Hello and welcome to Healthcare Magic. Thanks for your query.

There could be a few possibilities for the bloating of your stomach. One could be an acid peptic disease, which could be causing excessive gas formation in the stomach, leading to bloating. This is more likely since you have noted a clear change in your bowel habits recently after starting the Coumadin, and Coumadin is known to cause gastric irritation in some people. Second possibility, which could be complicating your problem could be the weight gain and excess fat deposition in the stomach area (which is the area most prone for fat accumulation) which is an after effect of quitting smoking. Another probable cause is the reduced muscle abdominal muscle tone and increased fluid retention which is associated with peri-menopausal hormonal changes.

Like you rightly mentioned, you have to be very cautious in taking any medication when you are on a blood thinning medication. I would suggest that you can try medication such as pantoprazole or omeprazole for the gastric irritation/ acidity and maybe a pro-biotic medication (such as Lactobacillus supplement), which will promote better digestion and reduce gas formation.

Dietary modifications often help a lot in avoiding or reducing bloating.
- Avoid oily or fatty foods, junk foods, carbonated drinks and alcohol.
- Increase the proportion of fruits and vegetables in your diet.
- Avoid vegetables such as brussels sprouts, turnips, cabbage, beans, and lentils
- Avoid starchy foods and choose simple carbohydrates like rice, oats, etc.
- Do not eat quickly and chew your food well before swallowing.
- Instead of eating 3 big meals a day, you can try smaller frequent meals - a 3-meal, 2-snack pattern of diet would be a good choice.

Regular aerobic exercises like brisk walking, jogging, cycling, swimming, etc. can all help in burning belly fat.In addition, abdominal muscle toning exercises will help in restoring the lax tone of the abdominal muscles and prevent protrusion of the belly.

Wish you all the best.

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