. I'm still pending the food intolerance testing.

- when I start the bloating process I usually pop a Zantac and drink plain hot water. This actually helps shut it down. It doesn't entirely go away but helps a lot. Same with a hot pack on my stomach.

- I drink electrolyte water only (per the CN) - this is helping with the mineral deficiency and balancing salts. Lots of time we can get adequate minerals/nutrition but our bodies just are not processing them (e.g. Slow oxidizer).

- definitely get regular exercise in there.

Good luck. I would still look into the food intolerance testing if you can. If it doesn't tell you anything but your insurance still covers if the honestly, what is the harm?
posted by floweredfish at 4:26 AM on November 19, 2017

Not a doctor, but having known people with similar symptoms - I would absolutely get checked first for gallbladder stuff. This is especially likely if it occurs more after meals with a higher fat content (one person I know who ended up needing gallbladder surgery had a terrible evening after eating potato salad made with egg/Mayo). Also, if you do get this checked out, be prepared to insist on a thorough investigation, especially if you are female and/or not skinny. Another of my friends who had a bad gallbladder ended up emergency levels of sick before getting surgery because the doctor initially told her she "just needed to lose weight".
posted by aecorwin at 9:06 AM on November 19, 2017

Thanks, everyone. Even more valuable than the disease suggestions was the idea that this is something I should push to get resolved. The gastro also said that this might just be a quirk I have, but you're right this can't just be something I live with as it's really impacting my life: on Friday night I got the bloat+nausea after a dinner and walk with a friend, and I had to cut the evening short, on Sunday I was so bloated by the evening I looked nine months pregnant again (but no nausea, maybe because I was just lounging around the house or because I took some Pepto/antacids) and it still hadn't completely deflated by this morning, and this morning on the train I got so hot and nauseated I would have passed out or thrown up if I hadn't sat down.

I just called the office to see if I could get an endoscopy sooner than the two weeks from now when it's scheduled because my symptoms had gotten worse, and they said no: There were no open appointments, they do not have a cancellation list such that they would call me if one opened up, and they would not allow a different doctor in the practice to perform the procedure.

Thanks again.
posted by unannihilated at 11:45 AM on November 20, 2017

I've been dealing with these similar issues for the last 3 years. I've had allergy tests, endoscopy, colonoscopy, gastic emptying...you name it, I've done it. On my worst week of the bloating, nausea and pain, doctor said there were no other tests to be done and to look at my diet. The only thing that relieved me of my symptoms was mung broth, kitcheri and yoga for intestines. It made a difference instantly & I've had no stomach issues since. The mug nu pani receipie that my mother uses is similar to this https://www.archanaskitchen.com/mung-pani-recipe-whole-green-mung-soup except that she suggests not soaking the beans so you can get a stronger effect and also just cooking for 20 mins on stove vs a pressure cooker. There are other tweaks as well that you can DM me about if interested. It's aurvedic and the only thing that has helped where drugs fell short.
posted by PeaPod at 1:49 PM on November 20, 2017

Nthing the gallbladder thing. Gallstones can present many different symptoms, and sometimes don't give pain, only nausea and vomiting, depending on their severity. My mother used to get intense nausea and certain foods she'd feel turned off by and just avoid. Like eggs. She loathed them when she was sick, and they'd make her feel bad instantly. Once she had her gallbladder removed, she was able to eat them again.

It took her a long time to get a diagnosis, though, because the stones didn't really show on the ultrasound. I believe she had an cholangiography/Xray, but it was a long time ago.

She also had bloating above her waist, which is what made me think it could possibly be that. I'm sorry you're going through this, and I hope you get to the bottom of it soon.
posted by Dimes at 9:48 PM on November 21, 2017

Take some digestive enzymes and some HCL or apple cider vinegar with your meals. That will fix it.
posted by Takeyourtime at 2:56 PM on April 11, 2018

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