A regular KidneyBuzz.com viewer wrote, "Hi. My brother has been on Hemodialysis for about three years and he seems to always be sick. Recently he has had a very swollen stomach and has been suffering from bad stomach and back pains. He has been in and out of the hospital because of the swelling and trouble breathing. He has seen lots and lots of doctors plus dozens of tests but unfortunately, nobody can find anything. I hate to see him suffer and I know he is getting tired and ready to give up. Any insight would be appreciated. Thank you."

Stomach pain and swelling are common issues among Chronic Kidney Disease patients, especially those who are conducting Dialysis. Excessive fluid intake (fluid retention) may be the cause for a swollen belly in some cases. However, when stomach bloat is uncomfortable, painful and accompanied by diarrhea, nausea, and/or vomiting it can greatly impact a patient's quality of life, and in some cases jeopardize their longevity. Hence, what can patients do to limit stomach pain and help improve their health outcomes as well as their quality of life?

Eating Before Dialysis: Some Chronic Kidney Disease patients have mentioned that they experienced less stomach pain by not eating food within two hours of their Dialysis Treatments. The reason may be that when patients eat before Dialysis blood from their muscles, legs and arms is easy to shift to their stomach, leading to stomach pain. Low blood pressure, nausea, and vomiting are all signs of this problem.

High-Fat Foods: Dietary options that are high in fat are said to stay in the stomach longer and are more likely to cause stomach problems. Lower fat alternatives include oven baked chips, tuna (fresh, not tinned), herring, mackerel, sardines, kippers, pilchards, salmon, chicken, and turkey breast (without skin).

Stomach Cramps: Cramping in the stomach causes extreme discomfort for Dialysis patients. The cause of this side effect is largely unknown, so the issue can only be addressed by trying to relieve the symptoms. According to the National Kidney Foundation, "Healthcare providers advise stretching to release the pain or applying hot packs to the affected area to help increase circulation." Although medications may provide some relief they must first be discussed with your Healthcare Team. In the meantime, patients have noted that drinking small amounts of tonic water or apple vinegar have helped in the past, suggested Kidney.org. 

Nausea & Vomiting: Having an upset stomach and/or throwing-up is challenging and likely means that Chronic Kidney Disease patients will be unable to lead a fulfilling day. While nausea and vomiting are associated with kidney disease, in general, Dialysis patients should realize that low blood pressure and excess fluid weight gain are also common causes. If a patient has nausea and vomiting during a Dialysis session, they should tell the nurse who can adjust the machine accordingly. On the other hand, if patients are suffering from these side effects at home after treatments, then they may consider speaking to their Healthcare Team about a prescription for anti-nausea medication.

Electrolyte Imbalance: With Dialysis Treatments, electrolyte imbalance occurs commonly causing high potassium levels, high phosphorus levels, and/or metabolic acidosis (a condition in which too much acid accumulates in the body). This is just one trigger of stomach cramping as well as diarrhea and vomiting. Dialysis patients may consider working with their Healthcare Team to adjust their dry weight and avoid excessive fluid from being removed during Dialysis Sessions to help limit electrolyte imbalances.

Peritonitis: For patients conducting Peritoneal Dialysis, there is a chance of peritonitis, which is an infection where the catheter is placed in the abdomen. Peritonitis can cause fever, nausea, vomiting, and stomach pain. A sure-fire sign of the infection is when patients may notice that their Dialysis solution looks cloudy. Treating peritonitis quickly is the key to stopping widespread, life threatening infection. Hence, be sure to go to the hospital if you believe that your may be suffering a stomach infection such as Peritonitis.

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