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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Done Abdominal Surgery And Ileostomy. Bloating, Abdominal Bulge. Taken Loperamide. Normal?

At the end of march this year I had abdominal surgery to remove part of my colon and right kidney following a volvulus caused by a lymphoma that required emergency surgery in march 2011. During the 2011 surgery I was given an ileostomy which was reversed during the surgery this year. I believe a lot of my colon was removed, maybe about half.

I have noticed in the last few weeks that I get quite a distinctive bulge on the right side of my abdomen after eating which is quite prominent. I also feel very bloated, especially if I take regular loperamide to slow bowel movements. The bulge is not painful but can be seen through clothes. It is round like an orange and seems to stop just next to my incision which is the length of my abdomen. Is this normal or should I be concerned? Am seeing my surgeon in December as saw him several weeks ago and hadn't noticed it the . Also is there anything I can take to reduce the bloating as the loperamide is effective in slowing and reducing frequency of bowel movements but after a couple of days I feel like I could explode, I am so bloated. Thanks
Sat, 20 Jul 2013
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General Surgeon 's  Response
Hi ! From the history of a major abdominal operation following which you have started noticing a bulge in your abdomen, an incisional hernia can not be ruled out. However, this needs to be examined clinically for confirmation for which you have to get yourself reviewed by your treating doctor.
For the bloating which might be a side effect of taking loperamide continuously, you may try on taking some probiotic drugs along with a proton pump inhibitor, whch may help. WIshiing you an early recovery.
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Allergist and Immunologist Dr. Muhammad Ijaz Nasir's  Response
Thanks for your query. Most probably you have developed Hernia of abdominal area. This is common with abdominal surgery. For this you need surgical repair of this area.
Meanwhile you can apply broad cloth belt around this bulged portion to give support.
•     Loperanmide, it’s slow down the bowl movement which leads to sluggishness of the bowl and its lead to bloating.
I will suggest you to switch on Domperidone 10 mg (1+1+1) half hour before meal.
You are also advised the following
•     Take soft diet
•     Avoid fatty foods
•     Avoid foods that cause more production of gases like cauliflower, ladyfinger etc (you can best judge with your own observations)
•     Always finish your food before fullness of your stomach and never take water after food till one hour.
•     Food containing fibers should always be used in moderate quantity.
•     Walk and exercise will also help you
I am sure you will get benefit If you don’t get relief,plz let me know onpakheim@gmail.compakheim@yahoo.com
My prayers are with you.
Thanks and best regards.
Dr. IjazNasir
Chest Specialist and Head of Chest Department
Gulab Devi Chest Hospital Lahore
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Done Abdominal Surgery And Ileostomy. Bloating, Abdominal Bulge. Taken Loperamide. Normal?

Hi ! From the history of a major abdominal operation following which you have started noticing a bulge in your abdomen, an incisional hernia can not be ruled out. However, this needs to be examined clinically for confirmation for which you have to get yourself reviewed by your treating doctor. For the bloating which might be a side effect of taking loperamide continuously, you may try on taking some probiotic drugs along with a proton pump inhibitor, whch may help. WIshiing you an early recovery.