What causes bloating?
Bloating is a common condition that can occur for many different reasons. Some of the most common causes of bloating include:
Diet
– Eating too much fiber too quickly can cause gas and bloating. Gradually increase fiber intake over time.
– Eating fatty, greasy foods can delay stomach emptying and lead to bloating.
– Consuming too much salt, sugar alcohols like sorbitol and xylitol, and carbonated beverages may cause bloating.
– Lactose intolerance or trouble digesting fructose (fruits, honey, etc) can cause bloating after consuming dairy or high-fructose foods.
– Food sensitivities and allergies may trigger an inflammatory response that leads to bloating. Common food triggers include wheat, eggs, nuts, and soy.
Digestive issues
– Gastroparesis causes delayed stomach emptying and can trigger bloating and fullness. This may occur in those with diabetes.
– Irritable bowel syndrome (IBS) affects the large intestine and commonly causes bloating and gas.
– Small intestinal bacterial overgrowth (SIBO) is linked to excessive gas, bloating, abdominal pain, and diarrhea.
– Constipation can cause stool buildup in the colon, triggering bloating and discomfort.
– Celiac disease damages the small intestine and interferes with nutrient absorption, often leading to bloating after meals.
– Crohn’s disease and ulcerative colitis are inflammatory bowel diseases that commonly cause abdominal pain and bloating.
– Diverticulosis causes small pouches to form in the colon which may become inflamed and trigger bloating.
Hormones and health conditions
– Period bloating is common before and during menstruation due to hormone fluctuations.
– Menopause hormonal changes and decreasing progesterone can cause bloating.
– Fluid retention, abdominal swelling, and bloating are common during pregnancy.
– Ovarian cancer may initially cause abdominal bloating along with loss of appetite and feeling full quickly.
– Liver disease and cirrhosis cause fluid accumulation in the abdomen, leading to distention.
– Heart failure can cause bloating and swelling due to inadequate pumping of blood and fluid accumulation.
– Kidney disease interferes with fluid balance and waste removal, potentially leading to edema and bloating.
– Severe bloating may result from blockage of the intestines, such as with a tumor or hernia.
– Inflammatory conditions like pancreatitis or infections can trigger swelling and bloating.
Medications
– Antibiotics disrupt the balance of gut bacteria, allowing gas-producing bacteria to thrive, causing bloating.
– Chemotherapy medications can cause digestive issues leading to bloating.
– Opioids slow the muscular waves that move food through the intestines, resulting in gas and bloating.
– Antidepressants like SSRIs may decrease bowel movement frequency, leading to constipation and bloating.
– Steroids like prednisone alter electrolyte balance, potentially causing fluid retention and bloating.
– Blood pressure medications like beta-blockers and ACE inhibitors can slow digestion.
– Iron supplements or calcium supplements may cause constipation.
– Oral contraceptives with progesterone can cause bloating in some women due to fluid retention.
Other factors
– Swallowing air when eating, drinking through a straw, chewing gum, sucking on hard candy, or smoking can introduce excess air into the digestive tract causing bloating.
– Insufficient digestive enzymes make it difficult to break down food, allowing undigested food to ferment in the gut causing gas and bloating.
– Slow digestion after a large meal diverts blood away from the digestive system, slowing the emptying of the stomach and causing temporary bloating.
– Dehydration causes electrolyte imbalance and fluid retention exacerbating bloating.
– Sedentary lifestyles and lack of exercise can increase the risk of developing constipation and bloating.
– Stress triggers the fight-or-flight response which diverts blood away from the digestive system leading to impaired digestion and bloating.
How do I know if my bloating may be serious?
Bloating is often caused by minor dietary or lifestyle factors, however prolonged, severe, or worsening bloating may be a sign of a serious underlying medical issue. Consider the following signs:
Severity
– Severe pain, bloating, nausea and vomiting may indicate a blockage or require emergency care.
– Bloating that is persistent, does not resolve with passing gas or a bowel movement, and interferes with daily activities.
– Bloating that is progressively worsening over time rather than episodic suggests an underlying disorder.
Associated symptoms
– Unexplained weight loss of 10 lbs or more over a short period of time.
– Persistent diarrhea, constipation, bloody or black stool.
– Loss of appetite, feeling full quickly when eating.
– Fever, chills, fatigue, weakness.
– Shortness of breath, fluid retention elsewhere in the body.
High risk groups
– Postmenopausal women over 50 at higher risk for ovarian cancer.
– Men and women over 60 at increased risk for colon cancer.
– People with chronic health conditions like diabetes, cirrhosis, congestive heart failure.
– Individuals taking medications known to cause bloating.
– Anyone with a family history of gastrointestinal disorders, celiac disease, or cancer.
Location
– Generalized bloating all over the abdomen indicates systemic causes like ovarian cancer, liver disease, heart failure.
– Localized bloating concentrated in a particular spot may indicate a blocked intestine or hernia.
– Left lower quadrant bloating may suggest diverticulitis or bowel obstruction.
– Right upper quadrant bloating could indicate cholecystitis, pancreatitis or liver enlargement.
When to see a doctor
If you are experiencing any of the following, consult a physician for evaluation:
– Bloating that is persistent, severe, or worsening
– Unintended weight loss
– Loss of appetite or feeling full quickly
– Fever, vomiting, diarrhea
– Abdominal pain, tenderness, swelling
– Constipation, bloody or black stool
– Shortness of breath, swelling in legs
– Bloating associated with any of the high risk factors
Diagnostic tests may include:
– Physical exam of the abdomen
– Blood tests to look for signs of infection, inflammation, liver issues, celiac disease
– Stool test to check for blood, cancer cells, parasites, bacterial overgrowth
– Abdominal CT or ultrasound to look for blockages, tumors, fluid
– Endoscopy procedures to view the esophagus, stomach and intestines
– Breath test for lactose intolerance or bacterial overgrowth
– Biopsy of tissue samples for microscopic examination
Based on the results, your doctor can determine if your bloating is due to a minor problem like constipation or food intolerance, or if it is a symptom of a more serious medical condition requiring treatment.
How to relieve bloating
Making dietary and lifestyle changes can help reduce mild, temporary bloating:
Dietary changes
– Limit gas-producing foods like beans, onions, broccoli, dairy, soda
– Try a low FODMAP diet to identify problematic foods
– Eat smaller, more frequent meals
– Reduce salt, sugar alcohol, fatty and fried food intake
– Try probiotic foods like yogurt, kefir, kimchi
– Increase fiber gradually and drink plenty of fluids
– Avoid chewing gum, drinking through a straw
Lifestyle changes
– Engage in regular exercise to improve digestive motility
– Manage stress through meditation, yoga, deep breathing
– Improve posture, relax when eating, and take time to chew thoroughly
– Quit smoking and minimize alcohol intake
– Get adequate sleep and try to maintain a regular schedule
Over-the-counter treatments
– Simethicone tablets help break up gas bubbles
– Probiotic supplements restore healthy gut bacteria
– Digestive enzymes facilitate food breakdown
– Peppermint tea has anti-spasmodic effects to relax the gut
Prescription medications
– Antibiotics for SIBO
– Laxatives for constipation
– Antispasmodics to relax intestinal muscles
– Low dose antidepressants to treat IBS
– Medications that slow stomach emptying
See your doctor if lifestyle changes and OTC options do not provide lasting relief from bloating. If an underlying condition is diagnosed, targeted treatment can help manage bloating. Urgent medical care is required for severe bloating with vomiting, high fever or pain. Though bloating can be uncomfortable, most cases are mild and temporary, however it is important to identify when bloating may indicate a serious problem requiring medical intervention.
Conclusion
Bloating is a common but disruptive symptom with an extensive list of potential causes. Dietary triggers like excess fiber, swallowing air, food intolerances and poor digestion account for many cases of temporary bloating that can be eased with lifestyle changes. However, prolonged, severe or worsening bloating may be a sign of underlying gastrointestinal disorders, medication side effects, hormonal shifts or even cancers in rare cases. Pay close attention to associated symptoms and risk factors that could distinguish serious bloating requiring medical attention. Diagnostic tests can determine if there is an underlying condition, and targeted treatment will be needed to manage chronic bloating. Though frustrating, mild functional bloating can often be reduced through dietary modifications, probiotics, digestive enzymes, physical activity and stress reduction techniques. But when in doubt, do not hesitate to consult a doctor for an evaluation.
