The main symptom of bacterial overgrowth SIBO , a condition that sometimes accompanies gastroparesis, is bloating. Careful use of antibiotics and probiotics may be helpful in the management of these symptoms.
There is no universally effective treatment for bloating and distension. Treatment availabilities vary from country to country and there are many underlying possibilities as to what is causing the symptoms. It is important to speak openly and honestly with your physician to express a clear picture of your experiences and symptoms. FGIDs present special challenges when communicating, specifically because of their vague symptoms and sensitive subject matter.
For more information about GI tests and how to prepare for them, see our website www. Learn how to prepare for tests. Individuals can help their physicians by describing their complaints as accurately and concisely as possible. With regard to bloating and distension, here are some important questions to ask and details to tell your health care provider keeping track of the things that trigger your symptoms is a good way to discover the answers :.
Some medications and other treatments have been found to help ease the symptoms of bloating and distension. Your doctor may talk to you about some of these options, depending on your symptoms and other health related considerations. Antispasmodics: These can relax the muscles of the bowel and provide relief. Examples include dicyclomine Bentyl and hyoscyamine Levsin in the United States and otilonium bromide or pinaverium bromide available in Latin America and some countries in Europe and Asia and a combination of pinaverium bromide with simethicone Alevian Duo in some Latin America countries.
Learn more about antispasmodics. Probiotics: These dietary supplements contain live bacteria that help balance out the existing bacteria of the intestines. Some that include a relatively low level of probiotic bacteria are available over the counter or in yogurt varieties.
Learn more about probiotics. Rifaximin: This antibiotic is only slightly absorbed and can be used for short periods of time. Usually it is used off-label to lessen bloating in people with IBS whose symptoms do not include constipation, or in those with small intestinal bacterial overgrowth. Prokinetics: These are medications that improve the time it takes for food to travel through the digestive tract. Some prokinetics have been shown to improve bloating.
Learn more about prokinetics also called promotility agents. Antidepressants: These drugs affect receptors in the gut and in the brain. Given in lower dosages than what is used to treat depression, they have been shown to help alleviate bloating and distension. Amitryptiline Elavil , a tricyclic antidepressant, is commonly used to treat pain and discomfort, as well as diarrhea, and may be helpful for bloating.
Other options: Medications that increase fluid content in stools, lubiprostone Amitiza or linaclotide Linzess for example, may also be used. Psychological therapies: Treatments including hypnotherapy and cognitive-behavioral therapy can be useful and help with symptoms and mood. FODMAPs are shortchain carbohydrates that are poorly absorbed in the small intestine and rapidly fermented by bacteria in the gut.
Bloating and distension are both very common, for the general population and for those with FGIDs and motility disorders. Either of the two may be very bothersome to individuals that are experiencing the symptoms, as well as challenging to those trying to treat them.
There is not a conclusive cause for bloating or distension, nor is there a universally effective treatment. For this reason, Dr. Lacy advises that acting like "good detectives" can help clinicians make an accurate diagnosis.
Conducting a thorough clinical history and physical examination that includes the following details will help determine which type of testing may be needed:. Given the broad range of possible causes associated with bloating and distension, identifying the most effective treatment for each individual with symptoms can be a complex process.
Therapeutic options include dietary changes, probiotics, antibiotics, prokinetic agents, antispasmodics, neuromodulators and biofeedback. According to Dr. Lacy and co-authors, more than one treatment strategy may be necessary. The chronic bloating and distension treatment algorithm outlines a process for managing patients with these symptoms. Lacy BE et al. Management of chronic abdominal distension and bloating. Clinical Gastroenterology and Hepatology. This content does not have an English version.
There are many potential causes of stomach swelling. Others may indicate an underlying health condition that requires treatment. A person should see their doctor if they experience severe, persistent, or recurrent stomach swelling. A doctor will work to diagnose the cause and provide appropriate treatments.
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