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What Causes Severe Abdominal Bloating?

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Posted on Mon, 21 Jul 2014
Question: Hi there am wondering what's causing my symptoms of severe bloating especially at evening time. I've also had 3 very light periods only lasting for 2-3 days with pink and dark brown discharge in between periods. I normally have very regular cycles and I'm am currently not on any birth control. I've also had nausea and lightheadedness if I get up from sitting down.I've also noticed some spotting as well after bowel motion. I've had very bad fatigue but has eased somewhat in last 3 weeks. I've had negative urine and blood pregnancy tests, normal pap and my thyroid function tests are also normal. I've had an abdominal and pelvic ultrasound waiting on official results but no masses or cysts were seen. I've have not gained any weight and there was hormone tests done which showed I have not ovulated ... I'm confused and worried as this has never happened to me before ? I don't know what is causing these symptoms.
doctor
Answered by Dr. Binu Parameswaran Pillai (4 hours later)
Brief Answer:
Hello

Detailed Answer:
Hello,

Good day.
I noted that your main symptoms are, Nausea, light headedness on getting up and bloating . How long have been these symptoms happening for?
Noted that you have been feeling fatigued which is improving now.

Most of these symptoms can be due to thyroid issues. But you have mentioned that your thyroid funtions were normal.

Other possibiity is that of an infection, ( viral) and you are recovering from it. Did you have fever, cough or urinary symptoms like burning sensation while passing urine ?

Any other details of blood tests like CBC, electrolytes etc ?

If you have had regular periods before, please do not worry about a single test which shows that you had no ovulation this time ( i presume the test which you mentioned was progesterone). Hopefully, when this stress ful period is over, it might improve.

If the symptoms are not improving and if lightheadedness is continuing, then it is worth doing a cortisol test to look for low cortisol.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (25 hours later)
My symptoms have been ongoing for over 8 weeks nausea has subsided the lightheadedness is new with past week. My abdomen remains very distended in particular at evening time and I don't have any abdominal pain.My CBC was normal except for ferritin level which was low at 9. My TFT's , electrolytes and coeliac screen all normal. Normal bowel pattern at present. Urinalysis performed by gp was normal and no burning or pain during urination just increased frequency by night. I didn't have any coughs colds or flus and no fever in past few weeks . Oh forgot to mention progesterone level was 15nmol on day 20 , FSH was around 6 and I think LH around 26 and prolactin was elevated at 510 ... Off BC around 1 month when bloods were taken . Gp queries PCOS based on blood results but on U/S normal ovaries and no cysts seen but follicles were small on day 7 .... According to radiographer .
doctor
Answered by Dr. Binu Parameswaran Pillai (7 hours later)
Brief Answer:
Hello

Detailed Answer:
Hello,

Good day.
"BC" is that bromocriptine ? or birth control pills ? Did they find out why your prolactin was rised. 510 is not a huge number though. This can even be due to anti nausea and acidity pills ( if you took few days before testing prolactin). What was the prolactin levels even before BC was started ?

bromocriptine itself can cause lots of symptoms like nausea and light headedness.

FSH and LH is best done on day 3 or 4 of the cycle and after that it tend to peak by around day 12 to day 16. It may be worth repeating the LH on the 3rd day of periods in fasting state.

My question is with an elevated prolactin, has an MRI pituitary been performed ? . And with your symptoms of nausea and light headedness, i would certainly suggest an 8 AM CORTISOL level to rule out a low cortisol level.

If the celiac screen was negative and other blood tests were okay, abdominal distension could also be due to irritable bowel syndrome. Try to eat less carbohydrate and use probiotics. Exercise and weight loss also will help.

Rgards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (14 hours later)
Hey there, BC is birth control pills off now for about 6 weeks . I am not on any other regular medication. My prolactin level was only taken once so I have no baseline to compare it to, my G.P will repeat it again but is not concerned with doing an MRI of pituitary gland. I currently have abdominal cramps similar to period ones but have just finished a very light period lasting a 1-2 days one week ago , I also have lower back ache & fatigue throughout the day, nausea occurring in the morning that usually lasts for about 20 -30 minutes. As regards to lifestyle I normally attend gym twice weekly which includes treadmill and swimming sessions. I am not overweight I'm 160cm and 55Kgs, no weight gain noted. My diet is varied and balanced with fruit & vegetables. As for IBS I currently have normal bowel pattern no diarrohea or abdominal pain or blood in stools. Thanks for your help.
doctor
Answered by Dr. Binu Parameswaran Pillai (52 minutes later)
Brief Answer:
Hi

Detailed Answer:
Hello,
Thank you for the reply. As you have had a normal pelvic and abdominal scan, i dont suspect any major issues with your reproductve tract causing the cramps. However, endometriosis is a condition which can present like this and sometimes an ultrasound can miss this. You must discuss about this with your doctor. Did you ever experience pain while sexual intercourse.

I totally agree with your GP about not doing MRI pituitary. No need of medicines for that level of prolactin. You need to repeat that later.

If your bowel movements are okay, i dont suspect any major intestinal problems as well.

Are you worried or depressed for any reason??

I would strongly advice to get an 8 AM serum cortisol test if you continue to experience light headedness and nausea

Regards
Binu
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Severe Abdominal Bloating?

Brief Answer: Hello Detailed Answer: Hello, Good day. I noted that your main symptoms are, Nausea, light headedness on getting up and bloating . How long have been these symptoms happening for? Noted that you have been feeling fatigued which is improving now. Most of these symptoms can be due to thyroid issues. But you have mentioned that your thyroid funtions were normal. Other possibiity is that of an infection, ( viral) and you are recovering from it. Did you have fever, cough or urinary symptoms like burning sensation while passing urine ? Any other details of blood tests like CBC, electrolytes etc ? If you have had regular periods before, please do not worry about a single test which shows that you had no ovulation this time ( i presume the test which you mentioned was progesterone). Hopefully, when this stress ful period is over, it might improve. If the symptoms are not improving and if lightheadedness is continuing, then it is worth doing a cortisol test to look for low cortisol. Regards Binu