Bloating

[Guest guest]

Hello everyone, I would appreciate the collective wisdom with a couple of cases. This is the first.

48year old woman with persistent bloating - thinks initially started intermittently, after the birth of her youngest (of 2 children) 16 years ago. The bloating has exacerbated particularly in the last 2 years. Is present most days to a greater or lesser degree, some days it is completely absent. She has tried keeping food diaries and can't find a pattern. She occasionally also RIF pain - on examination there is a quite distinct tender spot at this point - but this pain does not often coincide with the bloating. She often wakes with the bloating and her abdomen can look very distended. The bloating can also come on over the course of the day -so she'll start off in the morning, fairly comfortable, then by the evening she can look "several months pregnant". She also experiences constipation - generally bowels open every fourth day. Now at this point I can imagine that many of you are thinking "well, that's the issue" and I would agree, but whenever she's increases veg/soluble fibre etc, she has her bowels open daily, but the bloating becomes extreme and unbearable. She's tried herbal tx in the past and was given a herbal capsule containing various chologogues/choleretics/plus carminatives and again, BMs became more regular, but bloating was excessive and very uncomfortable. She has tried many elimination diets - when she first came to see me 3 weeks ago, she was 6 weeks into one from York Labs, following a food sensitivity test and like the others, this seems to have made no difference to her Sx although she has stuck to it rigidly. She has no indigestion, no nausea. Otherwise her general health is extremely good, occasionally gets slightly stressed (she's self employed), no headaches, no skin rashes, mood is good -altho she's fed up with the bloating, no joint problems. Only other things to note are that she was bulimic from 15years of age until she was 28 (on questionning, she says that she only took laxatives a handful of times during her eating disorder) - and on the 2nd day of her period, she gets loose stools.

She's recently had an abdominal scan and is awaiting results. Depending on what this shows, Gastroenterologist plans to send her to Nutritionist with view to looking at FODMAP diet - which is to do with eliminating certain carbs that seem to cause excessive bloating in some folk.

I've recommended pro-biotics and digestive enzymes.

Her first mix from me was:-

25

Curcuma 20

Foeniculum 20

Dioscurea 20

Glycyrrhiza 10

arch 10 2.5ml tds ex aq ac

This mix was very successful for a week, then the bloating returned - no worse, but no better.

2nd mix:-

Valeriana 25

Cynara 20

20

Carum 20

Elletaria 20 2.5ml tds ex aq ac this mix caused an increase in bloating, although she was having BM's every 3 days instead of every 4.

I'd appreciate all input regarding what's going on and herbs to use.

Thank you

Sue Salmon, Huddersfield