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I have seen some of the top doctors/nutritionists in the country (if not the world) and nothing they've suggested has provided long term relief.  As I continue to search for solutions, I am curious as to whether anyone else has experienced something similar and/or might have any suggestions in terms of what may help:

First off, I have a very high pain tolerance (broken bones, torn/completely severed tendons, undergone multiple surgeries) all w/o post-op pain meds; but the hunger pain I experience is so awful; to attempt to quantify: I'd rather break every bone in my body two times over than continue to deal with the horrible hunger.

I have a food scale and weight my food down to the gram in order to calculate my calories (since many doctors/nutritionists simply cannot believe that the hunger could drive me to eat so much).  Currently, hunger-driven gas pain is excruciating unless I eat 3,000-4,000 calories/day (in the past, the problem was worse and I was starved unless I ate 5,000-6,000 calories/day); both of which are HUGE amounts, considering I'm a 5'2" female!

Anyhow, there are two aspects of the problem (the first of which I've solved, but the second that continues to persist):

1. The initial hunger pain sensation (which used to be excruciating but is now bearable)

2. EXTREME gas/air build-up in my stomach if I fail to eat within just a few minutes of feeling the initial hunger pain

Eating in response to the initial hunger pain is NOT an option because the hunger has caused me to gain weight and makes it almost impossible to lose weight.  Even at times over the years when I am luckily enough to shed the pounds and get down to my normal weight, I am almost constantly hungry.  The initial hunger pain sensation is bearable, but the EXTREME build-up of air/gas make life a living hell.

In terms of preventing the painful gas, psyllium fiber is 100% fail proof if used at modest doses (2 servings, i.e. 18 grams/day); however, I am unable to dose it anywhere near this high because (despite drinking loads of water), it makes me constipation to point where I almost ended up in the ER (luckily some pretty high doses of OTC remedies – 2-3 TBSP of Espoms salts, senna tea, and literally 1/2 gallon of prune juice) free the psyllium-induced obstruction (but even despite all that, it STILL took lots of straining to pass).

Anyhow, if anyone has suggestions on what may be the cause or what I can do to prevent the horrible gas/air build-up (aside from eating because I am already over my ideal weight) then I'd really appreciate it.

In terms of medical conditions/clues, the only things that have been suggested are ulcers (which my doctors ruled out based on my complete absence of upper GI symptoms – i.e. no heartburn, reflux, indigestion, etc.) and parasite/microbial factors.  I had some sort of stool DNA test last year and for the most part, the "good microbes" were all at very healthy levels and almost all of the bad ones were at very low levels; but the ONE exception was H. pylori which was off the charts HIGH.

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My husband was diagnosed with an ulcer in his small intestine which is caused by H. Pylori, he is on a medication for it, I will have to get the name of it and post back later.  The foods that cause flare-ups for him are sugars and acids but he does not have the hunger pains although he does eat a lot of nuts and proteins to keep filled up longer which may help with this?  You should redo the H.pylori test again and see if you still test positive for that as there is medication to help with it, hopefully your intestine hasn't been damaged from the possible bacteria sitting in it.  Make sure you are eating or taking a probiotic supplement which helps to replenish good gut flora in the intestines which the bacteria will strip away.  Hope this helps

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