Bloated Stomach

1 Bloated Stomach Summary

Stomach bloating is so common in today’s world of varied lifestyle that it’s been deemed “epidemic.” Poor eating habits, stress, daily medications, and exposure to pollutants all lead to some sort of bloating.

Stomach bloating is a feeling of fullness or tightness, as if the stomach is distended uncomfortably. This differs from the accumulation of fat around the abdomen.

Bloating is mostly temporary and is commonly caused by a buildup of gas in the abdomen, resulting in a full, distended feeling. It is seen in different age groups, including both adults and children.

A feeling of fullness or distension is the most common characteristic of bloat. In some cases, this may be accompanied by other symptoms like abdominal pain, flatulence, and burping or belching. People with bloating complain of rumbling sounds from the stomach.

Some symptoms, when present with bloating, require medical attention, including:

The most common causes of bloating in the stomach are:

  • Digestive disorders: Many gastrointestinal disorders, including inflammatory bowel syndrome (IBS), ulcerative colitis, and celiac disease, are known to cause bloating and distention. It is also seen in people with chronic constipation and functional dyspepsia.
  • Edema: Buildup of fluids near or around the abdomen causes bloating and temporary weight gain. Fluid retention may result from conditions like liver disease and, rarely, cancer.
  • Dehydration: Dehydration is mostly accompanied by stomach bloat and discomfort. Dehydration and electrolyte imbalance affect digestion, leading to abdominal distress, including bloating and abdominal pain.
  • Constipation: This is one of the most obvious reasons for bloating in the stomach. Pain, discomfort, and gas are the accompanying symptoms.
  • Food allergies: Allergies, sensitivities, and intolerances to different types of food also result in bloating and distention. This includes dairy products, gluten-containing foods, and some carbohydrates.
  • Small intestinal bacterial overgrowth (SIBO): SIBO is characterized by high levels of harmful bacteria in the intestine. Inflammation, poor digestion, or a course of antibiotics sometimes remove natural bacteria from the gut, leading to the growth of abnormal fauna. This results in abdominal bloating and impaired digestion.
  • Infection: Infection leads to elevated levels of inflammation, characterized by other symptoms like fever, pain, and swelling of the lymph nodes.
  • Bowel obstruction: Obstruction of the bowels caused by a tumor or scar tissue may lead to bloating, constipation, nausea, and vomiting.
  • Hormonal changes: Changes in hormone levels, as in menstruation, increase the chances of digestive issues, constipation, and fluid retention. Bloating and distention are common symptoms during pre-menstrual syndrome.
  • Cancer: This is a rare cause of abdominal bloating. Cancer is usually suspected when bloating persists and the body does not respond to usual treatments.

Some simple lifestyle changes may help control bloating, including limiting the intake of carbonated beverages, avoiding gassy foods, eating slowly, and maintaining a healthy body weight.

Drinking plenty of water, reducing stress, exercising regularly, and having a healthy diet are all important in controlling the symptoms of bloat.

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2 Causes

There are multiple reasons for stomach bloating and distention. Bloating is usually associated with digestive issues. Factors that affect the health of the intestine, metabolic ability, and the elimination of waste, may all lead to bloating.

Often, bloating is caused by excess gas or wind in the stomach. Certain foods like beans, onions, broccoli, cabbage, sprouts, and cauliflower are known to cause bloating and wind.

Swallowing air while eating or drinking may also lead to a buildup of wind in the abdomen. Chewing gum, having carbonated drinks, eating while talking, and not being in the right posture while eating all lead to swallowing of air. Some other causes of bloating include:

  • Digestive disorders: Many gastrointestinal disorders like IBS, ulcerative colitis, functional dyspepsia, and chronic constipation cause bloating and distention. Studies show that a majority of people with IBS suffer from stomach bloating.
  • Edema: Retention of body fluids in different parts of the body, including the abdominal region, may cause bloating. Edema near the abdomen leads to temporary weight gain. Retention may lead to pain around the joints and tight skin. Liver disease and cancer may also cause fluid retention, though cancer is a rare cause of edema.
  • Dehydration: Eating salty foods and drinking too much alcohol lead to dehydration and bloating. Dehydration and electrolyte imbalance in the body affect digestion, leading to abdominal bloating and distention. As a response to dehydration, the body retains more fluids when one tries to rehydrate. Thus, after dehydration, the body will store more water, particularly around the abdomen, leading to bloating.
  • Constipation: Undigested food remaining in the intestine causes constipation, leading to a feeling of fullness and tightness in the stomach. It is followed by pain, gas, and abdominal discomfort. Constipation results from having less fiber in the diet and not having enough fluids or physical activity. Stress may also lead to constipation.
  • Food allergies, intolerances, and sensitivities: These are common reasons for bloating and distention in the abdomen. Many dairy products, gluten-containing foods, and some carbohydrates are the usual culprits. Foods like shellfish, eggs, and nuts also cause allergies.
  • SIBO: Dysbacteriosis, or the removal of the normal bacterial population from the intestine due to inflammation, infection, or a course of antibiotics, enables abnormal bacteria to establish themselves in the intestine. This affects digestion and the absorption of nutrients from the intestine. Certain foods may also lead to SIBO, causing bloat and distention.
  • Infection: Infection leads to inflammation and other associated symptoms like fever, swollen lymph nodes, and pain. Infection of the gastrointestinal tract results in abdominal pain and gas buildup.
  • Bowel obstruction: A tumor or scar tissue in the stomach may block the lumen of the bowel. It may also lead to the retention of fluid and stool in the intestine. Severe pain and bloating are the most common symptoms of bowel obstruction.
  • Hormonal changes: Changes in hormone levels increase the risk of constipation and fluid retention, which lead to bloating and pain in the abdomen. This is a regular occurrence during the menstrual cycle in women and is not a cause for concern unless accompanied by other symptoms like severe cramping and irregular periods. Many women may experience bloating during different stages of menstruation.
  • Cancer: This is a rare cause of bloating. In most cases, cancer is suspected only when bloating persists and does not resolve with conventional treatments.

Foods that can lead to bloating include sugary sweets or snacks, many dairy products, refined grains, difficult-to-digest foods, carbonated drinks, and artificial sweeteners.

3 Diagnosis and Treatment

Physical examination and medical history are important in diagnosing the underlying cause of bloating. Once the probable cause is determined, other tests are suggested for confirmation.

These tests include complete blood count, celiac serology, upper endoscopy, and duodenal biopsies. Those experiencing nausea, vomiting, and bloating may be asked to take a scan of the small intestine, while those dealing with diarrhea may have to undergo a colonoscopy or stool studies.

Imaging studies are mostly used in the diagnosis of bowel obstruction and bacterial overgrowth. There is no common treatment plan for all patients with bloating; the treatment is individualized based on the underlying cause.

The most common treatment methods are: 

  • Diet: An elimination diet consisting of only a few food groups are recommended for some patients. Once the body is used to it, other groups are gradually added back. This helps analyze the foods that improve symptoms. For other patients, the doctor may recommend removing one offending food from the diet. This also helps identify the causative food.
  • Exercise and posture: Physical exercise helps clear the abdomen of gas and reduce bloating. Retention of gas occurs more in the supine position, so patients are advised to stay in an upright position after eating.
  • Over-the-counter medications: A number of medications are now available to help clear gas and flatulence.
  • Probiotics: Probiotics are thought to confer health benefits by adding beneficial bacteria in the abdomen.
  • Antibiotics: Rifaximin is a commonly recommended antibiotic for the treatment of bloating. This was found to improve the symptoms in patients with IBS.
  • Tricyclic antidepressants: These prescription medications are used to treat abdominal pain mostly associated with functional dyspepsia.
  • Osmotic laxatives: These medications are usually recommended for treating constipation. Osmotic laxatives were found to improve symptoms of bloating.
  • Prokinetic agents: Prokinetic agents are commonly suggested in the treatment of pseudo-obstruction in the colon. These medications were found to be useful in improving clearance of gas in these patients.

Simple lifestyle modifications are important to control bloating. Chewing gum is a common cause of swallowing air and thus a buildup of wind in the abdomen.

Limiting the intake of carbonated beverages and chewing gum helps reduce bloat. Foods that cause gas should also be avoided. Maintaining optimum body weight by having a healthy, balanced diet and regular exercise will also help control this symptom.

Diet is known to play an important role in regulating the amount of air and poop trapped in the digestive tract. To ensure that everything flows smoothly, one should eat foods high in fiber. The aim should be to consume around twenty-five to thirty grams of high fiber every day. Usually, consuming fiber is not difficult, especially for people who eat fruits, green, leafy veggies, nuts, seeds, and legumes. However, one should note that bloating is caused by an individual’s overall lifestyle and is not restricted only to diet. Below are some of the best foods which can help battle stomach bloating:

  • Fruits and veggies rich in water: To relieve stomach bloat, one can consume veggies or fruits rich in water, electrolytes, and beneficial enzymes. Try eating both raw and cooked foods such as fennel, steamed veggies, cucumber, celery, melon, and berries.
  • Probiotics: Probiotics, which are generally called “good bacteria,” are known to maintain gut health in the digestive tract. They kill off the bad bacteria that can trigger issues in digestion due to certain foods or lifestyle changes. There are probiotics available in their natural form, such as yogurt, kefir, kimchi, and kombucha. One can also take probiotic supplements, which are readily available in the market.
  • Tea, spices, and herbs: Herbs, such as ginger, aloe vera, fennel, and dandelion, have been available for thousands of years to naturally promote good digestion and provide a soothing effect. Many of the herbs contain diuretics, which are known to help the body release extra fluid. Some herbs, such as ginger, are known to relax the muscles of the digestive tract and help provide relief from constipation. Green tea is known to be very beneficial for overall health, since it contains anti-inflammatory properties.
  • Dairy products: Consumption of raw diary is much healthier than the commercial products available in the market; the enzymes required for proper digestion get killed during the manufacturing process.

Below is a list of foods to avoid if stomach bloat is present, since these foods tend to make it worse:

  • Carbonated drinks
  • Snacks containing excessive salt or sugar
  • Veggies such as onion, broccoli, cauliflower, and cabbage, which are difficult to digest
  • Chewing gum
  • Flavored yogurts with artificial preservatives
  • Refined grains that contain gluten, which is difficult to digest
  • Legumes and beans, which are known to promote the production of gas

Tips to avoid stomach bloating include:

  • Consultation with a doctor: If suffering from stomach bloat, first, perform a self-check to understand what could be the reason for it. However, one can also consult a doctor, since there are so many disorders and medical conditions that make it difficult to narrow down the exact cause. The doctor may run some tests to figure out the underlying problem, as well as perform a physical examination, stool test, blood test, breath test, check for any transit follow-through, or check for blockages via ultrasound, esophageal manometer, endoscopy, or colonoscopy.
  • Increase fluid intake: To ensure that fiber is doing its job properly, one should drink enough water to avoid bloating. There is no exact amount to consume, but one can start by having at least six to eight glasses of water per day. The most important goal is to stay hydrated to keep bloating at bay. However, “fluids” does not include beverages such as tea, coffee, or carbonated drinks; these drinks can actually worsen the condition. Alcohol is also known to cause bloating along with caffeinated drinks. The best fluid plan would include plain water and fresh fruits or herbal tea, such as green tea.
  • Stay active: Active movement helps keep the digestive tract functioning properly. Staying active fights off constipation and keeps circulation moving, which is essential for body detoxification. One should exercise every day for at least thirty to forty-five minutes. Along with preventing bloat, exercise has multiple health benefits for the body. However, do not overdo any exercise, as it can lead to bloating. When one over trains, the body goes into stress mode, which then causes the adrenal glands to release more of the stress hormone cortisol.
  • Stress reduction: Digestion is impacted by anxiety and stress in a big way. The brain and gut are known to communicate well with each other via the vagus nerve. This is a network of circuitry tissue that lives within the lining of the gastrointestinal tract. These are known to communicate via hormonal and chemical messages to the central nervous system, which is called the enteric nervous system. The brain then triggers the enteric nervous system to produce enzymes, saliva, and secretions, which help in digestion as well as control the hormones mainly responsible for appetite. Hence, feeling sad or disturbed causes changes in this line of communication and the brain, as well as diverts attention away from better digestion, resulting in conditions like bloating. Cortisol levels increase in the body due to high amounts of stress. It is known to alter blood sugar and change the way other hormones are secreted, which at times can cause one to feel very hungry or constipated, or to store fluids.

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