Dear Dr Mitchell, Is it normal to be experiencing discomfort with bloating nine months after a C-section? Right up until about January I didn't have this problem, but since recently my tummy just got so big as if I am pregnant again. It does not happen near to my period so I do not think it is related to my menstrual cycle. This is my second C-section and I did not experience this after the first.
The bloating and abdominal discomfort that you experience nine months after your delivery by Caesarean section is definitely not normal and needs to be properly evaluated. The fact that you were perfectly well up until January is also significant.
The problem could be due to simple gastritis with gaseous distension, chronic constipation with distension of the bowels or an ovarian or bowel tumour.
Ovarian tumour can sometimes present with a sensation of bloatedness and abdominal discomfort. This may be seen in situations where the primary tumour actually starts in the stomach or colon and then spreads to the ovary, or may be seen in primary ovarian cancer especially where it is spread within the abdominal cavity with accumulation of fluid within the abdomen.
Other associated symptoms that would suggest a malignancy of the colon or ovary would include weight loss, night sweats, loss of appetite, abdominal distension, nausea and vomiting sometimes. If the problem is just simply due to gastritis then the use of antacids and proper diet with small frequent meals will give significant relief.
However, it is also important to rule out a serious problem such as an ovarian, colon or stomach cancer and specific investigations should be done to rule these out. An ultrasound of the pelvis and abdomen would be extremely useful.
A barium meal and enema would also help to rule out abnormalities in the stomach and colon. If you have a family history of colon, ovarian or breast cancer then this makes it even more important for a detailed work up to be done.
Consult your family doctor or gynaecologist who will examine you and do all the appropriate investigations. Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@ jamaicaobserver.com; mail c/o Jamaica Observer, 40-421/2 Beechwood Ave, Kingston 5; or fax to 968-2025.