I had been on 1st line ARV's until three years ago when I started to feel complications. A month ago my CD4 was down to 18 and viral load 580,000. I am now on Truvada & Aluvia but am getting severe abdominal pains, gas and bloating. It prevents me from eating and makes it very difficult to continue with the treatment. I have also developed ulcers. Help!

There are over the counter enzymes like Beano is the US that help with gas. Also , digestive enzymes either by prescription or over the counter seem to help. Avoid milk products (except yogurt), beans, broccoli, onions, and high sugar products that may increase fermentation in the colon. Supplements containing friendly bacteria could also help restore any potential shifts in your gut flora. But who knows how we are reacting to binders and fillers in those HIV medications anyway!

Gas is a common complain when starting therapy and no one has taken the problem seriously enough to do interventional studies. I feel very strongly that we need better GI based research in HIV. Sometimes bloating tends to get better with time, so hang in there.

Nelson