Abdominal bloating can be an uncomfortable feeling. When bloating is present, your belly can feel swollen. Discomfort and pain are likely. You often can physically see when you’re bloated as your belly will appear larger. Knowing the causes can help to reduce the frequency of bloating. Depending on your type of bloating, you could benefit from a visit to your physician.

What Causes Bloating?

With various causes of bloating, it’s vital to find the underlying cause so you can address the issue. No two people are the same and everyone’s digestive process is going to be different. Being aware of the different causes can help you reduce the severity of bloating.

Constipation - Some people don’t even realize they are constipated, but it’s quite common. It’s easy to assume that the way to tell if you’re constipated is if you don’t have a lot of bowel movements. However, that’s not always the case. According to Hopkins Medicine, you can still be constipated despite having regular bowel movements. A great way to determine if you could be dealing with constipation is if you tend to strain or push during a bowel movement, if you don’t feel an emptiness feeling following a bowel movement, and/or if your stool resembles pebbles or rocks.

Gut Sensitivity - People with irritable bowel syndrome (IBS) are sensitive to gas, which can lead to bloating, diarrhea, and cramping. Individuals with IBS usually notice their bloating symptoms get worse after eating, and a flare-up could last anywhere from 2-4 days.

Inflammatory Bowel Disease - This condition involves inflammation within the lining of the gastrointestinal tract, including ulcerative colitis and Crohn’s disease.

Small Intestinal Bacterial Overgrowth - The majority of healthy people typically have few bacteria in the small intestine. Individuals who went through intestinal surgery or those with IBS with diarrhea tend to have small intestinal bacterial overgrowth (SIBO). This condition can cause bloating.

Gastroparesis - With this condition, there is a delay of stomach emptying, which leads to nausea, bloating, and sometimes a bowel blockage. Gastroparesis makes your stomach unable to empty itself of food in a normal way, which causes the delay. The cause of this is unknown, but it usually happens when there is a damaged vagus nerve that prevents the muscles in the intestine and stomach from properly functioning. Women tend to experience gastroparesis more than men.

Gynecological Conditions - Depending on the specific issue, sometimes certain problems with the uterus or ovaries can lead to bloating such as endometriosis, ovarian cancer, and uterine fibroids. Be sure to never avoid getting your annual pelvic exam for early intervention.

Celiac Disease - Celiac is an autoimmune disease where the immune system will attack the small intestine. This happens when someone has a gluten allergy and eats something with wheat, barley, or rye. During the process of the immune system wreaking havoc on the immune system, it leads to bloating and abdominal pain, among other symptoms.

Reaction to Diet - Bloating can occur when your body has a difficult time digesting certain sugars in foods or other ingredients. Some people don’t make enough lactase in their gut to handle dairy, which leads to lactose intolerance. Thankfully, there are some over-the-counter lactaid medications to still enjoy your food, but avoid the downside of it later.

Cancer - Stomach, ovarian, pancreatic, and colon cancer are the top cancers that often have bloating as a symptom.

Symptoms of Bloating

Bloating can leave you with a feeling of being uncomfortable. It’s not just the feeling of a distended stomach, though. There are other symptoms to be on the lookout for:

Common Symptoms:

  • Buildup of gas
  • Excessive flatulence
  • An intense feeling of an urge to have a bowel movement

Severe Symptoms:

  • Blood in stool
  • Nausea
  • Vomiting
  • Heartburn
  • Diarrhea
  • Vaginal bleeding (between periods or when you are postmenopausal)
  • Noticeable weight loss
  • Fever (potentially from an infection)

When to See a Doctor for Diagnosis

Be sure to stay in tune with your body and keep track of what you’re experiencing. Mild bloating in general can signal a minor problem. However, chronic bloating should be addressed by a gastroenterologist as it can be part of a serious condition. Additionally, if you have any symptoms of severe bloating, you should mention it to a medical professional.

Diagnostic testing for chronic abdominal bloating includes:

Small Bowel Enteroscopy - This is a procedure that will use an endoscope so a physician can get a further look into the small bowel, which is roughly up to 25 feet long. Usually a small bowel enteroscopy is used to find the source of intestinal bleeding, lesions, and discover the source of nutritional malabsorption. The doctor will decide to use either a wireless capsule endoscope, double-balloon endoscope, or a longer conventional endoscope. An endoscopy is ideal to rule out Crohn’s disease, malabsorption, tumors, celiac disease, vascular malformations, esophageal disease, polyps, and medication injury.

H. Pylori Breath Testing - Undergoing H. pylori breath testing can help determine if you have H. pylori, which is a certain type of bacteria that lives in the digestive tract and leads to ulcers in the upper part of your small intestine or in the stomach lining. This test involves drinking a special solution that contains a substance that is broken down by H. pylori. If H. pylori is present, the breakdown products will show up in your breath as you exhale into a bag.

Upper Endoscopy - An upper endoscopy is a technique that involves looking inside the upper parts of the digestive system. It involves an endoscope, which is a long, flexible, and thin instrument with a light at the end and a tiny video camera. Sedation is typically used so you won’t experience any discomfort. This procedure will give your gastroenterologist the ability to see inside your duodenum, stomach, esophagus, and the beginning of your small intestine.

Endoscopic Ultrasound - An endoscopic ultrasound gives your doctor the ability to examine the lining and walls of your lower and upper gastrointestinal tract. This test studies the internal organs near the gastrointestinal tract to get a clear picture of what could be going on.

Anorectal Manometry - An anorectal manometry test is used to evaluate patients with fecal incontinence or constipation. This test will measure the strength of anal sphincter muscles, which is the sensation or nerves in the rectum.

Flexible Sigmoidoscopy - Having a flexible sigmoidoscopy can allow your doctor to examine the lower left portion of your colon. Usually this procedure is done when a patient presents symptoms like diarrhea, bleeding, abnormal x-rays, and those with inflammatory bowel disease activity.

Colonoscopy - A colonoscopy is the most efficient test when it comes to detecting colon cancer and polyps. This test will allow direct visual examination of your colon lining from a flexible tube your doctor will use called a colonoscopy.

Other testing may be available, depending on your specific symptoms and case. Bloating is common, but when it becomes an all the time thing or is associated with other symptoms, it’s time to seek a diagnosis from a gastroenterologist. Request an appointment with Asheville Gastroenterology Associates to rule out different conditions.