When Bloating May Be Something Serious

Seven serious conditions that cause bloating.

Medically reviewed in December 2019

ultrasound on stomach
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Bloating: it’s a not-so-fresh feeling in your gut that makes you wish you hadn’t eaten so much at lunch. Usually bloating is just an uncomfortable sensation that passes in a few hours, but it can sometimes be a symptom of a more serious condition. Click through to learn about seven times bloating may be a sign that something’s wrong. See your doctor if you have stomach pain with your bloating or if bloating is interfering with your day-to-day activities.

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About half of people over age 60 have bulging pouches in their large intestines called diverticula, which are believed to develop from a diet low in fiber. The inflammation or infection of these pouches is called diverticulitis. Common symptoms of diverticulitis include abdominal pain, bloating, nausea, vomiting, chills, cramps and constipation. Doctors advise patients to eat between 20 and 35 grams of fiber a day to prevent diverticula from becoming inflamed, but severe, repeated cases of diverticulitis may require surgical removal of part of the colon. 

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Ovarian cancer

Ovarian cancer may be relatively rare—about 22,000 cases a year are diagnosed in the US—but it causes more deaths than any other female reproductive cancer. Only about one in five cases are caught early because there are few reliable diagnostic tests. With advanced ovarian cancer, the belly can fill up with fluids, called ascites, and swell; other symptoms include abnormal periods, back pain, weight gain or loss, vaginal bleeding and digestive symptoms like nausea, gas, constipation and indigestion.

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Stomach cancer

Stomach cancer used to be the deadliest cancer in the US until it was surpassed by lung cancer. Like ovarian cancer, only about 20 percent of stomach cancers are caught in the early stages. Stomach cancer shares symptoms with many less serious conditions, such as heartburn, feeling full, nausea, abdominal pain and weight loss. Patients with stomach cancer can also experience bloating, due to a buildup of fluids in the belly.

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Pancreatic conditions

Your pancreas helps turn the food you eat into fuel for your body and helps regulate blood sugar. If the flow of enzymes from the pancreas to the small intestines gets blocked by gallstones or a pancreatic tumor enzymes can travel back to the pancreas and cause inflammation, a condition called pancreatitis. Abdominal swelling is a symptom in about 20 percent of pancreatitis cases.

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Irritable bowel syndrome

Irritable bowel syndrome (IBS) is the second most common cause of work absences, after the common cold. Symptoms include bloating, gas, abdominal pain, constipation and diarrhea. Researchers aren’t sure what causes IBS, but theories include abnormal intestinal contractions, food allergies and overactive nerves in the bowels. Diet changes—such as eating less dairy, legumes and cruciferous vegetables, and getting more fiber—are often recommended as treatment.

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Celiac disease

Going gluten-free has been the health craze for at least a decade. Most people don’t need to go gluten free, but there’s a group of about 2 million Americans who do: those with celiac disease. Celiac disease is an intolerance of gluten—found in wheat, barley and rye—that causes the immune system to attack the small intestine. Adults with celiac disease are less likely than children to be affected by bloating, but can develop headaches, fatigue, weak bones, depression, anxiety and infertility. Celiac disease can also prevent the small intestine from absorbing nutrients, leading to malnutrition.

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If your stomach is bloated and you have swollen legs, fatigue, lack of appetite, jaundice (yellowing of the skin and eyes) and weight loss, get your liver checked—especially if you drink too much or have hepatitis. These symptoms could be from cirrhosis, a scarring of the liver. Cirrhosis causes ascites and can lead to gallstones, kidney failure, high blood pressure in the vein that supplies blood to the liver (a condition called portal hypertension) and even liver cancer.

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Other causes

Just because you’re bloated doesn’t mean you need to panic. Bloating can have many less serious causes, from swallowing air, to eating too much, to lactose intolerance. Luckily, it’s easy to relieve discomfort from everyday bloating. Try going for a short walk, stretching or drinking a glass of water.

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