I have an ongoing daily problem with bloatedness where I feel my stomach never empties properly ,and I never approach a meal feeling hungry.I have accumulated visceral fat as a pot belly through lipoatrophy and have been trying to eat well- high protein/calorie diet to build a bit of muscle tone on my arms and legs in particular.Can you advise me how to get some relief from the bloating,the fat accumulation around the gut, and how to maintain the weight I have?. Many thanks for any help. Regards John

John

I tell you, your problem is my main problem also.

I have researched options for ten years. Eating smaller meals that do not contain milk products or sweets seeem to help. I avoid beans and brocolli also. I take four pills of Beano before meals and that helps sometimes. Eating yogurt twice a day gives me relief also.

Try to snack instead of having three large meals. Be really aware of any food allergies you may have, particularly milk and whey protein products. Drink lots of water also.

I have also tried Ultrase, a prescription digestive enzyme taken before meals. That seems to help a lot. Glutamine at 15 grams a day seems to be helping a lot of people (I have problems with adherence with powder products that require several doses a day)

The problem comes and goes for me without reason. I really think that keeping a healthy gut flora is key, and avoiding gas producing foods. Sometimes I wonder if binders used in HIV medications have an effect on our guts. It has also been shown by certain studies that our gut integrity is impaired after years of HIV, so who knows if that is also a factor in bloating and that "full feeling" that many of us have.

I have also noticed that my bloating gets worse when I take pain killers like ibuprofen. They have been shown to decrease gut motility, so that may be a factor.

Some patients have insisted to their doctors that they want a one slice CT scan at the L4 L5 level to see how much visceral fat they have. I am not sure if this is something that insurance companies would pay for and what the use would be to have such information. It is my belief that visceral fat can push on our intestinal tissue and gives us that feeling of fullness, but this is just a speculation from my part.

Many of us are suffering from this problem. Many have gone through colonoscopies, endoscopies, etc without any clear answers. Unfortunately, I know of no researcher looking into this problem.

I would work out three to four times a week to try to decrease fat accumulation. Do not go crazy with so much protein intake that counteracts the effects of exercise. Too many calories, no matter if they come from protein, will end up stored as fat if your energy expenditure is not high enough to compensate for the extra food intake. As I said, small 300-400 calorie snacks 6 times a day, lots of water, and exercise should be your basic program to start with.

I hope this helped some. It has become one of the hottest topics in this column so stay tuned since I usually do not let go of a problem until answers are found somehow :)

Nelson