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Bloated Stomach
Jul 2, 2013

Hi Nelson, I'm aptrila HIV for 19 yrs,55 yrs of age. I keep getting a big stomach by afternoon, I wake up ok but by night my gut seems to bloat.I some times have coffee most times green tea... any suggestions, Steve

Response from Mr. Vergel


I am sorry you feel bloated. I know the feeling since I have dealt with it a lot in my 27+ years of HIV.

Believe it or not, there is little research on this issue that keeps popping up as a question every time I give a lecture.

I have a few theories after reading all I can on gastrointestinal health in HIV disease and talking to a few GI doctors.

There may be one or a combination of factors involved.

1- Water retention created by hormone, liver or other issues.

2- Refined carbohydrate (low fiber, high simple sugars) intolerance due to impaired glucose tolerance and increased insulin levels after we eat. Also, gluten intolerance may be an issue in a few patients.

3- Deficiencies in digestive enzymes

4- Infection with H. Pylori in your stomach

5- Gut inflammation due to HIV infection itself

6- Food intolerance or allergies

7- Beneficial gut bacteria imbalance

My bloating has gotten a lot better since the following changes:

1- I started to eat more fiber rich foods, lowering refined carbs containing wheat/sugar and eliminating milk products except aged cheese and real Greek yogurt. Fiber-rich foods tends to lower gut inflammation and promote healthy gut bacteria.

2- I was diagnosed with H Pylori infection in my stomach (they do this via an urea breath test) that was treated with antibiotics. I replenished my friendly bacteria with probiotics after the antibiotics.

3- I focused on avoiding excessive coffee (one cup a day is enough) and spicy foods seem to also help. I avoid sodas like a plague also. These liquids can be very irritating to the gut mucosa. Green tea is definitely a better choice than coffee.

4- I used probiotic supplements and one serving of sugar free Greek yogurt help me also.

5- I discovered that chewing on dried ginger bits that I buy at the grocery store where the bulk nuts and grains are (most regular supermarkets in Houston have this option. Some cities with Whole Foods and Trader Joe's also do). Ginger is well known for anti-inflammatory and gut inflammation properties.

6- I switched to eating smaller meals more frequently and not having a big dinner before bed also help tremendously. Our digestive system may be able to handle smaller meals. This is also good to maintain better glucose levels during the day and to avoid overeating in one sitting. And remember that breakfast is the most important meal of the day (read more about what to eat here: Healthy eating

7- I noticed exercise keeps my excessive body water to a minimum also (I use the ring test. My ring is tight when I walk in the gym and lose when I walk out).

Drinking plenty of water regularly may also help even though we may feel bloated to do so.

If nothing works, you may want to be referred to a good gastroenterologist. I had to get a urea breath test, an upper GI endoscopy and stool tests to diagnosed my H Pylori infection.

I hope these tips help you. Let me know if anything works! I wish there was more research on gut associated issues in HIV long term survivors!

Stay well


Exercise that doesn't make me ill

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