You know it: The tight, full, uncomfortable feeling in your abdomen that begs you to loosen your belt a couple of notches or change into a comfy pair of stretchy sweatpants. And it's not because you ate too much. Your distended belly is the result of something amiss in your gastrointestinal (GI) tract.
So what causes abdominal bloating? If you guessed gas, that's a good guess. Excess gas can definitely make you feel uncomfortably full, and it can be the culprit for some people who experience bloating. Gas develops from:
- Air swallowed while eating, drinking (especially carbonated beverages), chewing gum, smoking, sucking on hard candy, or wearing ill-fitting dental appliances (dentures, retainers, etc.).
- Undigested food passing into the large intestine, where friendly bacteria break it down, releasing gas in the process. Top gas producers include undigested carbohydrates, soluble fiber, artificial sweeteners, and certain sugars found in fruit, vegetables, legumes, and dairy products.
Everyone passes gas -- anywhere between 10 to 25 times a day is considered normal. Now, here's the catch: Many people think gas and bloating are one and the same, so when people are bloated, they're likely to attribute their symptoms to excess gas. But excess gas is not always the culprit. It's possible to feel bloated even when producing a normal amount of gas. So what's going on down there?
The Real Culprits
The truth is that in addition to excess gas, there are a number of possible causes of bloating. One of the most common is a group of conditions known as functional gastrointestinal disorders. These disorders alter the way the GI tract works, but many of them have no known cause. If you suffer from uncomfortable GI symptoms, a doctor may perform lab tests to rule out diseases such as Crohn's or cancer. But if the results come back normal, it's possible that a functional GI disorder is causing your symptoms. And there may not be an obvious reason for those symptoms.
For example, someone with chronic bloating may not have an excessive amount of gas in the intestine -- but he or she still feels uncomfortable. It doesn't mean that the bloating isn't real; it just means that nothing out of the ordinary can be found with medical testing.
Doctors speculate that some people with functional GI disorders may simply be unusually sensitive to pain and normal amounts of gas in the gut. Or it could be that the muscle contractions along their GI tracts are not coordinated, which can cause unpleasant symptoms. Or there could be some other yet-to-be-defined reason for their discomfort.
Recent research has shown that, for some people, abnormal levels of serotonin -- a chemical neurotransmitter that is present mainly in the digestive tract -- play a role in certain functional GI disorders.
Bloating is a very common symptom of many functional GI disorders. In fact, up to 96% of people with functional GI disorders experience bloating.
Irritable bowel syndrome (IBS) is one of the most common functional GI disorders, affecting as many as one in five Americans. The condition causes abdominal bloating, pain, or discomfort. People with IBS also experience constipation, diarrhea, or alternating periods of both.
Other examples of functional GI disorders include dyspepsia, chronic constipation, chronic diarrhea, and chronic bloating.
If you suffer from abdominal bloating that is not the result of a medical condition, modifying your diet is a good first step. Change not only what you eat but also how you eat. Follow these tips:
1. Eat small meals frequently throughout the day.
2. Chew food thoroughly to aid digestion.
3. Sit up straight while eating.
4. Avoid drinking carbonated beverages.
5. Avoid high-fat meals; they slow digestion. Food lingers longer in the colon, and intestinal bacteria produce more gas.
6. Exercise every day to help maintain healthy bowel function.
7. Reduce gas-provoking foods in your diet.
Remember -- fruit, vegetables, dairy products, and whole grains are part of a healthy diet, so talk to your doctor if you have trouble tolerating them. He or she can recommend a nutritionally balanced diet that suits your needs. You may be able to ward off the effects of gas-forming foods by taking enzymes before you eat. For example, if you're lactose intolerant, lactase tablets may help you digest dairy products better. And Beano® tablets can help you ward off gas caused by eating legumes, whole grains, and vegetables.
Several herbs are well-known digestion aids as well. Try brewing up a cup of peppermint, chamomile, or fennel tea to help ease bloating. If that doesn't bring relief, you can try over-the-counter medications containing bismuth subsalicylate (Pepto-Bismol) or simethicone (e.g., Alka-Seltzer, Mylanta, Maalox, Gas-X). If your bloating is chronic or severe, your healthcare provider may recommend a prescription medication to relieve your bloating and associated symptoms.
When to See a Doctor
Usually, occasional bloating isn't a problem. But if dietary modifications or home remedies don't alleviate your symptoms and your bloating is bothersome, ongoing, or accompanied by other worrisome symptoms (nausea, vomiting, diarrhea, constipation, abdominal pain, bleeding, fever, or weight loss), you should be evaluated by your physician. The root cause of chronic bloating can be a medical condition, such as IBS, chronic constipation, or something more serious, like a bowel obstruction, Crohn's disease, celiac disease, or cancer.