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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Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
Glucose-6-Phosphate Dehydrogenase (G6PD) test Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that is found in every cell of the body and it plays…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
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?…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
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…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
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…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
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…
Isagenix diet weight loss
How are BMI and BMR different and what do these numbers mean? BMI and BMR are two important metrics that provide a clear picture of your body's metabolism and also…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
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…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
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…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
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…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
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…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Tight phimosis ring
Phimosis Read to know everything about phimosis, types, symptoms, treatment, risks and prognosis for patients with this condition.
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…