Dear Doctor: My husband and I ate more junk food than usual during the coronavirus lockdown, and we both gained a few pounds. We’re trying for a healthier diet, with more fresh fruit and vegetables, but now I’m getting bloated after meals. What causes that? How can I make it stop?

Dear Reader: Whether it’s due to stress, boredom or simply experimenting in the kitchen to help pass the time, many people during the lockdown began taking in more fuel than their bodies were burning. At the same time, physical activities that had been hardwired into our daily routines were suddenly absent. Visits to the gym, the two-block walk from the parking space to the office, the staircase you choose rather than taking the elevator, those quick, darting runs as you chase a toddler through the park -- they all add up. For many, the increase in food and the loss of activity have resulted in what has been dubbed the “quarantine 15.” And as you have experienced, dietary changes to address the weight gain can lead to abdominal bloating.

Although bloating can be a symptom of gastrointestinal disorders, including irritable bowel syndrome, Crohn’s disease and ulcerative colitis, more often, the condition is associated with a buildup of excess gas in the digestive tract. Symptoms can include a feeling of fullness that causes discomfort or pain, and which can cause the stomach to become distended. This is often accompanied by an increase in belching or passing gas and rumbling sounds in the stomach or bowels. If bloating leads to nausea, diarrhea, fever or blood in the stool, it’s important to seek medical care.

One of the most common reasons for a sudden onset of bloating is a change to the diet. For people who are lactose intolerant, even a small amount of a dairy product can set off an episode. Unfortunately, many of the foods we turn to when cleaning up our diets are notorious for causing gas. Cauliflower, kale, broccoli, Brussels sprouts and other cruciferous vegetables contain a sugar known as raffinose. It gets digested by the bacteria in your gut, which produce gas as a byproduct of their meal. Beans, legumes and certain grains also contain indigestible fiber and sugars that feed our gut bacteria and earn us a bout of bloating.

With a bit of detective work in the form of an elimination diet, it’s possible to pinpoint the foods causing your episodes of bloating. Remove all suspect foods from your diet for a few days. Then, day by day, reintroduce one of the suspected culprits. You can then either skip the difficult food altogether, or reintroduce it very gradually and see if your body adjusts. Some people who can’t tolerate raw broccoli or kale find that breaking it down through cooking helps mitigate the aftereffects.

Carbonated beverages, eating too much or too quickly, and meals high in salt and fat can also contribute to bloating, so be aware of your behaviors as well. And if the bloating continues or gets worse, please check in with your doctor to eliminate other potential causes.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My wife is 77 and has spinal stenosis. She’s often in pain. We read about a new procedure called “minimally invasive lumbar decompression,” which we are hoping might help. She really wants to avoid surgery. What can you tell us about it?

Dear Reader: To understand spinal stenosis and its treatment, we should start with the structure of the spinal column, or backbone. It’s a collection of 33 bones, known as vertebrae, which enclose and protect the spinal cord, along with the fluid that surrounds it. It also includes the muscles, tendons and other tissues that provide support and allow movement. The spinal column rises from the coccyx, or tailbone, and runs the length of the back to the base of the skull. The spinal cord, which serves as the master communications pathway between the brain and the body, houses 31 pairs of spinal nerves. These connect to the spinal cord and enter and exit the spinal column at various points, depending on their function. In between the vertebrae are discs, rubbery pads that provide additional space and cushioning.

In people who develop spinal stenosis, the spaces within the spine become constricted. (The word "stenosis" refers to the abnormal narrowing of a passage within the body.) This is often due to osteoarthritis, which damages the joints and discs in the neck and lower back, and may cause the growth of bone spurs. This results in pressure on the nerves in the region of the narrowing, which can cause symptoms such as a tingling sensation or numbness, muscle weakness and cramping, and pain in the lower back, buttocks and legs that can become severe. If nerve compression lasts long enough, numbness, weakness and, in more serious cases, even paralysis can become permanent.

Spinal stenosis usually occurs in the lumbar region, which is the lower portion of the spine. It’s typically treated with nonsurgical pain management, or with surgery such as laminectomy or discectomy. These are procedures that, in different ways, surgically excavate additional space within the spinal column. As with all surgeries, they carry a certain degree of risk.

However, as you mention in your letter, there is now a new approach to correcting spinal stenosis. Known as minimally invasive lumbar decompression, it uses a small implanted device that acts as a lift to create additional space within the spinal column. The device, which doesn’t use connecting hardware, is implanted via a small incision. The bone and tissue removal associated with traditional back surgery is usually not necessary. The procedure takes from 45 to 90 minutes and is often performed under local anesthesia. Patients may be asked to participate in physical therapy following the procedure and will have follow-up visits to assess progress. Many return to normal activities two to six weeks after receiving the implant.

Factors such as bone density and the degree of spinal stability play a role in whether this approach is appropriate. Complications can include fracture or tissue tears at the site of the implant. Unfortunately, studies regarding success rates aren’t yet available.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I saw my doctor because my heart was beating funny and I was losing weight even though I wasn’t dieting. She did a blood test, and it turns out to be Graves’ disease. Why did I get that? Is there a cure?

Dear Reader: When someone has Graves’ disease, it means a malfunction of their immune system has caused their thyroid gland to become too active. Known as hyperthyroidism, it’s a condition that causes the overproduction of thyroid hormones. Since these hormones play an important regulatory role in many parts of the body, the symptoms of Graves’ disease can be quite varied.

The thyroid is part of the collection of glands located throughout the body known as the endocrine system. Their job is to produce hormones, which are chemical messengers. They regulate bodily processes such as metabolism, sleep, mood, growth and development, reproduction, tissue function and sexual function, to name just a few.

The thyroid itself is a small gland. It weighs less than an ounce and is shaped roughly like a butterfly. It’s located at the base of the throat, just below the larynx, and consists of a pair of matching lobes that sit on either side of the windpipe. The thyroid takes the iodine in our diet and manufactures two main hormones, which help regulate vital functions throughout the body. These include heart rate, body weight, body temperature, muscle strength, breathing, cholesterol levels, the central and peripheral nervous systems, and in women, menstrual cycles. So you can see how any malfunction of the thyroid can have a wide-ranging effect on general health.

When it comes to Graves’ disease, the cause is unknown. It usually develops before the age of 40, and is more common in women than in men. People with existing autoimmune disorders are at increased risk of developing Graves’ disease, and family history can play a role. Cigarette smoking is a risk factor, as well.

Symptoms of Graves’ disease include the unexplained weight loss and irregular heartbeat that you experienced, as well as anxiety or irritability, sleep disturbance, fatigue, reduced libido, sensitivity to heat, and tremor in the fingers or hands. Some people develop Graves' ophthalmopathy, which is a collection of eye-related symptoms such as pressure, grittiness, light sensitivity and vision problems. Graves’ dermopathy, which is rare, causes the skin on the shins or tops of the feet to thicken and become red.

Diagnosis is via blood tests to determine thyroid hormone levels, imaging tests to look at the size of the thyroid or tests that assess the rate at which the thyroid is using iodine. There is no cure at this time. Instead, treatment focuses on slowing thyroid activity. This can be achieved through radioactive iodine therapy, which gradually destroys overactive thyroid cells; medications that either interfere with the thyroid’s ability to produce hormones or block the effects of thyroid hormones on the body; or thyroid surgery. Lifestyle changes such as a healthful diet, regular exercise and doing what you can to ease stress are also important for managing the condition. Complications can be serious, including heart disorders and problems during pregnancy, so it’s important to seek treatment.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)