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What Causes Severe Bloating With Abdominal Pain?

Posted on Thu, 23 Jan 2014

Question: hi...i got an abdominal issue for the past 10 days. severe bloating & pain. no other warning symptoms. CBC is fine. Im on some meds for the past few years: nexium 20 OD, Bipretrax 5mg OD, Lipitor 10 mg OD and aspirin. i had a complete abdomen & pelvic CT scan few months ago which was normal with only few diverticula in my sigmoid colon. an upper gastroscpoy in 2011 revelead "chronic inactive gastritis". the only agony I have is bloating & abdominal pain. bowel moement is ok with no blood or mucus.

Answered by Dr. Rakesh Karanwal (2 hours later)

Brief Answer: It may be diverticular infection+mild obstruction Detailed Answer: Hi there, Thanks for your query. Severe bloating with abdominal pain without any other symptoms, old CT scan evidence of diverticuli, normal CBC and bowel movement suggests either a mild diverticular infection (diverticulitis) with or without partial intestinal obstruction. Consult your doctor at the earliest and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Karanwal (13 hours later)

thanks for your opinion doctor. I dont understand what you mean by intestinal obstructin when my bowel movement is very normal (normal thickness + consistency + almost 12 inch long). I dont have any infection symptoms in my blood (normal WBC + CRP + ESR). I will discuss your opinion with my doctor anyway. But what made you suspect any obstruction ? I did mention my bad back problems and nerve referral pain to my abdomen wall. Would suspect any relation with my case ? I also forgot to mention that after meals, I get alot of burning pain in my upper left abdomen,may be suggestive of severe gastritis or even ulcer. awaitin your kind reply.

Answered by Dr. Rakesh Karanwal (11 hours later)

Brief Answer: Blood workup is usually normal in mild infections Detailed Answer: Hi, Nice hearing back from you. Firstly, it is common to have a NORMAL CBC, ESR and CRP in MILD intestinal infections, or mild diverticulitis. Further, I had mentioned PARTIAL (incomplete) intestinal obstruction, the bowel movements in which, remain NORMAL. Commonly, fecal matter collects in the diverticuli (particularly bigger and deeper diverticuli) and get impacted WITHOUT OBSTRUCTING the intestinal lumen. But the intestine construes this impacted stool as an obstruction and thereby, pumps harder to expel it, which causes severe colicky and generalized abdominal pain. Further, friction of the impacted stool causes abrasions in the diverticuli with consequent invasion of gut bacteria, causing diverticular infection (diverticulitis). I have carefully gone through your CT Scan report. The nerves emerging at D12-L1 level, represent groin and lower limbs and, NOT abdominal wall. Hence, compression on these nerves at D12-L1 level will NOT lead to referral pain to the abdominal wall. Lastly, burning pain in left upper abdomen after meals, is indeed due to hyperacidity (gastritis/duodenitis). Only Endoscopy will show presence/absence of ulcers. Hope I have answered your queries to your satisfaction. Fond regards, Cr. Rakesh Karanwal

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar