Bloating

Bloating stomach

Last Updated December 20th, 2021

Overview of bloating

Physiological complications of the gastrointestinal tract may give rise to associated disorders. A common disorder of the above category is “abdominal bloating” or simply “bloating”. Surprisingly, bloating is a phenomenon that may be temporarily observed in healthy individuals due to some minor environmental or dietary factors. According to epidemiological investigations by The American College of Gastroenterology, bloating affects nearly 20-30% of the general population and around 96% of the patients with gastrointestinal disorders. Proper diet and a healthy lifestyle can help prevent or at least regulate the problem of bloating to a considerable extent.

 

Definition of bloating

Bloating acidityBloating is defined as the abnormal swelling of the abdomen due to retention of excess gas and fluids, food intolerance and malabsorption of sugars. It causes visible abdominal distension and discomfort. The patients usually experience symptoms like the presence of excess gas in the abdomen and feeling of stomach fullness throughout the day. Five types of gases viz- Nitrogen, Oxygen, Carbon Dioxide, Hydrogen, and Methane constitute about 90% of the wind present in the gut. Abnormalities or imbalance in any of the above gases might lead to bloating. Under normal conditions, a person releases the gas from the body via wind passing or belching, about 14-23 times a day. Retention of the releasable gas may occur due to certain existing pathological conditions in the body and may lead to abdominal bloating.

 

Causes of bloating

In general, abdominal distension is caused by retention of gases or fluids in the abdomen. The physiological and anatomical factors that are responsible for this phenomenon are described below-

  • Gastrointestinal disorders: Few existing gastrointestinal disorders like Irritable Bowel Syndrome, Chronic Inflammatory Bowel Disease, Crohn’s disease, Celiac disease, functional dyspepsia (indigestion) or constipation can lead to abnormalities in gastrointestinal tract motility and visceral hypersensitivity, leading to abdominal swelling.
  • Sugar absorption: Consumption of few sugar compounds can cause abdominal bloating in few people due to malabsorption and rapid bacterial fermentation. Deficiency of lactase (lactose-digesting enzyme) can cause incomplete digestion of lactose, causing abdominal bloating, gas and diarrhea. Similarly, incomplete digestion of fructose may occur due to the absence of enzymes and also depends on other carbohydrates and glucose. Poor absorption of fructans occurs in most cases due to the absence of enzymes capable of breaking the fructose-fructose bonds. Sugar alcohols such as polyols present in artificial sweeteners can affect the bowel, causing abdominal distension.
  • Aerophagia: In this condition, a person swallows excess air during quickly gulping food, drinking water or saliva. Smoking can also let excess air enter the stomach. This excess air is mostly released outside the body via belching (eructation). But sometimes due to incorrect postures, the swallowed air is transferred to the small intestine. A portion of the oxygen and nitrogen of this swallowed air is absorbed into the circulating blood through the walls of the gastrointestinal tract.
  • Bacteria: Bacteria present in the colon help in the digestion of food to a certain extent. Incomplete digestion of certain carbohydrates causes bacteria to digest the remaining portion, thereby producing few by-products such as carbon dioxide, hydrogen, and methane. These collectively contribute to abdominal bloats.
  • Intestinal gas: Fermentation of lactulose in the colon leads to the generation of endogenous gas that may contribute to abdominal bloating.
  • Water in the small intestine: Quantity of water in the small intestine is raised due to slow absorption of few short-chained carbohydrates (fructose and mannitol). This leads to abdominal bloats.
  • Colon contents: Colon overloading may occur due to retained and hardened fecal matter which causes abdominal bloating. Again, fermentation of accumulated colonic contents by colon bacteria causes generation of carbon dioxide and methane gas, which also contribute to bloating.
  • Visceral sensitivity: Variations in visceral sensitivity may lead to abnormal gut sensations. Rectal hyposensitivity (caused due to increased rectal threshold) is observed in patients of chronic constipation. Again, rectal hypersensitivity (caused due to decreased rectal threshold) is observed in patients suffering from Diarrhoea. Visceral sensitivity fluctuations also occur during the perimenstrual phase. All these conditions may equally precipitate abdominal bloating.
  • Muscle functions: Abnormalities in functions of abdominal and diaphragm muscles contraction of the diaphragm and relaxation of the upper abdominal wall. Both the conditions may alter visceral sensitivity to a certain extent, causing abdominal bloating.
  • Pelvic floor function: Patients suffering from chronic constipation may experience an abnormal rectoanal inhibitory response that may lead to bloating. 

 

Symptoms of bloating

Bloating lactose intoleranceBloating is normally manifested as a swollen abdomen. But other few other symptoms are also identified. These are as follows-

  • Abdominal pain and distension
  • Feeling of stomach-fullness even after a very small meal
  • A feeling of the presence of excess trapped gas in the stomach
  • Mild rumbling sound (borborygmi) from the stomach (due to the shuffling of intestinal contents)
  • A loud rumbling sound from stomach caused due to repeated contractions of the intestine (observed in patients suffering from Crohn’s disease or Obstructive Bowel syndrome)
  • Frequent belching (eructation)
  • Passage of wind with a foul odor
  • Frequent burping
  • Feeling of rectal fullness (due to retained stool) even after a bowel movement
  • Frequent indigestion
  • A sensation of obstruction in the anus or rectum (anorectal blockage)
  • Abdominal cramps and pain after every meal

 

Diagnosis

Roughly speaking, abdominal bloating is a very common phenomenon. But in a few cases, it may be strong indicators of serious gastrointestinal disorders and must be taken care of immediately. The following diagnostic tests may be helpful prior to treatment of abdominal bloating-

  • Endoscopy
  • Colonoscopy or sigmoidoscopy (for detailed study of the colon)
  • Abdominal X-ray (to detect intestinal blockage)
  • Blood and breath test (to check for gluten sensitivity)
  • Lactose tolerance test (to check rule out bloating due to incomplete lactose metabolism)
  • Stool culture (to detect the presence of blood, fat or parasites)
  • Antibody test (to rule out Celiac disease)
  • Defecography (to test the functioning of the pelvic floor)

 

Treatment and prevention

Low FODMAP diet for bloating

FODMAPs are short chained carbohydrates, sugar, and alcohol which do not get digested properly by the body. They ferment in the large intestine, during digestion, absorb water and produce carbon dioxide, hydrogen, and methane gases which cause the intestines to expand.

FODMAP stands for:

F – Fermentable.

O – Oligosaccharides.

D – Disaccharides.

M – Monosaccharides.

A – and

P – Polysaccharides.

Beans such as black beans, broad beans, kidney beans etc, foods containing wheat such as biscuits, cereal, white bread etc. Vegetables such as celery and cauliflower and onions are some of the foods that have are high FODMAPs and may lead to bloating. Vegetables such as cucumber, zucchini, tomatoes etc, fruits such as banana, cranberry, papaya etc. Yogurt with probiotics, green and peppermint tea, and olive oil come under a low FODMAP diet, these foods help in relieving bloating.

A low FODMAP diet consisting of potassium can regulate the water levels in the body to help prevent bloating. Probiotics help in increasing the number of good bacteria such as lactobacillus and bifidobacterium in the digestive tract, thereby preventing bloating.

Gastrointestinal disorders – Irritable bowel syndrome (IBS) 

Treatment 

  • In mild cases of IBS, patients are advised to make a lifestyle change to ease their symptoms. These lifestyle changes may include avoiding triggers, getting sufficient sleep, reducing stress levels etc.
  • In moderate cases, doctors advise patients to restrict certain foods to aid their symptoms. Food that is advised to avoid include high-gas foods such as carbonated beverages, alcoholic beverages, raw vegetables and fruits etc, gluten and FODMAPS’s (carbohydrates that have a short chain and do not digest properly in the small intestine)
  • Medications are prescribed along with the dietary restriction. Medications to ease the symptoms of IBS such as constipation, diarrhea, depression, and pain are prescribed to those who have been diagnosed with IBS.
  • Medications to help slow down bowel movements will be prescribed along with supplements and diet plan for those with IBS.
  • Medication to ease pain and diarrhea will be prescribed.
  • Antibiotics to restrict bacterial growth and reduce the symptoms of diarrhea are prescribed.
  • To increase the water content in the small intestine, medication is prescribed. This medication helps in making stool passing easier.

Prevention

  • For those who have high-stress levels of IBS due to stress, counseling is recommended.
  • Dietary changes.
  • Knowing triggers.

Aerophagia 

Bloating stomachTreatment 

  • Ensuring that food being consumed is chewed properly.
  • Avoid chewing gum as this tends to increase the amount of saliva that is swallowed along with the air that we swallow.
  • Keeping the mouth closed while chewing food tends to reduce the amount of air that is swallowed.
  • Consuming carbonated beverages tends to increase bloating.
  • Mindful controlling of breath is helpful in ensuring that excess air is not swallowed.
  • Getting a check-up done for underlying causes or allergies can help in a treatment plan to prevent Aerophagia.

Prevention 

  • Practice breathing exercises.
  • Remember the importance of closing your mouth and eating.
  • Ensure that you chew your food properly.

Intestinal gas and pains 

Treatment 

  • In cases of mild intestinal gas and pain, doctors will recommend basic lifestyle change and take note on the progress of the treatment.
  • In case, the symptoms tend to increase doctors may recommend that the patient change their diet.
  • Reducing high fiber food such as beans, lentils, cauliflower etc. can aid in relieving bloating.
  • Sugar substances are recommended against consumption. They should be had in small quantities, or an alternative must be consumed.
  • Fried and fatty foods tend to increase bloating.
  • Carbonated beverages are to be avoided to aid the symptoms of bloating.
  • Fiber supplements are prescribed to those who have constipation along with intestinal gas, these supplements help in making stool passing easier.
  • Consuming water before every meal helps in relieving the symptoms of constipation.
  • Medications to help in breaking down the carbohydrates that have been consumed are prescribed. Along with medications to treat the symptoms of bloating and constipation. These medications can be bought over-the-counter (OTC) for those who have intestinal gas and pain.

Prevention 

  • Consume smaller portions of food.
  • Chew your food properly.
  • Do not smoke.
  • Do not chew gum.
  • Exercise regularly.
  • Do not suck on hard candies.
  • Visit the dentist frequently after new denture fittings.

Facts

  • Irritable bowel syndrome (IBS) is the most common type of gastrointestinal disorder.
  • 10-15% of the world’s population is diagnosed with IBS. Bloating is one of the major symptoms of this condition.

Facts

  • Food such as beans, lentils, wheat, onion and garlic tend to cause bloating.
  • Stress can aggravate bloating.

Facts

  • Hormonal fluctuations during pregnancy cause bloating.
  • One of the common symptoms of PMS  is bloating.

Related Conditions

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Dos and Don'ts

Dos
  • Manage your stress levels as doing can lower the severity of gastric issues.
  • Chew your food properly. Chewing food helps in digesting food faster and avoids bloating caused due to indigestion.
  • Hydrate before a meal. Having a glass of water helps in breaking down of the food that we eat.
Don'ts
  • Consume excess caffeine and alcohol; they tend to relax the muscles in the esophagus and stomach, thereby taking in more air and causing bloating.
  • Snack frequently, the stomach needs time to digest the food from the previous meal. Snacking frequently can lead to indigestion and bloating.
  • Be inactive, exercise regularly, this aids the digestion process, there inhibiting bloating.

 

 

 

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Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
maltodextrin sugar
Maltodextrin: What are the hidden health benefits of this food additive? Maltodextrin is one of the few food additives that has been relatively deemed safe. Many experts now have…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
Jackfruit: Slice your way into higher immunity, better digestion, & more… Native to the South East Asia, the jackfruit is a fruit brimming with thousands of health benefits. Discover…
Trisodium Phosphate: How a paint thinner made its way into your breakfast Ever thought how toxic chemicals find their way into our foods? How can they harm our body? And…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
gout diet purines
Gout Diet : Get relief from painful joints by eating these foods Are you a victim of this painful condition? Are medications providing only short relief? Find a list of…
Horny Goat Weed: Can it improve libido in human beings too? This plant got its name as Horny Goat Weed when one of the goats feeding on the plant…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Anti-CCP Test – Anti-Cyclic Citrullinated Peptide Anti-ccp or ACCP test is a blood test that is primarily employed to diagnose the onset of rheumatoid…
cardioliin antibody iga
Cardiolipin Antibody (ACL) – IgA test Cardiolipins are phospholipids that are constituents of the platelets and the cell membranes. The IgA test detects the…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
pilonidal sinus
Pilonidal sinus Pilonidal sinus is more common in young men than women. Learn about treatment options, surgical management, risks, and…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
low fodmap plan
Troubled with IBS? Here’s a complete roadmap to the low FODMAP diet Leaky & inflammatory gut troubling you? No medicine bringing you relief from the pain? Why not try the…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Atkins diet weight loss
Atkins Diet: The right steps to carb control that can help you lose those pounds fast The Atkins diet is a high fat, low-carb diet with proven weight loss benefits that is flexible enough…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Bone marrow aspiration Bone marrow aspiration is a process where a sample of the bone marrow is withdrawn from the bone…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
Sushi: health benefits and recipes Sushi is a traditional Japanese dish prepared with vinegared rice served with fish (often raw), vegetables, and other…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…