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Suggest treatment for bloating, swollen stomach, frequent belching and weight loss

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Posted on Thu, 21 May 2015
Question: my daughter is 5 yearsold and has since 4 weeks a bloated and swallen stomach and has to burp all the time. lost weight as well. she got lab work done for gluten and for h pyroi test, all negative. what else can it be. sitting next to her i can hear her stomach making noices all the time and burping and being bloated.
doctor
Answered by Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
Details below

Detailed Answer:
Hello

Thanks for the query

The common causes of persistent bloated abdomen and excessive flatulence in this age group are dietery disturbances,celiac disease,gastritis(one cause of gastritis is H.pylori),small intestinal bacterial overgrowth or lactose intolerance.

As you have mentioned that test for gluten(for celiac disease) and H.pylori for gastritis has been done and are negative.I would like to get a stool test done for reducing substance to see any lactose intolerance.

I would like to know if there is any constipation,disturbed bowel pattern,loose stool or pain abdomen associated with the flatulence.

The dietery modification helps in reducing the flatulence.High sugar containing drinks,carbonated beverages,milk,pulses and beans should be avoided.
Sometimes in gastritis(other than H pylori) lab test does not comes positive. In that condition long term use of probiotics,acid reducing agents like lansoprazole and carminatives(simethicone) along with dietery modification helps. Probiotics decreases the overgrowth of other intestinal bacteria producing excessive gas.Some aerobic exercises also helps in reducing the flatulence.

So I would request you to answer the queries and if possible upload the reports so that I better able to help you out.
I would suggest you to get a stool test done for reducing substance and also get a USG abdomen done to see any intestinal pathology after consulting your physician.Continue all the medications including the acid reducing agents along with dietery modification.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Pradeep Kumar Jain (21 hours later)
How to test for gastritis ? Is h pyroi test including gastritis or need to be done additionally?
My daughter was diagnosed lactose intolerant a year ago and the doc said that is doesn't require a test, so my understanding is my daughter is lactose intolerant. Herefore she give her only lactaid milk. What else can we improve based on this intolerance ?
Can you explain a little bit more the meaning of ,acid reducing agents like lansoprazole and carminatives(simethicone)? Where do we get this medication and does it require a prescription ?
Her stool is regular, not loose or constipated. She has lower tummy pain, but not strong where she couldn't move. As of right know her stomach feels swollen extremely . I m very worried doctor XXXXXXX The pediatrics couldn't find anything. They did some kind a small stool test for bacteria which came back negative.
Can you give me a little guidance on the dieterymodification, what to feed and what rather not. Thank you Dr XXXXXXX

Is the usg ultrasound be covered instead with a x ray? My daughter had an x Ray dao e, and they said they couldn't find anything . Should we still go for usg or is it compatible. Even a cat scan was done but nothing found.
doctor
Answered by Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
Details below

Detailed Answer:
Thank you XXXXXXX for your followup.I can understand your concern.
As CAT scan has already been done and the report was normal,there is no need of doing USG.
Gastritis is a clinical diagnosis in which the symptoms like burning sensation in the chest particularly after feed,abdominal discomfort,may be pain in upper abdomen and poor appetite can be there.H.pylori is the most common organism which can cause gastritis or gastric ulcer and if a diagnosis is made can be treated well.That is the reason once a patient comes with chronic abdominal discomfort,physician wants to get it done.There can be many other causes of gastritis and need to be managed conservatively like with acid reducing agent like lansoprazole,esomeprazole,pantoprazole etc.These medication work be decreasing the secretion of acid in stomach and thus the symptoms.
The diagnosis of lactose intolerance is mainly based on the presence of symptoms like bloating,abdominal distension or pain after taking lactose containg food product.The stool test comes positive for reducing substance.
Carminatives are agent that prevents gas formation and helps in expulsion of gas thus decreased flatulence.These are simethicon,herbal form like tincture ginger,oil of cardamom,oil of dil,pepermint oil.
I would like to give carminatives as there are very little side effects if any and it helps in relieving the flatulence.I would also like to give a short course of acid reducing agents as there may be some gastritis component too.Both these are prescription medicines and you have to get it prescribed by your physician.

Lactaid is a milk formula which does not contains lactose and tolerated well in lactose intolerant patients.Apart from milk lactose is present in many other food products. Most of the time avoiding milk only decreases the symptom but as your child appears to be severe lactose intolerant,I would suggest you to avoid all milk products like milk,fresh cheese,fresh or frozen yoghurt(you can give homemade yoghurt of more than 24 hours),any icecraeam,candy,chocolate,bread which contains milk(You can check this by reading composition).Also avoid pulses,beans or other gas producing foods as I mentioned above.Giving lactase tablets(containing lactase enzyme) and probiotic like lactobacillus(helps in degrading lactose) will also help.

I hope this answers your query.
I shall be glad to follow you up.
If you have any further query I shall be happy to solve it out.
Wish you and your child good health.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2051 Questions

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Suggest treatment for bloating, swollen stomach, frequent belching and weight loss

Brief Answer: Details below Detailed Answer: Hello Thanks for the query The common causes of persistent bloated abdomen and excessive flatulence in this age group are dietery disturbances,celiac disease,gastritis(one cause of gastritis is H.pylori),small intestinal bacterial overgrowth or lactose intolerance. As you have mentioned that test for gluten(for celiac disease) and H.pylori for gastritis has been done and are negative.I would like to get a stool test done for reducing substance to see any lactose intolerance. I would like to know if there is any constipation,disturbed bowel pattern,loose stool or pain abdomen associated with the flatulence. The dietery modification helps in reducing the flatulence.High sugar containing drinks,carbonated beverages,milk,pulses and beans should be avoided. Sometimes in gastritis(other than H pylori) lab test does not comes positive. In that condition long term use of probiotics,acid reducing agents like lansoprazole and carminatives(simethicone) along with dietery modification helps. Probiotics decreases the overgrowth of other intestinal bacteria producing excessive gas.Some aerobic exercises also helps in reducing the flatulence. So I would request you to answer the queries and if possible upload the reports so that I better able to help you out. I would suggest you to get a stool test done for reducing substance and also get a USG abdomen done to see any intestinal pathology after consulting your physician.Continue all the medications including the acid reducing agents along with dietery modification. Regards