Have you ever stopped to consider why you’re often bloated? It might be more than just overeating.

Feeling bloated isn't just about overindulging at dinner—for many, it's a sign of a deeper issue that could be linked to chronic conditions like IBS.

IBS affects up to 24% of women and can cause persistent bloating along with other symptoms.

One of the most common gastrointestinal (GI) symptoms is bloating, a frequent complaint among patients of all ages.

This symptom is especially common in patients with irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs), as well as in those with organic disorders.

Many clinicians suggest that they frequently encounter complaints from patients such as "too much gas in the abdomen," "a heavy and uncomfortable feeling in the abdomen," and "a full belly."

What Are The Causes Of Bloating?

The causes of bloating are complex, involving factors like gas production, gut microflora, and gut hypersensitivity. Many patients with bloating tend to have IBS or functional dyspepsia (FD), so treatments typically focus on managing these conditions.

• Gut sensitivity: Due to  IBS people can become extremely sensitive to gas, which can cause pain, cramping, and diarrhea

• Small intestinal bacterial overgrowth (SIBO): Most healthy individuals have relatively few bacteria in their small intestine. while people who have undergone intestinal surgery are more prone to developing small intestinal bacterial overgrowth (SIBO), which can lead to bloating.

• Gastroparesis: This condition can lead to delayed stomach emptying, resulting in bloating, nausea, and even bowel blockages.

• Gynecological conditions: Sometimes women with issues related to the ovaries or uterus may also experience bloating.

MedBound Times reached out to Dr. Shaheen Sultana, Registered Dietitian from Hyderabad, Telangana. She was kind enough to share her knowledge and expertise to help us better understand this topic.

Bloating is a feeling of fullness or swelling in the abdomen, usually caused by gas in the intestines. Some causes of bloating include:

• Eating too much, eating too fast, or consuming certain foods and drinks like raw vegetables ( broccoli, cabbage) and fizzy drinks can cause bloating.

• Swallowing air while eating can cause bloating.

• Constipation, lactose intolerance, and other digestive conditions like SIBO, Gastroparesis can cause bloating.

• Too much infusion rate, fat malabsorption.

• Abruptly increasing the amount of fiber in your diet can cause bloating.

• Bloating can be caused by water retention due to circulation in the blood and the body's ability to eliminate water.

• Stomach infections caused by bacteria or viruses can cause bloating.

• And also many potential mechanisms for bloating, including gut hypersensitivity, impaired gas handling, and altered gut microbiota.

Why does bloating occur, and how is food digested?

In healthy adults, intestinal gas infusion increases muscle activity in the abdominal wall.

It leads to decreased contraction of the abdominal wall muscles concurrent with inappropriate relaxation of the internal oblique muscles. This abnormal viscerosomatic reflex activity with bloating means that abdominal wall muscles relax, rather than contract, with gaseous distention of the GI tract, emphasizing luminal gas.

In contrast to healthy volunteers, the diaphragms of bloating descend while the ventral abdominal wall muscles relax, leading to an increase in abdominal girth.

More than 65% of patients presenting with bloating or distention rated the symptoms as moderate to severe in intensity, while 54% of them reported that the symptoms influenced their daily activities and 43% had to resort to the use of medication.

When to expect to see your doctor

Excessive belching, passing gas, and bloating often resolve on their own or with simple lifestyle changes these are the only symptoms you experience, they rarely indicate a serious underlying condition

It's time to consult a healthcare professional if your symptoms don't improve with simple lifestyle changes, particularly if you also notice:

• Diarrhea

• Persistent or severe belly pain

• Bloody stools

• Changes in the color or frequency of stools

• Losing weight without trying

• Chest discomfort

• Loss of appetite or feeling full quickly

HOW TO REDUCE BLOATING

Belching: Getting rid of excess air

Belching, also known as burping, is your body's way of expelling excess air from the upper digestive tract.

Here are some tips to reduce belching:

• Eat and drink slowly Taking your time can help minimize the amount of air you swallow. Try to make mealtimes relaxed, as eating quickly or while stressed can increase swallowed air.

• Don't drink carbonated drinks and beer. These beverages release carbon dioxide gas.

• Skip the gum and hard candy. Chewing gum or sucking on hard candy causes you to swallow more frequently, including more air

• Don't smoke. Smoking leads to inhaling and swallowing air.

• Check your dentures. Ill-fitting dentures can result in swallowing excess air during eating and drinking.

• Get moving. A short walk after meals may help

• Treat heartburn

Ms. Shaheen suggests some treatments to reduce bloating, including:

• Diet

• Exercise and posture

• Over-the-counter medications

• Probiotics

• Antibiotics

• Smooth muscle antispasmodic

• Osmotic laxatives

• Prokinetic agents

• Chloride channel activators

• Tricyclic antidepressants.

Summary

Bloating is a common symptom caused by excessive gas, delayed digestion, or gut imbalances. It occurs when the digestive process produces more gas or when the stomach empties slowly. Simple lifestyle changes can often help, but persistent bloating may need medical evaluation to rule out underlying conditions

Reference

• Jiang, X., Locke, G. R., Choung, R. S., Zinsmeister, A. R., Schleck, C. D., & Talley, N. J. (2008). Prevalence and risk factors for abdominal bloating and visible distention: a population-based study. Gut, 57(6), 756–763. https://doi.org/10.1136/gut.2007.142810

• Seo, A. Y., Kim, N., & Oh, D. H. (2013). Abdominal Bloating: Pathophysiology and Treatment. Journal of Neurogastroenterology and Motility, 19(4), 433–453. https://doi.org/10.5056/jnm.2013.19.4.433

• Bloating: Causes and Prevention Tips. (2021, September 20). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/bloating-causes-and-prevention-tips

• Belching, gas and bloating: Tips for reducing them. (2024, January 30). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gas-and-gas-pains/in-depth/gas-and-gas-pains/art-20044739

• Professional, C. C. M. (2024, May 1). Bloated Stomach. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/21740-bloated-stomach

• Sullivan, S. N. (2012). Functional Abdominal Bloating with Distention. ISRN Gastroenterology, 2012, 1–5. https://doi.org/10.5402/2012/721820

By Simran Sethi