Bloating: Common Causes, Remedies, and When To Seek Care

Bloating is a feeling of fullness and discomfort in the abdomen. This part of the body can also become "distended," which means it is swollen. A wide range of factors can cause bloating, including overeating, eating certain foods, constipation, swallowing air, or conditions like irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD).

Bloating is estimated to affect between 16-31% of people and usually is not a sign of anything serious. If the issue becomes chronic, it can significantly impact your quality of life. Bloating accompanied by other symptoms may indicate the need for medical attention.

Symptoms That Accompany Bloating

Bloating is a symptom, not a condition or disease in itself. But it's sometimes accompanied by other symptoms. Bloating is a subjective feeling, meaning it cannot be seen or measured by your healthcare provider. The symptoms that come with it are mostly temporary and resolve on their own.

Typical signs and symptoms that come with bloating include:

• Belching or flatulence (farting)
• Discomfort in the upper abdomen, just below the rib cage
• Distention, or swelling and expansion of the abdomen
• A feeling of fullness or tightness in the abdomen

If your bloating is chronic, it can also seriously impact your quality of life. Discomfort caused by bloating can inhibit you from completing your daily tasks.

What Causes It?

Bloating can be caused by a variety of behaviors and conditions. It is generally agreed that bloating occurs when your intestines struggle to handle the gas produced during digestion, although more research is needed. Bloating can be triggered by your diet, food intolerances or allergies, and certain conditions.

Dietary Factors

Many cases of bloating are directly associated with what or how you eat and drink, such as if you:

• Consume foods or medications high in lactulose or sorbitol, which are sugar substitutes
• Drink alcohol
• Eat too much in one sitting
• Have a high-fiber diet
• Swallow air, especially while eating

Allergies and Food Intolerances

Bloating can occur due to food sensitivities, intolerances, or allergies. Having a food intolerance means that your body is unable to properly digest a certain food or type of food.

Common food intolerances include:

• Carbohydrates
• Gluten, which is found in wheat and grains, among other foods
• Lactose, which is found in milk

Food allergies can be life-threatening. They occur when your body has an overactive immune response, often causing difficulty breathing and hypotension (low blood pressure). Common food allergies include peanuts, tea nuts, shellfish, milk, and eggs, among others.

Food sensitivities occur when your body has a negative response to food that cannot be attributed to intolerance or allergy. You may develop bloating if you eat food you are sensitive to in large amounts.

Health Conditions

A great deal of health conditions can cause bloating, including:

• Ascites, or a build-up of fluid in the abdomen
• Constipation
• Gastroesophageal reflux disease (GERD)
• Irritable bowel syndrome (IBS)
• Pelvic floor dysfunction, which is characterized by weak pelvic muscles
• Small bowel bacterial overgrowth (SIBO), in which excessive bacteria grow in the small intestine

Other conditions that can contribute to bloating are:

• Abdominal tumor
• Celiac disease, which is an inability to digest gluten
• Dumping syndrome, or a condition that causes nausea, diarrhea, and light-headedness after eating
• Gastroparesis, or a muscular disorder that slows the movement of food from your stomach to your intestines
• Ovarian cancer
• Pancreatic insufficiency, in which the pancreas does not produce enough digestive enzymes

What Should You Do When You Feel Bloated?

Bloating can cause a significant amount of discomfort, but it generally does not require medical treatment. If you are feeling symptoms, there are several ways to ease them at home:

• Abdominal self-massage: Lay on the ground and rub your abdomen in a clockwise, circular motion.
• Antacids: These are over-the-counter (OTC) medicines that help neutralize the acid in your stomach. Antacid brands include Alka Seltzer, Mylanta Gas, and Maalox Anti Gas.
• Lactaid: If lactose intolerance is causing your bloating, the OTC medication Lactaid (lactase) contains enzymes that can ease symptoms.
• Light activity: Going for a walk or doing light physical activity can promote digestion.
• Pepto-Bismol: If your bloating is related to an upset stomach, Pepto-Bismol (bismuth subsalicylate) may help.

Long-Term Treatment

If you have chronic bloating or it comes back often, there are several options for managing and preventing it. Management focuses on changing your dietary and lifestyle habits, avoiding triggering foods, and addressing underlying causes.

Dietary Changes

Modifying what and how you eat and drink can go a long way in managing bloating. These approaches include:

• Add herbs: Adding certain herbs and spices to your diet can help with flatulence. These include cumin, ginger, dill, parsley, and others.  
• Cut out artificial sugars: Steer clear of foods containing sorbitol or other kinds of artificial sugars.
• Eat slowly: If you eat too quickly, you are more likely to overeat and inhale air while eating, which can trigger bloating. Slowing down and chewing food fully can be a preventive measure.
• Identify food triggers: Keep a food diary and figure out what your trigger foods are. Once you identify them you will be able to avoid them.
• Practice portion control: Have 4-7 smaller meals a day (rather than the standard three) and steer clear of high-fat foods and foods with simple carbohydrates when you eat.
• Skip drinking while eating: Drinking any beverage while eating or immediately after eating can promote flatulence. Wait an hour after eating before doing so.
• Steer clear of carbonated beverages: The bubbles from carbonated sodas or other beverages can trigger bloating.
• Try a low FODMAP diet: Avoid foods high in carbohydrates or other sugars that cause bloating, known as FODMAPs.

Lifestyle Changes

Other lifestyle changes you can try include:

• Avoid smoking: Smoking or using tobacco products can also impact digestion, among other negative health effects.
• Do not chew gum: When you chew gum, you tend to swallow air, which can cause bloating. Sucking on candies can also have the same effect.
• Get active: Boosting your level of physical activity has been shown to promote healthier digestion.
• Reduce alcohol: Since alcohol can also cause bloating, limit or cut out your consumption.

Treating Underlying Causes

If your bloating has been linked to a health condition, treating it should also help ease your bloating. Seek out care and keep up with prescribed treatment. Make sure to carefully follow a healthcare provider's instructions.

If your bloating is associated with SIBO, you may be prescribed antibiotics to manage the condition. If constipation is the issue, lifestyle interventions, medications, and gradually increasing fiber in your diet and water intake may help.

When To Seek Care

Unless it becomes chronic or recurrent, bloating usually is not serious. If you are finding the issue disruptive or if it does not go away, it is worth seeking medical attention.

Certain symptoms alongside this issue may be signs of a more significant health issue. Call a healthcare provider if you experience:

• Blood in your stool, or stool that has a dark, tarry appearance
• Diarrhea
• Nausea or vomiting
• Pain in the abdomen
• Weight loss  
• Worsening heartburn (stomach acid that backs up into your esophagus)

A Quick Review

Bloating is a feeling of fullness in the abdomen, sometimes accompanied by expansion of the belly as well as gas and belching. This can be caused by many factors, including eating too quickly and consuming triggering foods. Conditions like food allergy or intolerance, constipation, and GERD can also be the culprit.