DEAR DOCTOR,

A friend of mine gets abdominal swelling when she eats, it makes her look pregnant. The swelling eventually goes down a bit. She says there is some associated pain. This has been going on for a week now. What could be the cause of this and how is it treated? 

OLIVE

DEAR  OLIVE,

The most common cause for abdominal swelling after eating food is presence of gas in the stomach. It causes bloating and feeling of swelling.  Taking high fibre food, carbonated drinks, drinking sodas very fast, binge drinking of alcohol, are some of the common causes of sense of bloating after meals. Swallowing excess air, as it is with chewing gum, can cause swelling in abdomen. Intake of fried food, consuming a very heavy meal, eating late in the evening, taking a very heavy meal in the evening, are some factors that impair adequate digestion and lead to production of excess gas in stomach. This manifests as sense of swelling after food. If the bowels are not emptied adequately, the food present in intestines gets fermented by intestinal bacteria, resulting in sense of swelling. At times, there may be overgrowth of bacteria normally present in the intestines. This may result in rapid fermentation of food present in intestines, resulting in sense of bloating. Along with sense of swelling, an individual may have abdominal pain, burning chest pain, nausea and or vomiting, acid reflux, and et cetera, one or more of these dyspeptic symptoms.  

To prevent such a problem, it is important to take meals early in the evening, avoid heavy fried meals, particularly in evenings, taking small frequent meals is useful, as it is easily digested by intestines. One should avoid drinking sodas, and alcohol binge drinking. Drinking adequate amount of water, consumption of fresh fruits and vegetables, helps prevent constipation and the resultant sense of bloating. Food intolerance or allergies can be identified by removing a food item for some days from the diet and then reintroducing it. Disappearance of symptoms after stopping a food item and then relapse after reintroducing it, definitely points to the substance being responsible for bloating. Avoiding foods such as cabbage, broccoli, which produce much flatulence, is useful. Chewing food slowly, drinking slowly, are some beneficial measures. Foods such as cumin, fennel, coriander, ginger, have natural carminative properties and are useful in preventing bloating.

Food intolerance, such as lactose intolerance, also gives rise to abdominal swelling after food. It may be due to stress, irritable bowel syndrome. Adequate relaxation helps prevent this. Disorders and diseases of heart, kidneys and or liver, causes accumulation of fluid inside the stomach, resulting in swelling.  But in these conditions, there would be other symptoms as well, like swelling over feet, face, breathlessness, etc. Any one of these conditions can easily be diagnosed by medical history, physical examination and imaging like X-rays and ultrasound. Here, the swelling would reduce only after taking drugs that can remove excess fluid.  

However, if swelling is increasing progressively or there is associated pain and or discomfort, it is advisable to consult in a hospital or medical clinic.

Dr. Rachna Pande,Specialist internal medicine rachna212002@yahoo.co.uk