Tom Le Goff
The question
How can I reduce bloating? I experience it several times a week. Could it be a sign of a bigger health issue?
The answer
Bloating is a sensation of the belly feeling full and tight. It is usually caused by swallowing air or by gas produced from the digestion of food. The intensity of pain depends on the amount of gas and your sensitivity to the sensation of gas stretching the stomach and intestinal walls. When gas does not pass through burping or flatulence, it can build up and lead to uncomfortable bloating.
For some, bloating occurs occasionally and for others it can occur repeatedly in a single day. Most cases of bloating are due to digestion or intolerance to food - but in rare occasions, bloating may a warning sign of a more serious medical problem.
The most common causes of bloating include:
Overeating
Swallowing air: You may swallow air when eating or drinking too quickly, talking while eating, chewing gum or drinking carbonated beverages. Smoking can also increase gas (because when you inhale smoke, you are also swallowing air.)
Irritable bowel syndrome (IBS): A relatively common condition that causes increased sensitivity to the sensation of gas pressure and can have symptoms of bloating, diarrhea, constipation and abdominal pain.
Diet: Some foods can be difficult for the body to digest and can lead to a sensation of fullness. Common culprits include beans, broccoli, cabbage, carbonated drinks, coffee, sorbitol/fructose products (such as chewing gum) and alcohol.
Food intolerance: Gluten, nuts, dairy products and wheat are the most common foods associated with food intolerance, meaning that the body is potentially missing an enzyme required to break down these foods.
Constipation: Infrequent, hard stools or straining to have a bowel movement may mean that you are constipated. Over time, constipation can lead to bloating, abdominal pain and, if left for too long can lead to serious complications.
Hormonal changes: At different times during your menstrual cycle, bloating can occur due to changes in hormonal levels.
Medical conditions: Certain conditions including diabetes and HIV can lead to a slowing of activity of the intestines over time and can lead to bloating. In addition to the burning sensation and discomfort of reflux disease or heartburn, bloating can also occur.
Here are some tips, if you are experiencing uncomfortable bloating:
Keep track of foods you've eaten when you feel bloated to identify potential triggers.
Decrease the amount of air you swallow: Eat and drink slowly and avoid carbonated drinks, smoking and beer. Ill-fitting dentures can also increase air swallowing when eating, so a quick check-in with your dentist may be helpful.
Drink water, increase fibre and exercise regularly: These three changes can aid with digestion and help to prevent constipation by moving things along in the intestines. Exercise specifically can significantly help decrease bloating associated with menstruation.
Over-the-counter medications: There are multiple options for bloating to be found over the counter. Some people find it helpful to use probiotics to rebalance normal bacterial content in the intestines. Beano may help with digestion of legumes and if you have been diagnosed with lactose intolerance, there are enzymes that can help digest dairy products.
Uncommon but important causes of bloating include bowel obstruction or cancer such as those arising from the liver, uterus, stomach or ovaries. Ovarian cancer is often not detected until very late in its course because it has few symptoms until it has progressed. It is now recognized that bloating is a symptom that may help identify this cancer earlier.
If you suffer from persistent bloating, have noted changes in your menstrual cycle, vaginal bleeding after menopause or frequent urination - I would strongly recommend visiting your doctor to rule out this serious cause.
Occasional episodes of bloating usually resolve on their own with diet modification and behavior change. If you have made these changes without any resolution of symptoms, or you are experiencing persistent bloating or heartburn, diarrhea, nausea/vomiting, weight loss, fever, blood in the stool or severe abdominal pain - I would recommend seeing your doctor as these symptoms may be a warning sign for something more serious.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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