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Why Is My Stomach Blowing Up After Eating While Taking Methotrexate?

Posted on Fri, 17 Jan 2014

Question: Hi I am 61 years old, I have RA and been on methotrexate for 7 years, recently I started to inject myself with it instead of tablets, my main issue is my stomach, I have had rapid weight gain 11 months ago and everytime I eat ANYTHING my stomach blows up to look 9 months pregnant,I cannot digest veges, fruit or meat, been on domaperidom 4 times a day which helps a little , I have had many tests but don't seem to have an answer, it has become such an issue, my ra specialist said to do a rice only diet but have gained more weight, have I got gastroparesis and what can I do, I live in NZ and my local hospital say my gp must deal with it, I am desparate and feel I would rather die than have this huge stomach that is inhibiting my breathing, lifestyle and ability to eat. thankyou

Answered by Dr. Sonila Borici (3 hours later)

Brief Answer: Please refer to the following answer. Detailed Answer: Hi, I have read your medical history and feel sorry for the situation you are in. Usually, methotrexate use is associated with candida infection (especially of GI tract) as it comprimises the immunity of the patient. So, in your case I’d suggest to do the examination of stool for ova/parasites and culture of stool for candida. Meanwhile, I’d advise to: - Eat often and small portions and slowly chewing up - Avoid foods that cause gas in your GI (beans, meat, carbonated drinks, etc.) - Start taking probiotics to stabilize your intestinal flora - Avoid fatty or too sugar foods - Drink more water - When it comes to rice, I’d advice to choose brown rice as it is low in calories (low glycemic index) and has more fiber content. All the best! Dr.Sonila

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sonila Borici (42 minutes later)

thankyou for your reply. I have had those tests, no bacteria,i am frustrated by the huge size of my stomach and not knowing what to eat and still gaining weight and the terrible discomfort, what ailment do I have and why is it not responding, 12months is a long time/

Answered by Dr. Sonila Borici (8 hours later)

Brief Answer: Please follow the following answer. Detailed Answer: Hi again, Thank you for following up. I am glad to come to know that there is no bacteria. However, I still insist to get checked for candida infection, which is different from bacterial infection. To my opinion, you might also need to take anti-fungal therapy. Gaining weight is related to : - eating (white) rice - reduced physical activity due to current problems. The more you are physically involved, the less discomfort you will feel. However, I advise to be physically involved as per your current health situation. So, the earlier advice are also helpful together with choosing foods, including: - no sugary/no fatty/no processed foods - no carbonated/caffeinated drinks - eat slowly to avoid swallowing too much gas. All the best! Dr.Sonila

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sonila Borici (2 hours later)

thankyou for your reply, what would you suggest I eat to keep my nutrients balanced without my stomach blowing up. as I said I cant eat meat, veges or fruit. thankyou

Answered by Dr. Sonila Borici (1 hour later)

Brief Answer: Please follow the answer below. Detailed Answer: Hi again, Thank you for following up. If you can't eat meat, veggies or fruit, I'd suggest to eat fish, eggs, cheese, yogurt, or curd. I'd suggest to - avoid too fatty or too salty/sugary foods. - introduce foods gradually to your meals - take supplements containing vitamins, minerals and essential amino acids as additional to your poor-in-nutrients diet. All the best my dear! Dr.Sonila

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Above answer was peer-reviewed by : Dr. Raju A.T