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Separation of abdominal muscles possibly due to aerophagia or gastric insufflation
Feeling very upset after seeing my pcp. He said, ‘ I don’t want to give you false hope, most surgeons will not want to operate.” My situation is complicated. I am 6 weeks post op from having spinal stenosis surgery of L 4 and L 5. I was having stomach distension for over a year before this surgery and had ct scans and a gastro Dr. who kept giving me meds for constipation. I had been complaining that in the am it took me a long time to go empty my bowels. I didn’t connect the distension with my cpap. My cat scan showed nothing unusual. I had several cat scans. I also went to see pulmonary Dr. who stated she did not think i was swallowing air because memory card in cpap did not indicate a leak. She did not mention gastric insufflation.
6 weeks ago after surgery for my back I was terribly distended due to constipation from pain meds and because I was sleeping a lot, I was also using my cpap a lot. I looked like I was 9 months pregnant when I left rehab after being in the hospital 5 days and rehab 7 days
When I got home,. I immediately stopped pain meds but my stomach did not go down and even though I was having bowel movements finally I also could not eat much without pain. Lost 10 pounds without trying because I feared eating much.. I previously had been dx about 1 yr ago by my Gyn Dr. with a very small hernia to the lower left of my belly button but she said she did not think it needed any attention. I had a steroid injection for my spinal stenosis about a year ago but was told i would eventually need back surgery. Right after this my stomach got bigger and even though I had not gained any weight I had to buy tops one size bigger due to my stomach distension. This may have been coincidental or a side effect of the injection. I was chewing sugarless gum due to a dry mouth from side effects from provigil medication for Narcolepsy. After recent back surgery I have gone cold turkey and no longer chew sugarless gum . Wondering if I have caused my stomach distension with the gum. I was chewing a lot of gum maybe 8 or 9 pieces of trident a day. Back to my pcp trying not to give me false hope. I burst into tears and felt hopeless after speaking to him. I have tried to only use cpap a few hours last night, but felt very sleepy today and could barely drive to see my pcp. My stomach was not as distended today and I didn’t have the terrible pain I had all day yesterday. I had used my cpap 4 or 5 hrs 2 nights ago,.
I need some hope that things can get better. I did read about the Dr. Falcon position and will try it tonight. I need to be able to continue working but between the Narcolepsy, Sleep apnea, aerophagia or gastric Insufflation andf abdominal muscle separation in upper belly, pain in my belly not sure if I should see surgeon first or try another sleep Dr.
I am female, 73, hx of gall bladder, appendix removal, schwanoma removal from spine in 2002 (possibly have adhesions) degenerative discs, surgery on neck 4 months ago and 6 weeks post op spinal stenosis surgery of L4 and L 5 and hx of Narcolepsy.
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5 Replies
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Surgeon is now saying I do not have an incisional hernia after he saw cat scan with contrast film and narrative which say nothing showed. He said he originally thought I had an incisional hernia because my colon was distended when he did the ultra sound test in his office. But he even pointed out on the ultra sound the white area where he thought the incisional hernia was.
I have lost confidence in this surgeon. He looked exhausted when I saw him and he initially did not remember he gave me a dx of incisional hernia 2 weeks before.
When I commented that he looked tired he said he had gotten 5 hours sleep which was a lot for him. He apparently does not think he needs much sleep.
Distention is a little worse this morning. I am looking about 4 months pregnant today. I continue going to physical therapy twice a week and I am doing exercises on my own daily.
Surgeon has ordered a pelvic scan to evaluate for ovarian lesions. My question. What kind of Dr. should I go to get a good evaluation of my stomach distention?. It am still full of air in my upper abdomen.
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Glad the distention is improving. If part of it was due to the spineal stenosis, then perhaps your muscles are recovering from that.
I cannot answer any questions about cancer. That is a whole different forum.
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Dr. Towfigh. Thank you for responding to my post. Here is some additional info. The gastropheresis test was negative.
My stomach has stayed distended since I had spine surgery for spinal stenosis in June. At first I thought it was due to constipation from pain meds but even after i stopped pain meds my stomach has stayed distended. It has gone down some. I looked 9 months pregnant and now only look about 3 months pregnant. I have distention all the way across and Surgeon says it sounds like I am filled with air. No history of pregnancy. I have lost 10 lbs since surgery because I can only eat a very small amount. Surgeon tells me I have an incisional hernia from a previous surgery about 15 yrs ago and says my diastasis recti is small. I had a cat scan in June at the ER and it was negative except I found out I was anemic. I am taking something called Easy Iron for anemia.
I am worried that I have Cancer. Is that a possibility? I do not have an appendix or a gall bladder and I am 73. I also use a Cpap but recently stopped using it thinking I have Aerophagia. Could the incisional hernia be cause of my symptoms of distension, pain, upper stomach filled with air, and burping and feeling so full so quickly.
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I am sorry to hear about this.
There are a lot of reasons for abdominal distention. If it is related to eating (e.g., wake up in the morning flat, then look pregnant after any oral intake), then a gastroenterologist needs to be involved. If the distention is only on the left or right side, i.e., asymmetrical, then that may be due to nerve damage at the spine level. If there is a history of pregnancies and weight gain, then diastasis recti is a possible contributor.
Some of these are correctable problems. A CT scan can help with the diagnosis.
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I have been doing a lot of reading since I posted separation of abdominal muscle. My pcp called it a Diastasis Recti. Apparently its not a hernia. I do also have a small hernia lower down. on belly. I will continue researching. I believe several factors caused my problem starting with the steroid injection over one year ago which made connective tissue weaker. Also, my age 73, and previous abdominal surgery to remove a benign tumor on my spine.in 2002. In addition I believe cpap use and swallowing air and constipation from recent back surgery aggravated this problem. Will research more about pelvic floor physical therapy and try a new position for sleep suggested by Dr. Falcon. I am less emotional today and trying to figure out what to do next. Anyone else with this problem or suggestion from any of the doctors would be appreciated.
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