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Floating Bloating

Posted 5 years ago by Adam

I once asked a nurse what was the most common problem she had to deal with among her patients, and she replied, “the swell”.  Swelling of what? Hands, feet, legs?  No, it was two different types of swell – the sea, and the stomach, because she was no ordinary nurse but one who worked in the ship’s hospital on a large luxury cruise liner.  She explained that her little surgery was always full of people on the first morning of every cruise complaining of either a feeling of queasiness and discomfort, or a tight and bloated stomach.

The ship would leave Southampton and slowly navigate the flat calm waters towards the North Atlantic Ocean.  Meanwhile, passengers were dressing up in their finery ready for the Captain’s cocktail party that evening, to be followed by a Gala dinner.  It was often while people were on their second or third free gin and tonic that we began to enter the notorious Bay of Biscay.  The ship would suddenly heave slowly up and to the left, then dip down and to the right.  This slow corkscrew movement could be unpleasant and cause all sorts of digestive problems, particularly among passengers who had never been to sea before, from stomach ache and/or bloating, through to full-blown seasickness.

But determined not to miss the Gala dinner, passengers would make their way to the restaurant as best they could, and feast on fabulous foods with rich sauces, super-sweet puddings, exotic liqueurs and fancy chocolates, then finally retire to their cabins and roll into their bunks and try to sleep.  As I used to do a stint on the ship’s wheel at night (under the instruction of a Quartermaster) I tried to minimise the effects of the swell as best I could.  Stabilisers were deployed (long fins that stuck out from the sides of the ship) and I would steer into a starboard swell to prevent too much movement to port, and then steer back to port to counteract the resulting starboard recovery.  (I remember one night overdoing this manoeuvre completely, and caused plates to slide off tables, but that’s another story!).

And so to morning surgery.  The nurse saw many grey faces, some sickness and diarrhoea, and lots of bloated stomachs.  Of course many of these were the result of the ship’s movement or the rich food and free drinks of the night before. But many admitted that they regularly experienced bloating and excessive wind.  While the nurse was able to provide some temporary medical relief in the hope that people would then enjoy their cruise, she also took time to advise on how they could get more permanent relief when they returned home.

She explained that bloating or distension of the stomach was often due to the build-up of gas in the large intestine (colon) during digestion, which can be up to 5 litres a day.  The bloodstream absorbs some of this, but the rest is expelled as wind.  Certain foods can cause over-production of gas, especially those high in carbohydrates such as sugars and starches, and fatty foods (often the sort of food readily available on these ships, and the type that people are keen to eat on holiday...) Bacteria in the gut produce gas, and furthermore if there is an imbalance between the good and bad bacteria (often encountered on travels or at sea), the result can be bloating and abdominal swelling.

I was particularly interested in what the nurse had to say, because I suffered from regular episodes of bloating, probably due to my unsatisfactory diet which in those days seemed to consist only of eggs, beans, and deep fried food.  I had a particularly painful attack of bloating in the middle of the examination for my Merchant Navy Steering Certificate, because stress can also cause excessive gas.  Apart from a review of my steering ability (which was recorded on a printout) I had to recite the 32 points of the compass to the Captain, who happened to be an American. When I asked how I had done, he replied in his Texan drawl, “You did just swell, son”.

How right he was!

By the way, that nurse went on to be a highly respected Ward Sister at Guy’s Hospital in London. And me? Well, I’m here with you.

About Adam Whitby

Adam has been involved in health and medicine for over thirty years, mostly reviewing clinical studies for general practitioners, writing patient information leaflets and producing medical video programmes.

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