Strong flatulences

Question

Hello,

I suffer again and again from a very distended stomach. After an odyssey about 2 years ago (inclusively Fructose-intolerance breathing test, endoscopy of the bowel, both with negative result) a lactose-intolerance has been diagnosed. In addition, a mis-colonization of the bowel, which should have been treated with rotating antibiotics. This had however to be abandonned due to an infection that required again another antibiotic drug.

After adherence to a lacotse-free diet, the symptoms ameliorated markedly, reoccur since a few months now increasingly. I hardly dare to eat anything and I am at my psychological limits.

Recently I read something about new knowledge, according to this the symptoms in case of CF could come also from a chronic-inflamed small bowel and should be treated accordingly. Can you tell me some sources about that? With the problem itself I do namely not really feel taken for serious in the CF center nor in a hospital for internal medicine, in contrast. The stomach was simply "a bit" distended, "Oh, there is indeed much air in it", but more than vague trials without results does not happen for months. I am slowly at the end of my nerves.

Many thanks in advance.

Answer

Hello,

as it sounds, it has to be done still a bit of diagnostics in order to find out, what is the reason and it would be the best to talk about this with the dietician of your CF center.

In case you really live lactose-free and still have flatulences, one should also look for a fructose intolerance, as well as for a celiac disease - both diseases can result in flatulences. You write in your question, that a FI-breathing test had been performed; the hydrogen breathing test investigates normally the frucotse malabsorption, in case this is pathologic and there are symptoms one would call it an intestinal frucotse intolerance, which has been looked for in your case. It is indeed true, as you mention it in your question, that chronic inflammatory bowel diseases (as well as celiac disease) are more frequent in CF patients; these can however be excluded to a great extend with an endoscopy of the bowel which has been performed in your case.

In case the mis-colonization does still play a role, one should go about this again and treat it.

Helpful for the nutritional couselling is always a nutrition-protocol, that the doctor or dietician can go through with you and not seldomly the specialists find out nutritional mistakes in the diet or mistakes at the intake of pancreatic enzymes, which could be the reason for the symptoms. The worst variant is to eat little respectively not to dare to eat anything, because it causes complaints - so please stay stubborn and let it have clarified until eating makes fun again.

I wish you success with that
Prof. Joachim Bargon

19.07.2011