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I am a nineteen year-old female from the USA. I am mostly of Norwegian and German decent. Since childhood, I have had chronic constipation. In the last few years, my stomach problems have resurfaced and have started interfering with my daily life. Almost every day, I experience a few hours (about 1-3) of simultaneous acid reflux, pelvic distention (which I would describe as feeling like inflammation), and brain fog. These episodes may occur anywhere from 1 to 3 times a day. I have been vegetarian since I was in the fourth grade (I am currently a freshman in college) and do not eat a lot of dairy. I do tend to eat the same meals day after day, and that often includes nut butters, falafel, salads with ranch dressing, cereal with skim milk, bread and peanut butter, and tofu and steamed vegetables. I have seen an allergist and have tested for nut, dairy, gluten, bean, and other allergies/intolerances, and all results came back negative. I have not been able to target any foods specifically besides honeycrisp apples - if I eat a large honeycrisp apple, no matter what time of day or how much else I've eaten, my symptoms arise and I tend to start burping. While I eat very healthy foods, eating fruits or vegetables usually makes my bloating worse and gives me frequent and foul-smelling gas. However, when I try to avoid fiber for this reason, processed and easy to digest foods like bread and bagels also trigger my pain. At one point, I thought oats set off my symptoms, but again, this only happens sometimes. I have had a sigmoidoscopy that was normal and took antibiotics for potential SIBO but I did not notice a difference after taking them. I also had a pelvic ultrasound done and that too came back normal. I am about 5'4.25" and currently weigh just over 115 lbs. As my symptoms worsened, I began to gain weight. I gained about 15 pounds in six months during my senior year of high school. I think part of this is attributed to the well-known fact that eating temporarily relieves acid reflux symptoms, but I still do not shove myself with food every time a symptom occurs and I do monitor my calorie intake. My exercise has remained largely the same, with one night of intense cardio every week, walking/running/lifting about three days per week. I am currently taking Pristiq and Remeron for my depression, and Linzess and Pantoprazole for my reflux and constipation symptoms. What might be some more obscure reasons for my problems? I know different shapes of distention indicate different problems. Based on the pictures I have included, what might be triggering my distention? All of my "abdominal" pain is actually located right above my pubic bone in the pelvic area. Thanks!


