Living with functional dyspepsia, specifically postprandial distress syndrome (PDS), can be quite challenging. This condition leads to severe bloating and abdominal pain after eating or drinking, and it is thought to be related to a disturbance in the brain-gut axis. Despite undergoing a loop end ileostomy to address evacuation issues, the discomfort after meals persists. Here are some suggestions and insights that might help manage these symptoms:

1. Meal size and eating technique
- Try eating very small, "toddler-sized" portions and take your time with each meal.
- Chew your food thoroughly and take tiny sips of fluid instead of large gulps.

2. Food and beverage choices
- Stick to foods that are easier to digest and avoid red sauces, high-acid foods and drinks, greasy or fried items, and breaded foods.
- Some people find plain white bread to be gentler on the stomach than whole-wheat bread.
- For relief from gas pressure, sipping on 7-Up or ginger ale might help.

3. Pharmacologic help
- Consider using a strong proton-pump inhibitor like Protonix (pantoprazole) for controlling acid and GERD-related symptoms.
- Keep prescription anti-nausea medication available if nausea accompanies the bloating.
- Although results can vary, low-dose antidepressants such as duloxetine or amitriptyline might help with nerve-misfiring and brain-gut axis issues, even if they haven't worked for everyone.

4. Complementary therapies
- Acupuncture is considered a reasonable option to try for conditions involving nerve mis-signaling. Some people with neuropathy have reported benefits, so it might be worth exploring for PDS.