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What Causes Abdominal Bloating, Nausea And Low Appetite?

Posted on Sat, 9 May 2015

Question: I am a 63 y/o BF, with the following diagnoses: morbid obesity (BMI 50); HTN; DM Type II; asthma; sleep apnea; and depression x 46 years). I have had the following surgeries: C-section 1972; XXXXXXX BSO in 1998 and LapBand in 2004. For the past 2 weeks I've felt slight abdominal bloating; slight nausea; and a marked decrease in appetite (not a bad thing, but highly unusual). Bowel habits seem a bit sluggish and there is decreased flatulence. I worry about some sort of intestinal blockage or torsion, but my doctor said a tortious bowel would be very painful. So of course I catastrophize and wonder if I am developing some sort of abdominal tumor. Whatever is going on is in the early stages. How long should I allow these symptoms to persist before I request an abdominal CT or other scan/exam? BTW, I had an abdominal CT w/contrast a few months ago as I was contemplating the gastric sleeve, and it was unremarkable.

Answered by Dr. Dr. Klerida Shehu (20 hours later)

Brief Answer:
Upper endoscopy advised...

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concerns.

First, I'd recommend to run upper endoscopy before running ct-scan to evaluate possible changes in upper GI tract. If it shows normal study then please go for CT scan. Better as soon as possible, but however it is not emergency at present.

Your symptoms are not typical for malignant pathologies but more to an upset stomach.

You are also reporting to have type 2 diabetes. If uncontrolled, it will give GI problems as you are having now. That's why I advise to monitor your blood sugar levels and try to keep them well controlled.

Being obese is also another aggravating factors, so I highly recommend to try to reduce weight. Healthy diet and lifestyle regimen can also help.

Hope it was of help!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Dr. Klerida Shehu (13 hours later)

Thanks for the prompt response, Dr. Shehu. Unfortunately, since I have a lap band in place, I do not believe I can have an upper endoscopy, right?

I still have no appetite, which is good because my portion sizes have significantly decreased. The bloating seems less bothersome, too. I will continue to monitor my symptoms and do a better job of monitoring my blood sugar.

I am already making small changes to improve my health - walking 5000 steps a day as I build to 10000; preparing meals at home; staying away from fast food places.

I was also taking probiotics and am considering continuing with that practice.

Answered by Dr. Dr. Klerida Shehu (16 hours later)

Brief Answer:
Hope you'll continue with healthy diet&lifestyle regiment

Detailed Answer:
Hi back,

First, let me congratulate you about the small changes you are doing to improve your health like walking and preparing meals at home.

It is also great that you are not having appetite. Thus, you will have more possibilities to lose weight and to keep your blood sugar under control.

With regards to upper endoscopy after lap band intervention, yes, it can be done only if endoscopyst knows exactly where the lap band has been placed.
It is necessary to evaluate stomach damages after bariatric surgery.

All the best!
Dr.Klerida

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Above answer was peer-reviewed by : Dr. Neel Kudchadkar