Bloating is a common complaint that can make your stomach feel swollen or enlarged. It usually happens after eating, but can occur at any time. Bloating is often caused by gas buildup in your gastrointestinal tract, but there are many other possible causes. Identifying the underlying reason for bloating can help you find ways to prevent or treat it.
What causes bloating?
There are several possible causes for chronic or frequent bloating:
Swallowing too much air when you eat or drink is one of the most common causes of bloating. Things that can contribute to swallowing excess air include:
– Eating or drinking too fast
– Talking while eating
– Chewing gum
– Drinking through a straw
The air you swallow enters your digestive tract and can accumulate, causing abdominal distension.
Gas production in your gut is a normal part of digestion. However, some people may produce more gas due to:
– Food intolerances like lactose or gluten intolerance
– Carbohydrate malabsorption
– Small intestinal bacterial overgrowth (SIBO)
– Alterations in gut bacteria
When your body is unable to properly digest certain foods, it can result in excess gas production when these foods reach your colon.
Constipation slows down digestion and can cause bloating when stool builds up in your colon. Some reasons for constipation include:
– Not enough fiber in your diet
– Medications like opioids
– Irritable bowel syndrome (IBS)
– Thyroid disorders
– Nerve damage
When constipation persists, it allows gas produced by your gut bacteria to accumulate, causing bloating.
Some people experience bloating specifically after eating certain foods even though they do not have a diagnosed food allergy or intolerance. Foods that frequently cause bloating issues include:
– Beans, lentils, soybeans
– Wheat and gluten-containing foods
– Cruciferous vegetables like broccoli or cabbage
– Onions and garlic
– Carbonated beverages
– Artificial sweeteners
The underlying reasons are not always clear, but may involve poor digestion, irritation of the gut lining, or sensitivity to certain compounds in foods.
Gastroparesis causes delayed emptying of the stomach. Food sits in the stomach for longer than normal before passing into the small intestine. This disorder can be related to:
– Nervous system diseases like Parkinson’s
– Surgery on the vagus nerve
– Medications, particularly narcotics and antidepressants
When the stomach doesn’t empty properly, it can lead to bloating, nausea, and a feeling of fullness.
Pelvic floor dyssynergia
This condition affects the coordination between your abdominal and pelvic floor muscles. Instead of relaxing your pelvic floor when you try to pass gas or have a bowel movement, these muscles tense up. This can make it difficult to release gas, resulting in bloating.
Inflammatory bowel diseases
Chronic inflammation in the gastrointestinal tract from Crohn’s disease or ulcerative colitis may contribute to bloating. Inflammation can impair normal digestion and lead to gas and fluid accumulation. Bloating tends to worsen during IBD flares.
Irritable bowel syndrome (IBS)
IBS is a common condition affecting gut function. Changes in bowel contractions and sensitivity are thought to cause symptoms like bloating, gas, abdominal cramping, and irregular bowel movements. Exact causes of IBS are unknown, but may involve the gut-brain connection.
In women, reproductive health issues can sometimes cause abdominal bloating. These include:
– Menstruation and premenstrual syndrome (PMS)
– Ovarian cysts
– Uterine fibroids
– Pelvic inflammatory disease
Shifts in hormones and prostaglandins during the menstrual cycle can provoke bloating in some women.
Other medical conditions
Some medical conditions that may be associated with chronic bloating include:
– Celiac disease
– Cancer, especially ovarian or gastrointestinal
– Chronic pancreatitis
– Cirrhosis and liver disease
– Congestive heart failure
– Kidney disease or kidney failure
If bloating persists without any other obvious cause, it’s important to see your doctor to rule out an underlying medical issue.
When to see a doctor
Occasional mild bloating that resolves with passing gas or a bowel movement is usually not a concern. But you should make an appointment with your doctor if you regularly experience:
– Bloating that persists for days or weeks
– Abdominal pain along with bloating
– Bloating even with dietary changes to cope with gas
– Fullness that impairs your ability to eat
– Unintentional weight loss
– Other worrisome digestive symptoms
Persistent bloating could indicate a gastrointestinal, gynecological, or other health condition requiring treatment. It’s important to seek medical advice to determine the cause.
How is bloating diagnosed?
To diagnose the cause of chronic bloating, your doctor will typically begin with a medical history and physical exam. Be prepared to describe your symptoms in detail, including when they occur and any other associated issues.
Your doctor may order tests to look for potential causes, such as:
- Blood tests to check for celiac disease, food allergies, thyroid dysfunction, kidney disease, and other systemic issues
- Stool tests to look for bacterial overgrowth or parasites
- Breath tests for lactose intolerance or bacterial overgrowth
- Abdominal x-rays or CT scans to check for intestinal blockages
- Endoscopies to visually examine your upper and lower GI tract
- Ultrasound or pelvic exam to evaluate reproductive organs in women
Based on your test results and evaluation, your doctor can determine if your bloating is due to an underlying medical condition that needs treatment.
Diet and lifestyle changes
Certain diet and lifestyle modifications can help reduce bloating for some people:
Avoid foods that tend to cause gas
The main offenders are beans, lentils, carbonated beverages, onions, broccoli, cabbage, and dairy. Limit foods that seem to provoke bloating.
Eat more slowly
Make a conscious effort to eat slower and chew your food thoroughly. This allows more time for digestion and reduces swallowed air.
Avoid chewing gum and drinking through straws
Chewing gum and sucking on straws causes you swallow more air, which can get trapped in your GI tract and lead to bloating.
Drink plenty of fluids
Staying hydrated helps prevent constipation, a common cause of bloating. Aim for around 2 liters of total fluid intake daily.
Increase fiber gradually
Fiber helps reduce constipation by adding bulk to stools. But abruptly increasing fiber intake can cause gas and bloating. Boost fiber slowly and drink more fluids.
Physical activity accelerates digestion and stimulates intestinal contractions to help pass gas. Even light exercise like walking helps.
For some people, bloating gets worse with stress. Stress management techniques like meditation, yoga, or counseling can help break this association.
Smoking causes you to swallow air, which can accumulate in the digestive tract. Quitting smoking may help alleviate bloating.
If lifestyle measures don’t provide adequate relief from chronic bloating, your doctor may prescribe medications or other treatments targeted to the underlying cause:
These provide the enzyme needed to properly digest lactose in dairy products. They reduce bloating caused by lactose intolerance.
Antibiotics for bacterial overgrowth
Antibiotics like rifaximin can eliminate excess bacteria from the small intestine to remedy bacterial overgrowth-related bloating.
Probiotic supplements contain beneficial gut bacteria that may improve digestion and reduce bloating for some individuals by optimizing the intestinal microbiome.
Medications like dicyclomine help relax intestinal muscles, which may relieve cramping and bloating associated with IBS.
Medications for constipation
Stool softeners, laxatives, or prokinetic agents that improve motility can treat constipation and associated bloating.
Treatment for underlying conditions
If bloating stems from a health condition like gastroparesis or endometriosis, treating the disorder often resolves bloating as well.
In severe cases, surgery may be warranted to address an obstruction, adhesion, or motility disorder causing persistent bloating.
Lifestyle remedies for quick bloating relief
Certain natural home remedies may help alleviate mild, temporary bloating when it flares up:
– Massage your abdomen in a clockwise motion using warm oil
– Apply a warm compress to your stomach
– Drink ginger, peppermint, or chamomile tea
– Take activated charcoal capsules to reduce gas
– Use essential oils like lemon, lavender, or rosemary oil
– Take a warm bath with epsom salt
– Try yoga poses like child’s pose, knees to chest, or twisting poses
– Go for a walk to encourage passing gas
– Wear loose, comfortable clothing around your waist
However, persistent bloating warrants a visit to your doctor. Recurring bloating should not be ignored or simply masked with remedies.
When to see your doctor
While occasional bloating can be managed with lifestyle changes and home remedies, it’s important to consult your doctor if you regularly experience:
– Bloating that persists for days or weeks
– Bloating along with pain or cramping
– Bloating even after dietary modifications
– Inability to finish meals due to fullness
– Unexplained weight changes
– Other concerning digestive symptoms
Chronic or recurrent bloating may indicate an underlying medical condition requiring diagnosis and treatment. Speaking with your doctor can help determine if your bloating is a symptom of a treatable disorder.
The bottom line
Bloating is very common but bothersome. It’s often caused by swallowed air or gas production during digestion. Dietary adjustments like avoiding gas-producing foods can help reduce bloating. Stress management, exercise, probiotics, and herbs may also provide relief in some cases. But persistent or worsening bloating should be evaluated by a doctor to rule out a medical disorder. Treating any condition causing bloating should resolve it.