Ask Dr. Beck
Dr. Beck is board certified in general and colon and rectal surgery and is a Clinical Professor of Surgery at Vanderbilt. Dr. Beck conducts research into colorectal diseases, has authored and edited nine medical textbooks, and written over 350 scientific publications. He was the President of the American Society of Colon and Rectal Surgeons (ASCRS) from 2010-2011. Dr. Beck is a nationally recognized expert in inflammatory bowel disease, anal, rectal and colon cancer, stomas, adhesions, bowel preparation, sphincter saving surgery for cancer, laparoscopic surgery, and postoperative pain management.
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Chronic Cramping
I have had my ileostomy for 40 years. My colon was removed. Lately, I have had mild stomach aches no matter what I eat or don’t eat. I also have more gas than normal. I am 78, healthy, active and take no medications. Should I try going gluten free? Does this happen after years of malabsorption?
S.W.Dear S.W.,
Crampy abdominal pain and increased gas can result from a number of causes. A common reason is increased or uncoordinated bowel activity. When a “faster” section of bowel runs into a “slower” piece of bowel the proximal bowel is stretched which is experienced as crampy abdominal pain. Faster sections of bowel can be caused by stress, hormones or something in the lumen that irritates the bowel. For people with gluten intolerance, the ingested gluten causes inflammation in the bowel which increases motility. Gas in your intestine is either gas that you swallow or gas produced by gut bacteria eating food that you do not digest.
An example is lactulose intolerance. Milk sugar is two sugars that are bound together. Humans do not absorb this bound sugar. Babies have an enzyme (lactase) which breaks down this sugar and allows it to be absorbed. Many adults do not have enough of this enzyme and their gut bacteria metabolize the unabsorbed sugar and produce gas. If this is your problem, you can avoid milk, try milk with lactase, or take Lactaid (lactase) when you have milk. There are tests to check if you are gluten intolerant or you could try minimizing gluten in your diet and see if this helps.
