### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My daughter age 36 yrs, had an open cholecystectomy 10years ago. In the past 5 years she has suffered badly with abdominal bloating which has increased in severity this last 12 months.The bloating is so severe she looks as if she is 9 months pregnant and the pain is unbearable.She is normally very active even athletic .Recently underwent flexible colonoscopy and endoscopy that showed no abnormality but fasting lactose tolerance failed to reveal any rise in her glucose level. Her severe reaction following consumption of the lactose substance made it in impossible for her to undertake a confirmation galactose test.She was discharged from her local hospital with no satisfactory explanation for her symptoms. Since then she has followed a strict lactose diet but she continues to get serious and debilitating bloating episodes. Her cholecystic scar is badly keloid and the pain is always located in that region and radiating to the back. When suffering an episode of bloating it is easy to palpate something that feels like tubes in the area of her liver. I would like to point out that her cholecystectomy was not an easy operation as she had badly blocked ducts and she was badly jaundice. Also she has noticed blood in her saliva on a few occasions during a bloating episode. My questions ..could the cause be due to adhesions and has the lactose intolerance be connected.

### output:

Hi. Thanks for your query for your daughter, read the history and understood her problems You're noticing : When suffering an episode of bloating it is easy to palpate something that feels like tubes in the area of her liver is highly suggestive of intestinal obstruction. The bloating is due to adhesions for sure. And not due to lactose intolerance. I would advise her the following:Get a CT scan done with water-soluble contrast. -Plan for a surgery to get rid of the adhesions and get well soon.