Bloated Stomach

What is a bloated stomach?

A bloated stomach is first and foremost a feeling of tightness, pressure or fullness in your belly. It may or may not be accompanied by a visiblydistended (swollen) abdomen. The feeling can range from mildly uncomfortable to intensely painful. It usually goes away after a while, but for some people, it’s a recurring problem. Digestive issues and hormone fluctuations can cause cyclical bloating. If your bloated stomach doesn’t go away, you should seek medical care to determine the cause.

Why is my stomach bloated?

The most common cause of stomach pain and bloating is excess intestinalgas. If you get a bloated stomach after eating, it may be a digestive issue. It might be as simple as eating too much too fast, or you could have a food intolerance or other condition that causes gas and digestive contents to build up. Your menstrual cycle is another common cause of temporary bloating. Sometimes a bloated stomach can indicate a more serious medical condition.

How common is stomach bloating?

Between 10% and 25% of otherwise healthy people complain of occasional abdominal bloating. As many as 75% describe their symptoms as moderate to severe. About 10% say they experience it regularly. Among those diagnosed with irritable bowel syndrome (IBS), it may be as much as 90%. Up to 75% of women experience bloating before and during their period. Only 50% of people who experience bloating also report a distended abdomen.

What causes bloating in the stomach?

Gas

Gas is a natural byproduct of digestion, but too much intestinal gas means your digestion is gone awry. While you can ingest gasses by swallowing air or drinking carbonated beverages, these gasses mostly escape through belching before they reach your intestines. Gasses in your intestines are mostly produced by gut bacteria digesting carbohydrates, in a process called fermentation.

If there’s too much fermentation going on, it’s because too many carbohydrates weren’t naturally absorbed earlier in the digestive process, before reaching those gut bacteria. That could be for several reasons. Maybe you just ate too much too fast for proper digestion. Or you might have a specific food intolerance or gastrointestinal (GI) disease. Some possible causes include:

• Carbohydrate malabsorption. Many people have difficulties digesting particular carbohydrates (sugars). Some common culprits include lactose, fructose and the carbs in wheat and beans. You may have an intolerance, or you may just have general difficulties that cause your body to struggle more with tougher carbs. A nutritionist or GI specialist can help you isolate your dietary sensitivities.

• Small intestinal bacterial overgrowth (SIBO). This occurs when gut bacteria from the colon overflow into the small intestine . The overgrowth of these bacteria can also overwhelm other bacteria that are meant to balance them. Some bacteria actually absorb the gasses produced by others, but too many of one kind and not enough of another kind can throw this balance off.

• Functional digestive disorders . IBS and functional dyspepsia are diagnosed when your body struggles more with digestion for unexplained reasons. Symptoms often include gas and bloating after eating. Keep an eye out for classic alarm symptoms such as diarrhea or constipation, nausea, vomiting, fever, bleeding, anemia, and unintentional weight loss.

• Visceral hypersensitivity . Some people feel like they’re gassy and bloated even when their volume of gas is normal. This condition often correlates with IBS and other disorders involving the gut-to-brain neural pathways . Some people even develop a muscular hyper-reaction to make more room in the abdominal cavity for gas (abdominophrenic dyssynergia). Their abdominal muscles relax and protrude outward in the presence of gas, even when the actual volume is normal.

Digestive Contents

These can include solids, liquids, and gas. Digestive contents can build up in your digestive system when there is a backup or restriction in your digestive tract or when the muscles that move digestive contents along are somehow impaired. Any build-up of digestive contents along the digestive tract will leave less room for normal amounts of gas to process through. It also leaves less room for other things in your abdomen, including circulatory fluids and fat, making everything feel tighter. Causes of build-up can include:

• Constipation . You may have occasional constipation due to diet or lifestyle factors, or you may have chronic constipation due to an underlying condition. Backed-up poop in your colon causes recently-digested food to stay longer in the intestines, waiting to descend. Everything expands to contain the extra volume, leading to bloat.

• Bowel obstructions . When it isn’t backed-up poop obstructing your bowels, it could be something more serious. Both your l arge and small bowels can become blocked by tumors, scar tissue, strictures, stenosis, or hernias. Inflammatory diseases such as Crohn’s disease
  and diverticulosis can damage parts of your small bowels, creating strictures that narrow the passage of digestive contents.
• Motility disorders can cause constipation, or they can simply cause everything to move more slowly through your digestive tract. These are usually disorders of the muscles and nerves that sense digestive contents in the digestive tract. Examples include intestinal pseudo-obstruction , a condition that mimics the effects of an obstruction when there is none, gastroparesis , partial paralysis of the stomach muscles, and pelvic floor dysfunction .
• Recent weight gain . Weight gained within the last year or so tends to go to your belly first. If you’ve gained ten pounds or more, it’s probably impacting your abdominal volume. This means less room for normal digestive processes, so that even a normal meal may cause you to feel abnormally bloated during digestion. Sometimes weight gain also involves water retention, which can make you feel bloated with fluids in your stomach and elsewhere.

Hormones

Maybe you’ve noticed that your stomach bloating follows a different cycle — not so much your digestive cycle, but your menstrual cycle. If so, you’re not alone. As many as 3 in 4 women say they experience abdominal bloating before and during their menstrual periods. Bloating is also a common complaint during the hormone fluctuations of perimenopause . Female hormones deserve a special mention when it comes to stomach bloating because they can affect bloating from many angles — fluids, gas, digestive back-up — and also your sensitivity to those things. First, estrogen causes water retention. When estrogen spikes and progesterone drops, you'll notice bloating from fluids. This, in addition to the increased volume of your uterus just before menstruation, can give you a bloated stomach. But hormones also interact with your digestive system. Estrogen and progesterone can each cause intestinal gas by either slowing or speeding your motility. Estrogen receptors in your GI tract also affect your visceral sensitivity — what makes you feel bloated.

Other Causes

Bloating that comes and goes is usually digestive, hormonal or both. These causes can also make you feel generally sick and tired. As long as your symptoms eventually go away, they probably aren't serious. But if your bloated stomach doesn’t go away or gets worse, or if you have other symptoms of serious illness, such as fever or vomiting, you should seek medical attention to rule out other medical causes. These may include:

• Ascites

  . This is a gradual build-up of fluid in your abdominal cavity. It’s usually caused by liver disease , and sometimes by kidney failure or heart failure .

• Pancreatic insufficiency. This is a kind of pancreatic dysfunction in which your pancreas can no longer make enough digestive enzymes to serve its function in the digestive process.

• Inflammation of the stomach (gastritis) or the intestines (enteritis). This is usually caused by a bacterial infection (commonly,H. pylori infection)or by drinking too much alcohol. It can also be related to peptic ulcers.

• Cancer(ovarian, uterine, colon, pancreatic, stomach or mesenteric). Yearly check-ups with your primary care physician are important to screen for cancer.

How long does a bloated stomach last?

If your bloating is due to something you ate or drank or to hormone fluctuations, it should begin to ease within a few hours to days. If you are constipated, it won’t go down until you start pooping. Water, exercise and herbal teas can help encourage all of these things along. If it doesn’t go away or gets worse, seek medical attention.

What relieves bloating?

What brings relief in the long term will depend on the cause of your distress. You might need a professional diagnosis to get to the bottom of it. But if you’re looking for home remedies to debloat your stomach today or avoid bloating tomorrow, there are a few things you can try.

• Herbal teas , including peppermint, chamomile, ginger, turmeric and fennel can aid digestion and help process gas. Dandelion tea can help relieve water retention.
• Peppermint oil capsules are a natural antispasmodic. That means they help your intestinal muscles relax. This can help you pass trapped poop and gas, especially if your problems derive from a motility issue.
• Antacids have been shown to relieve inflammation in the digestive tract and help pass gas more easily. Antacids often include the active ingredient simethicone, which works to pass gas by grouping smaller gas bubbles together. Simethicone is also available separately.
• Magnesium supplements help to neutralize stomach acid and relax the intestinal muscles. Magnesium has a natural laxative effect, which can be helpful from time to time but can be habit-forming if you use it too often.
• Probiotics can help supplement or rebalance your gut bacteria. Some will help you digest your food better in the first place, and others may actually help absorb excess gasses. You may have to take them consistently for a few days or weeks to really notice a difference.
• Psyllium husks are a popular fiber supplement that can help you poop more regularly. Always introduce fiber supplements gradually, and with lots of water. Over-the-counter laxatives can also be used as needed.
• Regular exercise with a focus on core body strengthening can help combat abdominal bloating.

How can I prevent stomach bloating?

If your stomach bloating is caused by diet or alcohol, you can help prevent it by making some lifestyle changes. Some good general guidelines include:

• Eat enough fiber . If you don’t typically get a lot of fiber in your diet, you should start gradually so that you don’t overwhelm your system. Fiber will cause more gas at first, but once it starts sweeping through your digestive system, it will help clean out the fermenting fecal matter that’s stuck in there. Fiber also tells your body to drink more water, and it makes you feel full sooner so that you don’t eat too much. Finally, fiber is a prebiotic that helps feed and promote the good bacteria in your gut.
• Drink enough water . This will encourage motility along your entire digestive tract and keep your digesting food from becoming too hard and compacted to pass through. Water also helps you feel full between meals.
• Get some exercise . Exercise helps prevent water retention and keeps your bowels moving. It can also help prevent the rapid weight gain that often goes straight to your belly. If you have a desk job, regular exercise can seem more daunting, but it doesn’t take too much — just remember to get up and walk around now and then.
• Avoid processed foods. Processed foods are low in fiber and high in salt and fat. Salt causes water retention, and fat slows down the digestive process because it takes longer to digest. All of these things can lead to constipation and bloating. Processed foods are also low in nutrition, so they will leave you feeling hungrier even after you’ve consumed a lot of calories. This leads to more eating and compounding the problem.
• Practice mindful eating . Take your time to chew thoroughly and stop before you are full. Feeling full is a delayed reaction because it takes a while for the food you eat to actually reach your stomach. Most people eat enough to be full before they can actually feel that they are.
• Notice sensitivities . Whether it’s alcohol or particular foods, just paying attention can help you notice which ingredients you are most sensitive to. Some people keep a food journal and take notes to keep track of how different meals make them feel. You can also try eliminating foods one at a time and notice if you experience any difference in your symptoms.

If the cause of your bloated stomach is something more specific, such as specific food intolerance, perimenopause or a medical condition, you might need a little help with diagnosis, treatment and prevention. Some options include:

• Elimination diet . A dietician can help guide you through an elimination diet to identify your food sensitivities and give your digestive system a chance to heal. This usually means maintaining a very restricted diet for a short period of time and then adding certain classes of foods back in one at a time to see how your body reacts. A good one to try for bloating is the low-FODMAP diet . FODMAP foods include all of the carbohydrates that most commonly cause digestive problems, bloating and gas.

• Hydrogen breath test. This relatively simple test is an efficient way to screen for a few different digestive disorders, including specific sugar intolerances and SIBO. You can take it as an outpatient or sometimes at home and have results in a day or two.

• Targeted probiotics . If your healthcare provider diagnoses you with SIBO or another gut bacteria imbalance, they can help rebuild your microbiome by reintroducing the specific bacteria that you are lacking to help balance out the ones that are dominating.
• Hormone therapy . Some women find relief from monthly bloating and other symptoms of PMS by taking hormonal birth control pills. You can discuss the pros and cons of the pill with your healthcare provider. Some women in perimenopause find relief from their symptoms with supplemental estrogen and progesterone. Talk to your healthcare provider to find out if hormone replacement therapy (HRT) is right for you.

• Biofeedback. This is a kind of mind-body therapy that can help you relax and retrain your bodily functions. Biofeedback may help prevent a bloated stomach if you tend to experience indigestion or constipation as a response to stress, or if you have visceral hypersensitivity and feel bloated even when your digestion is normal.

When should I be worried about abdominal bloating?

See your healthcare provider if your bloated stomach:

• Gets progressively worse.
• Persists for more than a week.
• Is persistently painful.
• Comes with symptoms of illness, such as fever, vomiting or bleeding.

A note from Royallee Cancer Hospital

A bloated stomach is not a pleasant feeling. While it’s a common experience and usually temporary, you may become weary of the cycle. Spending a little focused attention on the problem to identify the cause can be well worthwhile. Try recording your symptoms and possible triggers in a journal. Note diet, hormonal and stress factors. When in doubt bring your notes to a specialist for professional guidance. The different factors that contribute to bloating can be complex and difficult to parse, but medical testing can help. As always, seek medical attention if your symptoms are persistent or severe.