Bloating

Last updated
Bloating
Specialty Gastroenterology   OOjs UI icon edit-ltr-progressive.svg
Symptoms
DurationA few hours to days
Causes
Risk factors
Prevention
  • Eating high fiber foods
  • Drinking water
  • Exercise
Treatment
Frequency
  • 10–25% of healthy people
  • 75% of women experience bloating before or during their period
  • 10% Experience bloating regularly[ citation needed ]

Abdominal bloating (or simply bloating) is a short-term disease that affects the gastrointestinal tract. [1] [2] Bloating is generally characterized by an excess buildup of gas, air or fluids in the stomach. A person may have feelings of tightness, pressure or fullness in the stomach; it may or may not be accompanied by a visibly distended abdomen. [3] Bloating can affect anyone of any age range and is usually self-diagnosed, in most cases does not require serious medical attention or treatment. [4] [5] Although this term is usually used interchangeably with abdominal distension, these symptoms probably have different pathophysiological processes, which are not fully understood. [6]

Contents

The first step for the management is to find a treatment for the underlying causes that produce it through a detailed medical history and a physical examination. The discomfort can be alleviated by the use of certain drugs and dietary modifications. [4]

Bloating can also be caused by chronic conditions and in rare cases can be a reoccurring life-threatening problem. [7]

Symptoms and signs

The most common symptom associated with bloating is a sensation that the abdomen is full or distended. Rarely, bloating may be painful or cause shortness of breath.[ citation needed ]

Pains that are due to bloating will feel sharp and cause the stomach to cramp. These pains may occur anywhere in the body and can change locations quickly. [8] They are so painful that they are sometimes mistaken for heart pains when they develop on the upper left side of the chest. Pains on the right side are often confused with problems in the appendix or the gallbladder.

One symptom of gas that is not normally associated with it is the hiccup. Hiccups are harmless and will diminish on their own; they also help to release gas that is in the digestive tract before it moves down to the intestines and causes bloating. Important but uncommon causes of abdominal bloating include ascites and tumors. [9]

Causes

There are many causes of bloating, including: diet, irritable bowel syndrome, lactose intolerance, reflux, and constipation. [10] [11] [12] [13] Specific medical conditions like Crohn's disease or bowel obstruction can also contribute to the amount of stomach bloating experienced.

Common causes of abdominal bloating are:

Important but uncommon causes of abdominal bloating include:

In animals, causes of abdominal bloating include:

All the factors mentioned contribute to bloated stomach abdominal pain.

Every person produces gases in their body during the digestion of food, such as methane, hydrogen, carbon dioxide, and nitrogen. And some of them are released outside the body, sometimes in small quantities that one does not notice and sometimes in larger quantities that may affect the normal course of life.

Fiber

Most cases of stomach bloating are due to improper diet.[ medical citation needed ] Gas occurs because of the bacteria in the colon and is a by-product of soluble fiber digestion. Inadequate or irregular intake of fiber and water will cause a person to experience bloating or constipation. The most common natural sources of fiber include fruits and vegetables as well as wheat or oat bran. These fibers are most likely to cause flatulence. [29] Fiber is made by plants and is not easily digested by the human gastrointestinal tract. There are two main types of dietary fiber: soluble and insoluble fiber. Soluble fiber is prebiotic and readily fermented in the colon into gases, while insoluble fiber is metabolically inert and absorbs water as it moves through the digestive system, aiding in defecation. Most types of fiber (insoluble) are attached to body water in the intestine and increase the volume of stools.[ citation needed ]

Bowel gas

Gas in the gastrointestinal tract has only two sources. It is either swallowed air or is produced by bacteria that normally inhabit the intestines, primarily the colon. [30]

Belching or burping is a universal ability that works by removing gas from the stomach through the mouth. The stomach can become bloated when too much air is swallowed during eating and drinking too quickly. As the stomach swells, belching removes the gas and alleviates the pain associated with it. Burping can also be used as a form of relief from abdominal discomfort other than too much gas in the stomach.[ citation needed ]

Flatulence, or farting, provides relief of much the same kind as burping, but involves the passage of gas from the body via the anus, not the mouth. Bacteria present in the intestinal tract cause gas that is expelled from the anus. They produce the gas as food is digested and moved from the small intestine. This gas builds up and causes swelling or bloating in the abdominal area before it is released.

Constipation

A common gastrointestinal problem is constipation—infrequent bowel movements, hard stools, or strain during the movements—which causes serious cases of bloating. Since most cases of constipation are temporary, simple lifestyle changes, such as getting more exercise and increasing one's intake of fiber, can contribute to alleviating constipation. [31] Some cases of constipation will continue to worsen and require unconventional methods to release the feces and reduce the amount of stomach bloating. Blood in the stool, intense pain in the abdomen, rectal pain, unexplained weight loss, and continued bloating and constipation not relieved by the above lifestyle changes should be reported to a doctor. Bloating consistently accompanies constipation, and they will not develop without an underlying cause. [22]

Heartburn and acid reflux

Painful burning sensations in the chest that are caused by gastroesophageal reflux is known as heartburn. Reflux is the backflow of gastric acid juices from the stomach into the oesophagus. [32] Heartburn has different triggers, including certain foods, medications, obesity, and stress. These triggers are different for each individual. Gastroesophageal reflux disease or GERD is a chronic condition that can lead to more serious complications like esophageal cancer. [33] Treatment options are available to treat the symptoms and the condition, but there is no cure for the disease. Symptoms include burping, abdominal and stomach bloating, along with pain and discomfort. Heavy meals, lying down or bending over after eating should be avoided to help prevent reflux from occurring. The stomach bloating experienced with reflux is intense and will remain until the food is digested all the way.

Postmortem bloating occurs in cadavers, due to the formation of gases by bacterial action and putrefaction of the internal tissues of the abdomen and the inside of the intestines. [34]

Conditions that are related to bloating include constipation, lactose intolerance, and acid reflux disease. [32] All of these conditions share the same symptoms and can share the same causative agents. These causes include unhealthy diet, smoking, alcohol consumption, low amount of exercise, and overall health. Each of these conditions can be experienced as a symptom of the others and is also a cause for each of them. In most cases where one of the conditions is present, there is at least one if not two of the others. Treatment for each condition is performed using the same medications and recommended dietary changes like increased fiber intake and reduced fat intake. If the conditions develop into diseases such as gastroesophageal reflux disease or chronic constipation, additional medications will be required. Bloating and flatulence are sometimes related to constipation, and treating the underlying condition may be helpful. [35]

Treatment

Diets

Promising evidence on the potential efficacy of the low-FODMAP diet in functional abdominal bloating is provided by the reduction of the bloating which has been observed in some studies on patients with irritable bowel syndrome. Regarding the gluten-free diet, there is insufficient scientific evidence to recommend it to reduce bloating and abdominal distension. [36] As regards the FODMAP diet, this should be provided by experts in nutrition to reduce the risks associated with elimination diets. [37]

Medications

There are many over-the-counter (OTC) medications that can be used to treat bloating. Food enzymes can be found in some products that will help break down the sugars found in grains, vegetables and dairy products. They can be taken before food is consumed or added to the food that causes the gas and bloating. [38] The most common treatment is antacids. These medications have no effect on the gas that is present in the intestines but enable gas build-up to be belched away more easily, reducing the amount of bloating that develops. Another treatment is simethicone, an oral anti-foaming agent that helps the body to expel the gas more quickly. Combinations of prokinetics, such as domperidone + metoclopramide + diphenhydramine (the latter for the prevention of extrapyramidal reactions, especially acute dystonic reactions) + proton pump inhibitors (PPIs), have dramatic effects on bloaters and belchers especially.[ citation needed ]

See also

Related Research Articles

Flatulence is the expulsion of gas from the intestines via the anus, commonly referred to as farting. "Flatus" is the medical word for gas generated in the stomach or bowels. A proportion of intestinal gas may be swallowed environmental air, and hence flatus is not entirely generated in the stomach or bowels. The scientific study of this area of medicine is termed flatology.

<span class="mw-page-title-main">Defecation</span> Expulsion of feces from the digestive tract

Defecation follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus or cloaca. The act has a variety of names ranging from the common, like pooping or crapping, to the technical, e.g. bowel movement, to the obscene (shitting), to the euphemistic, to the juvenile. The topic, usually avoided in polite company, can become the basis for some potty humor.

<span class="mw-page-title-main">Constipation</span> Infrequent or difficult bowel movements

Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

<span class="mw-page-title-main">Irritable bowel syndrome</span> Functional gastrointestinal disorder

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by a group of symptoms that commonly include abdominal pain, abdominal bloating and changes in the consistency of bowel movements. These symptoms may occur over a long time, sometimes for years. IBS can negatively affect quality of life and may result in missed school or work or reduced productivity at work. Disorders such as anxiety, major depression, and chronic fatigue syndrome are common among people with IBS.

<span class="mw-page-title-main">Stomach rumble</span> Noise produced by gastrointestinal system

A stomach rumble, also known as a bowel sound, peristaltic sound, abdominal sound, bubble gut or borborygmus, is a rumbling, growling or gurgling noise produced by movement of the contents of the gastrointestinal tract as they are propelled through the small intestine by a series of muscle contractions called peristalsis. A trained healthcare provider can listen to these intestinal noises with a stethoscope, but they may be audible enough to be heard with the naked ear as the fluid and gas move forward in the intestines. The lack of bowel sounds is indicative of ileus, intestinal obstruction, or some other serious pathology.

<span class="mw-page-title-main">Bowel obstruction</span> Mechanical or functional obstruction of the intestines

Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital.

<span class="mw-page-title-main">Gluten-free diet</span> Diet excluding proteins found in wheat, barley, and rye

A gluten-free diet (GFD) is a nutritional plan that strictly excludes gluten, which is a mixture of prolamin proteins found in wheat, as well as barley, rye, and oats. The inclusion of oats in a gluten-free diet remains controversial, and may depend on the oat cultivar and the frequent cross-contamination with other gluten-containing cereals.

<span class="mw-page-title-main">Fructose malabsorption</span> Medical condition

Fructose malabsorption, formerly named dietary fructose intolerance (DFI), is a digestive disorder in which absorption of fructose is impaired by deficient fructose carriers in the small intestine's enterocytes. This results in an increased concentration of fructose. Intolerance to fructose was first identified and reported in 1956.

<span class="mw-page-title-main">Malabsorption</span> Abnormality in absorption of food nutrients across the gastrointestinal tract

Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal (GI) tract. Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anaemias.

<span class="mw-page-title-main">Achlorhydria</span> Lack of hydrochloric acid production in the digestive organs

Achlorhydria and hypochlorhydria refer to states where the production of hydrochloric acid in gastric secretions of the stomach and other digestive organs is absent or low, respectively. It is associated with various other medical problems.

<span class="mw-page-title-main">Ileus</span> Disruption to the propulsive ability of the intestine

Ileus is a disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction. The word 'ileus' derives from Ancient Greek εἰλεός (eileós) 'intestinal obstruction'. The term 'subileus' refers to a partial obstruction.

<span class="mw-page-title-main">Small intestinal bacterial overgrowth</span> Medical condition

Small intestinal bacterial overgrowth (SIBO), also termed bacterial overgrowth, or small bowel bacterial overgrowth syndrome (SBBOS), is a disorder of excessive bacterial growth in the small intestine. Unlike the colon, which is rich with bacteria, the small bowel usually has fewer than 100,000 organisms per millilitre. Patients with bacterial overgrowth typically develop symptoms which may include nausea, bloating, vomiting, diarrhea, malnutrition, weight loss, and malabsorption by various mechanisms.

Food intolerance is a detrimental reaction, often delayed, to a food, beverage, food additive, or compound found in foods that produces symptoms in one or more body organs and systems, but generally refers to reactions other than food allergy. Food hypersensitivity is used to refer broadly to both food intolerances and food allergies.

<span class="mw-page-title-main">Volvulus</span> Twisting of part of the intestine, causing a bowel obstruction

A volvulus is when a loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction. Symptoms include abdominal pain, abdominal bloating, vomiting, constipation, and bloody stool. Onset of symptoms may be rapid or more gradual. The mesentery may become so tightly twisted that blood flow to part of the intestine is cut off, resulting in ischemic bowel. In this situation there may be fever or significant pain when the abdomen is touched.

Aerophagia is a condition of excessive air swallowing, which goes to the stomach instead of the lungs. Aerophagia may also refer to an unusual condition where the primary symptom is excessive flatus (farting), belching (burping) is not present, and the actual mechanism by which air enters the gut is obscure or unknown. Aerophagia in psychiatry is sometimes attributed to nervousness or anxiety.

<span class="mw-page-title-main">Abdominal distension</span> Physical symptom

Abdominal distension occurs when substances, such as air (gas) or fluid, accumulate in the abdomen causing its expansion. It is typically a symptom of an underlying disease or dysfunction in the body, rather than an illness in its own right. People with this condition often describe it as "feeling bloated". Affected people often experience a sensation of fullness, abdominal pressure, and sometimes nausea, pain, or cramping. In the most extreme cases, upward pressure on the diaphragm and lungs can also cause shortness of breath. Through a variety of causes, bloating is most commonly due to buildup of gas in the stomach, small intestine, or colon. The pressure sensation is often relieved, or at least lessened, by belching or flatulence. Medications that settle gas in the stomach and intestines are also commonly used to treat the discomfort and lessen the abdominal distension.

<span class="mw-page-title-main">Lubiprostone</span> Medication used for constipation

Lubiprostone, sold under the brand name Amitiza among others, is a medication used in the management of chronic idiopathic constipation, predominantly irritable bowel syndrome-associated constipation in women and opioid-induced constipation. The drug is owned by Mallinckrodt and is marketed by Takeda Pharmaceutical Company.

FODMAPs or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are short-chain carbohydrates that are poorly absorbed in the small intestine and ferment in the colon. They include short-chain oligosaccharide polymers of fructose (fructans) and galactooligosaccharides, disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols), such as sorbitol, mannitol, xylitol, and maltitol. Most FODMAPs are naturally present in food and the human diet, but the polyols may be added artificially in commercially prepared foods and beverages.

Non-celiac gluten sensitivity (NCGS) or gluten sensitivity is a controversial disorder which can cause both gastrointestinal and other problems.

A low-FODMAP diet is a person's global restriction of consumption of all fermentable carbohydrates (FODMAPs), recommended only for a short time. A low-FODMAP diet is recommended for managing patients with irritable bowel syndrome (IBS) and can reduce digestive symptoms of IBS including bloating and flatulence.

References

Notes

  1. ↑ staff, familydoctor org editorial; Rice, Alex. "Bloating - Bloated Stomach - What Causes Bloating?". familydoctor.org. Archived from the original on 2023-04-16. Retrieved 2022-02-22.
  2. ↑ "Bloated Stomach: Causes, Tips to Reduce & When to be Concerned". Cleveland Clinic. Archived from the original on 2023-09-26. Retrieved 2022-02-22.
  3. ↑ "Bloating: Causes and Prevention Tips". www.hopkinsmedicine.org. 20 September 2021. Archived from the original on 2023-09-26. Retrieved 2022-02-22.
  4. 1 2 3 Seo AY, Kim N, Oh DH (2013). "Abdominal bloating: pathophysiology and treatment". J Neurogastroenterol Motil (Review). 19 (4): 433–53. doi:10.5056/jnm.2013.19.4.433. PMC   3816178 . PMID   24199004.
  5. ↑ Abdominal bloating Archived 2016-07-05 at the Wayback Machine , National Institutes of Health, Retrieved November 7, 2013
  6. ↑ Lacy BE, Gabbard SL, Crowell MD (2011). "Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?". Gastroenterol Hepatol (N Y) (Review). 7 (11): 729–39. PMC   3264926 . PMID   22298969.
  7. ↑ "Abdominal bloating: Causes, symptoms and remedies". www.medicalnewstoday.com. 2020-01-14. Archived from the original on 2022-02-22. Retrieved 2022-02-22.
  8. ↑ Gas and Gas Pains Archived 2010-02-13 at the Wayback Machine Mayo Clinic. Retrieved on 2010-01-26
  9. ↑ Abdominal Bloating Archived 2016-07-05 at the Wayback Machine MedLine Plus. Retrieved on 2010-01-26
  10. ↑ Talley NJ (November 2006). "Irritable bowel syndrome". Internal Medicine Journal. 36 (11): 724–8. doi:10.1111/j.1445-5994.2006.01217.x. PMC   1761148 . PMID   17040359.
  11. ↑ "Lactose Intolerance". NIDDK. June 2014. Archived from the original on 25 October 2016. Retrieved 25 October 2016.
  12. ↑ "Acid Reflux (GER & GERD) in Adults". National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 5 November 2015. Archived from the original on 22 February 2020. Retrieved 21 February 2020.
  13. ↑ "Constipation". The Lecturio Medical Concept Library. Archived from the original on 12 July 2021. Retrieved 10 July 2021.
  14. ↑ Brunicardi, Charles (2015). Schwartz's Principles of Surgery (10 ed.). McGraw-Hill. pp. ch 26.
  15. ↑ "Lactose Intolerance". The Lecturio Medical Concept Library. Archived from the original on 27 July 2021. Retrieved 27 July 2021.
  16. ↑ "Premenstrual syndrome (PMS) fact sheet". Office on Women's Health. December 23, 2014. Archived from the original on 28 June 2015. Retrieved 23 June 2015.
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  18. ↑ National Institute of Allergy and Infectious Diseases (July 2012). "Food Allergy An Overview" (PDF). Archived from the original (PDF) on 2016-03-05.
  19. ↑ Levitt MD, Furne J, Aeolus MR, Suarez FL (1998). "Evaluation of an extremely flatulent patient: case report and proposed diagnostic and therapeutic approach". Am J Gastroenterol. 93 (11): 2276–81. doi:10.1111/j.1572-0241.1998.00635.x. PMID   9820415. S2CID   20991299.
  20. ↑ "Symptoms & Causes of Celiac Disease". NIDDK. June 2016. Archived from the original on 24 April 2017. Retrieved 15 April 2018.
  21. ↑ Czaja-Bulsa G (Apr 2015). "Non coeliac gluten sensitivity – A new disease with gluten intolerance". Clin Nutr (Review). 34 (2): 189–94. doi: 10.1016/j.clnu.2014.08.012 . PMID   25245857.
  22. 1 2 "Constipation". The Lecturio Medical Concept Library. Archived from the original on 12 July 2021. Retrieved 27 July 2021.
  23. ↑ Feuerstein, JD; Falchuk, KR (August 2016). "Diverticulosis and Diverticulitis". Mayo Clinic Proceedings (Review). 91 (8): 1094–1104. doi: 10.1016/j.mayocp.2016.03.012 . PMID   27156370.
  24. ↑ "Ovarian Cancer Prevention". NCI. December 6, 2013. Archived from the original on 6 July 2014. Retrieved 1 July 2014.
  25. ↑ Seiden, Michael (2015). "Gynecologic Malignancies, Chapter 117". MGraw-Hill Medical. Archived from the original on September 10, 2017. Retrieved June 24, 2017.
  26. ↑ "Megacolon". The Lecturio Medical Concept Library. Archived from the original on 27 July 2021. Retrieved 27 July 2021.
  27. ↑ "Cardiopulmonary Resuscitation (CPR)". The Lecturio Medical Concept Library. Archived from the original on 5 August 2021. Retrieved 5 August 2021.
  28. ↑ Bloat in Dogs: Causes, Risks and Treatment Archived 2018-02-06 at the Wayback Machine Pack of Pets. Retrieved on 2018-02-05
  29. ↑ Fiber And Increased Gas Archived 2010-01-19 at the Wayback Machine MedicineNet. Retrieved on 2010-01-19
  30. ↑ What Causes Flatulence, bloating [ permanent dead link ] thesananews.com Retrieved on 2021-09-27
  31. ↑ Constipation Definition Archived 2010-02-11 at the Wayback Machine Mayo Clinic Retrieved on 2010-01-19
  32. 1 2 "Gastroesophageal Reflux Disease". The Lecturio Medical Concept Library. Archived from the original on 24 February 2024. Retrieved 23 July 2021.
  33. ↑ "Esophageal Cancer". The Lecturio Medical Concept Library. 26 October 2020. Archived from the original on 22 July 2021. Retrieved 23 July 2021.
  34. ↑ Shedge R, Krishan K, Warrier V, et al. (2022). "Postmortem Changes". National Center for Biotechnology Information, U.S. National Library of Medicine. PMID   30969563 . Retrieved 23 July 2021.
  35. ↑ Belching Bloating and Flatulence Archived 2010-05-01 at the Wayback Machine American College of Gastroenterology. Retrieved on 2010-01-26
  36. ↑ Pessarelli, T., Sorge, A., Elli, L., & Costantino, A. The Gluten-free Diet and the Low-FODMAP Diet in the Management of Functional Abdominal Bloating and Distension. Frontiers in Nutrition, 2680.
  37. ↑ Pessarelli, T., Sorge, A., Elli, L., & Costantino, A. The Gluten-free Diet and the Low-FODMAP Diet in the Management of Functional Abdominal Bloating and Distension. Frontiers in Nutrition, 2680.
  38. ↑ Hasler, WL. (2006). "Gas and Bloating". Gastroenterology & hepatology. 2 (9): 654–662. PMC   5350578 . PMID   28316536.

Bibliography

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