Gastro-intestinal Barotrauma?

[BAGELS]

My husband frequently has abdominal pain about 1/2 to 1 hour after diving. The pain starts in the abdomen and can radiate up into his chest and feels like gas pain. The duration is at least one hour, but it can also last several hours.
When diving he tries to descend feet first and have his head up when equalizing. Depth and dive duration do not seem to make a difference. He has mentioned this problem to his physician who does not have a clue as to what it is, or what to do.
Could this be gastro-intestinal barotrauma? Any suggestions?

 

[DocVikingo]

Hi Bagels,

Does your husband have any history of or current signs/symptoms of stomach ulcer, gastrointestinal reflux disease (GERD), hiatal or other hernia, or other GI issue? Is it possible that he is swallowing air during his dives? Is his discomfort associated with belching or flatulence?

Regards,

DocVikingo

 

[Hatul]

That was my thought as well, that it's most likely reflux which is very common in diving. Still he needs to be checked that it's not a heart issue.

 

[mmadiver]

What sort of physical shape is your husband in? BMI?

 

[Duke Dive Medicine]

I don't think GI barotrauma can be ruled out completely but it's highly unlikely that the pain would set in that long after a dive. It typically occurs immediately with changes in ambient pressure. When you say depth and bottom time don't make a difference, what's the range you're talking about?

Best regards,
DDM

 

[BAGELS]

He is not aware of any GI issues. No belching or flatulence with his discomfort. Recently had an ECG which was ok.
BMI of 26.
Discomfort occurs when diving no deeper than 60 feet or when diving down to 120 ft. Dive duration is usually between 45 minutes to 1 hour 10 minutes. We most commonly do multi-level shore diving with about 10 minutes in less than 30 feet.
Thanks,
Bagels

 

[Hatul]

He is not aware of any GI issues. No belching or flatulence with his discomfort. Recently had an ECG which was ok.
BMI of 26.
Discomfort occurs when diving no deeper than 60 feet or when diving down to 120 ft. Dive duration is usually between 45 minutes to 1 hour 10 minutes. We most commonly do multi-level shore diving with about 10 minutes in less than 30 feet.
Thanks,
Bagels

Gastric reflux may present as burning chest or throat pain or even as spasmotic pain without flatulence or belching. And a normal resting ECG does not rule out heart disease.

 

[Duke Dive Medicine]

He is not aware of any GI issues. No belching or flatulence with his discomfort. Recently had an ECG which was ok.
BMI of 26.
Discomfort occurs when diving no deeper than 60 feet or when diving down to 120 ft. Dive duration is usually between 45 minutes to 1 hour 10 minutes. We most commonly do multi-level shore diving with about 10 minutes in less than 30 feet.
Thanks,
Bagels

Does the pain occur with any other activity? How about with/after exercise, heavy meals, or when laying down?

If it's reflux that is only associated with diving, he could try descending head-first or horizontally and remaining horizontal during the dive. There is some literature to support that in a head-up position, the pressure is higher in the stomach than in the esophagus, which could cause increased reflux.

Ditto Hatul in that a normal resting ECG alone is not diagnostic of cardiac disease or abnormality.

Best regards,
DDM

 

[Bill Parker]

Scuba Diving Medical Safety Advice ? DAN | Divers Alert Network

When I first started diving I had a case of really bad heart burn. I
found a DAN article that helped me understand and eliminate the
problem. There are many good DAN articles. Perhaps one will help
you.

 

[BAGELS]

The pain does not occur with any other activity. The first "attack" he had was 14 years ago and occasionally thereafter.
In the last 3 years they have become very frequent, 2 - 3 times during a week of diving at 3 dives per day.
He usually stays very horizontal during the dive. He tried the head up position because he thought he was swallowing too much air and that was causing his pain.