Bloating- Causes, Diagnosis, and Management

Introduction:

Bloating is the most common symptom and can cause trouble giving an uncomfortable feeling to the abdomen. Bloating is when the belly (abdomen) feels full and tight, often due to gas. The abdomen may be swollen, stiff, and painful. Bloating differs from abdominal distension. Distension is a visible or measurable increase in the size of the stomach. Bloating and distension can occur independently, but mostly they co-exist. Bloating is usually associated with gastrointestinal disorders, but it may also appear alone. Bloating affects men and women of all ages. Bloating is also known as meteorism. The severity of bloating varies from mild discomfort to severe and can be troublesome, affecting normal day-to-day activities.

What Causes the Sensation of Bloating?

The cause of bloating is multifactorial and often misunderstood. Bloating is frequently triggered by gas, particularly following meals, as it is a natural component of the digestive process. Gas pain can arise when gas becomes trapped or moves sluggishly within the digestive system, and an uptick in gas or discomfort can be the outcome of consuming foods known to generate gas. Gas is usually released from the body either by burping or flatus. Swallowing more air can lead to trapped gas.

Common causes of bloating include:

• Overeating: Overeating is one of the causes of bloating. Eating smaller portions can reduce the pain.

• Eating Fatty Foods: Fatty foods can make a person feel bloated. Proteins and carbohydrates are harder to digest than fat. Limiting fat in an everyday diet can reduce bloating.

• Drinking Carbonated Beverages: Beverages can make a person feel bloated.

• Drinking With a Straw: Drinking with a straw can swallow more air.

• More Salt: Too much sodium results in water retention in the body leading to bloating.

• Eating Too Fast: Eating too fast or drinking too quickly leads to more gas buildup.

• Chewing Gum: It leads to swallowing more air.

• Constipation: Experiencing a reduced number of bowel movements compared to the typical pattern is an indication of constipation. Straining to start or finish the bowel movement, the stool looks like rock and pebbles, and not feeling empty after a bowel movement are the features of constipation. Constipation causes abdominal pain and bloating. Bloating can occur if the stool stays for a long time in the colon.

• Gastroesophageal Reflux Disease: Frequent swallowing is expected when the stomach acid enters the esophagus. This results in swallowing more air.

• Small Intestinal Bacterial Overgrowth: People who have had intestinal surgery are more likely to have bacterial growth, which results in bloating.

• Irritable Bowel Syndrome: Bloating is the second most common symptom in these patients secondary to abdominal pain.

• Gastroparesis: A condition in which the stomach can not empty itself, leaving a full stomach.

• Celiac Disease: The condition in which some nutrients are not appropriately absorbed, leading to bloating.

• Inflammatory Bowel Diseases: Diseases such as ulcerative colitis and Crohn's disease can make a person feel bloated.

• Liver Disease: Ascites that cause fluid buildup in the abdomen to bloating.

• Cancer: Colon, ovarian, stomach, and pancreatic cancer can all cause fullness of the stomach.

• Lactose Intolerance: The lactase enzyme's inability to digest sugar results in bloating. People experience bloating after eating foods such as milk and cheese.

• Food Allergies: Some people experience allergies to certain foods such as eggs, dairy, and peanuts which cause bloating.

• Hormonal Imbalance: Bloating may be caused during menstruation.

• Bloating After Ovulation: It can occur due to hormonal changes, increased progesterone levels, and the body's preparation for a potential pregnancy. This post-ovulation bloating typically resolves on its own within a few days as hormone levels stabilize.

• Smoking: Inhaling more air while smoking leads to gas formation.

• Alcohol: Wine, beer, and spirits may cause temporary bloating.

• Wearing Loose Dentures: Can cause excessive swallowing of air.

• Chronic Stress: Stress can lead to bloating.

How to Diagnose Bloating?

Physical examination and brief questions about the symptoms can diagnose the cause of bloating.

Some additional tests are done to rule out other conditions:

• Complete Blood Count: A total blood count is taken to check for blood loss or other infections.

• Urine Test: This helps to find out urinary tract infections and pregnancy.

• Computed tomography (CT) scan, magnetic resonance imaging (MRI), and ultrasound are taken if needed to rule out associated disorders.

What Are the Lifestyle Changes to Be Done to Reduce Bloating?

The symptoms of abdominal bloating can be reduced by adopting a few simple lifestyle changes as follows:

• Do not eat too quickly.

• Avoid chewing gum.

• Limit the intake of carbonated drinks.

• Avoid gas-producing foods, such as cabbage, lentils, dried beans, cauliflower, plums, apricots, candies, apples, pears, milk, and ice cream.

• Avoid drinking through a straw.

• Use lactose-free dairy products.

• Follow a diet with a low FODMAP (fermentable oligo-, di-, and monosaccharides and polyols).

• Eating a high-fiber diet includes fruits, vegetables, and whole grains.

• Eat foods with potassium like bananas, avocados, and sweet potatoes.

• Avoid smoking.

• Reduce intake of salt.

• Drink plenty of water or some clear fluids to help reduce bloating.

• Avoid painkillers such as Aspirin, Ibuprofen, and other non-steroidal anti-inflammatory drugs.

• Steer clear of synthetic sweeteners like sorbitol, mannitol, and xylitol

• Stay physically active by doing some exercise regularly.

• A little walk after eating may stimulate digestion and relieve bloating.

• Massaging the abdomen can improve bowel movement.

What Are Some Natural Remedies That Can Help Reduce Bloating?

Many individuals prefer natural remedies for managing bloating. Here are some natural approaches that may help reduce symptoms:

• Herbal Teas and Supplements: Certain herbal teas, such as ginger and peppermint tea, are known for their digestive benefits and can help relieve bloating. Additionally, supplements like activated charcoal may absorb excess gas and reduce bloating.

• Probiotics: Probiotic supplements or foods like yogurt and kefir can promote a healthy gut microbiome and improve digestion, potentially reducing bloating.

• Yoga and Relaxation Techniques: Stress can contribute to bloating. Engaging in relaxation methods such as yoga, meditation, and deep breathing can be beneficial.

• Home Remedies: Some simple home remedies, like applying heat to the abdomen or massaging the belly, may provide temporary relief from bloating discomfort.

What Are the Medications Given to Reduce Bloating?

There is no specific treatment for bloating. If other methods does not relieve abdominal bloating, medications are given.

• Over-the-counter gas-reducing medications such as Simethicone drops or digestive enzymes are given to reduce bloating.

• Antibiotics and antispasmodics are also given depending on the other symptoms and disease conditions.

• Antibiotics like Rifaximin can be given to patients for bloating in irritable bowel syndrome for a short duration.

• Lubiprostone and Linaclotide are drugs that improve fluid secretion in the gut, which can treat constipation.

Conclusion:

Abdominal bloating is the sensation of trapped gas, a sense of fullness, or pressure. Bloating is a highly prevalent condition that should be appropriately diagnosed and treated. Simple dietary modifications can help improve the symptoms.