Dr. Christian Diaz Stone, MD

A lot of possible causes so would need a lot more information to narrow down the possibilites. Assuming there are no other worrisome symptoms like weight loss or anemia, most of the time pain like this is due to stomach hypersensitivity. When you eat, the ingested food settles in the first half of the stomach and causes the stomach to stretch to accommodate the food. That strecthing can cause discomfort in patients with hypersensitivity.
Talk to a primary care doctor for evaluation.

There is no specific contraindication to soda if you have reflux. But in general it is best to avoid high calorie, high fat and large meals. Liquids are handled by the stomach differently than solids. Liquids empty faster and probably have less effect at exacerbating reflux. Every individual is different, however, so if soda consistently causes you to feel more heartburn then it is best to avoid it.

Bloating can be a difficult problem. We don't understand it well but there are several possible causes:

1. Certain foods that we don't digest well can draw fluid into the small bowel lumen causing distension and bloating. Fluid, not gas, is causing the bloating. In your case, rice may have carbohydrate content that is doing this more than in most people.
2. Upper GI dysmotility causes poor handling of foods ingested causing bloating.
3. Recent research has shown that some patients actually involuntarly contract their diaphragm and relax the abdominal wall muscles resulting in significant bloating and increased abdominal girth.

#1 is the easiest to treat - try the Low FODMAP diet to eliminate carbs that can poorly digested. Reducing rice also reduces the carb content in the diet. You can see a GI doc to get more specifics on this diet.
#2 would need GI evaluation for possible prescription therapy.
#3 is still being researched and treatments with biofeedback are experimental.

Yes, it's a good idea for an IBD patient to take a multivitamin daily (any, like Centrum or whatever) plus extra calcium especially in women (1 g per day). No specific supplements are recommended.

However, keep in mind that ANY actively inflamed bowel will have a much bigger negative effect on nutritional state than not taking vitmains. The point being that your primary aim in IBD is to make sure and confirm that the bowel is healed and there is no inflammation (deep remission). Once this is achieved, then your nutritional needs would be the same as a healthy person with no history of IBD.

As a GI doc I can tell you that it is not a problem from a digestive standpoint.
What you call "indigestion" is not a medical term so I cannot comment unless i know more detail as to what the symptom really is. But whatever it is, it may have nothing to do with eating eggs.
Best to see a primary crae doc first to look into that.

Bloating can be a difficult problem. We don't understand it well, but there are several possible causes:

1. Certain foods that we don't digest well can draw fluid into the small bowel lumen causing distention and bloating. Fluid, not gas, is causing the bloating.
2. Upper GI dysmotility causes poor handling of foods ingested causing bloating.
3. Recent research has shown that some patients actually involuntarily contract their diaphragm and relax the abdominal wall muscles resulting in significant bloating and increased abdominal girth.

#1 is the easiest to treat - try the Low FODMAP diet to eliminate carbs that can poorly digested. You can see a GI doc to get more specifics on this diet or try it on your own first.
#2 would need GI evaluation for possible prescription therapy.
#3 is still being researched and treatments with biofeedback are experimental.

Hope this helps.

There are many different parasitic infections and they have multiple different treatments. I cannot provide more detail unless a specific infection is asked about.

Yes, It should be safe to try a home enema after a bypass surgery. Not sure if you mean a heart bypass for coronary artery disease or a stomach bypass for obesity, but should be safe for either.

You could have a narrowing in the esophagus (e.g., a small ring) or an infection causing those symptoms. Esophageal cancer can also do this if you are older or have a history of smoking, alcohol use, or weight loss. You should have an upper endoscopy done by a gastroenterologist.

If your weight is stable then there is nothing wrong with your digestion or absorption. Malabsorption or other digestion problems would result in weight loss unintentionally. Your intestines probably work just fine.

Weight loss is very hard to achieve for many reasons but malabsorption is not one of them. You may want to seek the help of a registered dietician to go over your precise daily caloric needs, i.e., how many calories you should be consuming (given your exercise regimen) in order to lose weight. Initially, you may be adding muscle while fat goes away, but weight stays the same. Eventually, the weight will go down as long as you are not overeating.

#1 reason for this might be delayed gastric emptying - a consequence of diabetes, especially if it is not well controlled. Sometimes, doctors will call this gastroparesis, but beware of this label because the test for this (gastric emptying scan) is unreliable and inconsistent in people with diabetes. Treatment for delayed gastric emptying includes tight diabetes control, smaller meals, lower calorie foods and more liquid foods.

Nausea is a rather vague symptom. Other causes are possible of course - ulcer, pyloric stricture, H pylori, etc. - so a work up is probably warranted, not knowing her other history and past procedures done. Best to see a GI doctor.

Hope this helps.

I will answer your questions in reverse order.

Celiac is diagnosed in two steps, usually. First, a blood test is done for antibodies, either TTG or Endomysial antibody. If one of these is positive, then the next step is a biopsy of the duodenum, which should confirm the diagnosis. One should be on gluten while this testing is done. If a patient is on gluten free diet then the tests could be falsely negative.

The most common symptom of celiac disease is nothing...no symptoms. Most people have silent disease - it show up only on some lab abnormalities such as elevated liver tests or anemia. If symptoms occur then they are protean - can be diarrhea, bloating, abdominal discomfort, cloudy headed feeling, a specific type of rash called dermatitis herpetiformis, or other vague symptoms.

You son's symptoms are more compatible with a true wheat allergy more than celiac disease. Currently, the medical community recognizes three possible conditions related to wheat ingestion:

1. Wheat allergy
2. Celiac disease
3. Non-celiac gluten sensitivity (this condition is still a bit mysterious and not fully understood)

An allergist would be best to confirm wheat allergy. A gastroenterologist is best to confirm or rule out celiac or NCGS.

Hope this helps.

Not an easy problem to tackle. Hiccups are spasms of the diaphragm muscle that divides the lungs (thorax) from the abdomen. It could be that the muscle (which lies just over the stomach) is being irritated by ingestion of food and air due to stretching of the proximal stomach. This pushes against the diaphragm. A hiatal hernia could be present, too, leading to hiccups.

There are some medicines used to treat hiccups, but an evaluation may be needed with X-rays or endoscopy. If this problem doesn't go away, then you should seek care from a GI doctor.

Yes, this is a well-known phenomenon. Stress can alter bowel habits (diarrhea and/or constipation) and cause pain, especially if there is underlying irritable bowel syndrome or dyspepsia. Either treat the stress or the bowel symptoms based on which is predominant.

Hi there,

Bloating and flatulence are not indicative of poor digestion. As long as you don't have diarrhea and weight loss, chances are that you are digesting just fine. No need to take any remedies to improve digestion per se.

There are certain components in foods that no one can digest well and those components are what tend to cause bloating and flatulence. For gas in particular, the main culprit is carbohydrates, i.e., sugars in the (mainly) vegetables that we consume. The classic example is beans, which contain carbs that humans cannot break down. Thus, those carbs end up in the colon and are then processed by our gut bacteria to produce gas as a byproduct. To reduce gas, reduce carbs in the diet. It is impossible to eliminate all flatulence.

Sometimes reducing carbs can also reduce bloating, which is often a different problem than flatulence. A low FODMAP diet (a type of low-carb diet) can help both gas and bloating. Bloating is much more difficult to treat since we understand it less. See a GI specialist if bloating doesn't improve with diet changes.

Good luck.

No, surgery is not the only way, but the only other option (placing a tube into the gallbladder and injecting chemicals to dissovle stones) is really not avaiable except in very few academic centers. Not worth your while to pursue the nonsurgical option because it is not a conventional treatment.

Stones will only exit the gallbladder (GB) if they are small enough, but even that is not necessarily a good thing because the stones can get stuck in the bile ducts and cause pancreatitis. Large stones seen on an ultrasound will probably never be able to exit the GB. You don't need surgey to remove the GB if the stones are not causing a problem, such as causing pain (biliary colic) or inflaming the GB (cholecystitis).

Most people with gallstones are overweight or obese. Eating less fatty foods and losing weight can help prevent more stones from forming and stop existing stones from getting bigger.

Hope this helps.

Not easy to answer this because, first, I would want to confirm what you describe as constipation. It could mean fewer stools or difficult to pass stools. I like to ask patients how many days they go without any stool. Even up to three days with no bowel movement can be considered normal for certain people but it would not be normal if it represents a change from a person's baseline.

Assuming constiaption means that you are having fewer stools per day or per week as you usually do, then this can occur for various reasons, often secondary to changes in mood, e.g., stress, anxiety, depression, which affect the colonic function via the Brain-Gut Axis. Initial remedies might include using over-the-counter Miralax and increasing fiber, e.g., use Benefiber 1 TBSP three times per day with food or liquid. Drinking more water does not necessarily help colonic function - it is a commonly believed myth that drinking water helps you move your bowels. There is actually no proof of this and in fact if you drink more water then you will simply excrete all the excess water through the kideys and it will not help your colon motility as a rule.

Gas is a separate issue, almost always the result of carbohydrates ingested. If you reduce carbs in the diet, then gas gets better, but it never goes away completely. It is normal to produce gas even several times per day.

Hope this helps.

Your mother's situation is tough because her symptoms of fullness, bloating, nausea, and poor appetite are rather vague and can be caused by many things. But overall, yes, it is possible that underlying diabetes and kidney disease could be contributing to the symptoms. It's very important to keep the blood glucose controlled at all times over 24 hours. Optimizing kidney function by a nephrologist is important too. Lastly, there could also be GI-specific reasons (delayed gastric emptying, H pylori, carbohydrate malabsorption, functional disease, etc.) for those symptoms, so a visit to a gastroenterologist would be reasonable.

Good luck.

Hello. This one is a bit tricky to explain. The air in excessive belching actually originates as air swallowed then immediately belched out. The air does not come from the stomach. This symptom is usually called supragastric belching syndrome. My opinion is that this is caused by dyspepsia or uncomfortable sensation in the stomach, which feels better if air is
expelled since this reduces stretching of the stomach and/or esophagus. If you watch closely, air is swallowed immediately before each belch. This is mostly an involuntary reflex.

Best to get evaluated fully to make sure nothing else is wrong before deciding on treatment, which can be challenging for isolated supragastric belching syndrome.

Hello and sorry for your mother's troubles.

I'm afraid there is not enough information provided to be able to comment with any specificity.

By cramps, I assume you mean that pain comes and goes or fluctuates. If this is the case, then it is probably coming from the lumenal GI tract, but without additional details, I cannot tell if the stomach, small intestine or colon might be the origin. The exact location of pain and any other features that worsen or lessen the pain are important to know. Much more information about the cramps would be needed in order for a doctor to determine what the cause might be.

Sorry that I cannot be of more help.