Why am I bloated? The 13 possible underlying causes of bloating

Easy Ways to Live Well: Steph McGovern discusses bloating

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Bloating is a very common problem, especially amongst women. While it’s normally nothing serious, bloating could be a sign of an underlying condition. Don’t suffer in silence if you are often bloated and it is impacting your day to day life. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out why YOU might be bloated.

When someone says they feel bloated, this means they feel their abdomen is distended.

Dr Lee explained: “They often feel that gas is trapped inside.

“When you feel bloated, the feeling exists without there being any measurable increase in your abdominal girth. Burping and belching may or may not be associated.”

The correct term is functional bloating, Dr Lee said, which is bloating for which no medical cause can be found.

Bloating is very common and the cause is normally easy to pinpoint.

In one American household survey, 31 percent of the adult population reported feeling bloated in the previous three months.

IBS is one of the most common causes, with more than 90 percent of patients with irritable bowel syndrome (IBS) suffering from bloating.

Dr Lee pointed out: “In IBS, women tend to have higher rates of bloating than men.

“Bloating is also more common in constipation linked to IBS, than to diarrhoea.

“In patients without IBS, over 75 percent classify their bloating as moderate to severe, and over 50 percent say that it has interrupted their daily activities.”

Why does bloating occur?

The reason bloating occurs is complex and poorly understood.

However, anything that disturbs the natural passage of the products of digestion through the gut can result in bloating.

Dr Lee said: “This might be poor gut motility, abnormal bacteria in the gut, diseases that affect the nerves and muscles of the gut wall, or any combination of these factors.

“Women frequently feel bloated in the run-up to a period, and this usually settles as the menstrual bleed starts.

“Sometimes bloating can be a side effect of hormonal contraception, often associated with estrogen which can cause fluid retention. Bloating is also a normal symptom in pregnancy.

“Although rare, bloating is a common symptom of ovarian cancer.

“Bloating is also more common in those suffering from obesity.

“It may be that those who are obese eat a higher fat diet, as high-fat diets delay gastric emptying, and can result in bloating.”

What else could it be?

When a patient complains of bloating, there are a wide variety of possible underlying causes rather than something more obvious.

Functional dyspepsia is present when these diagnoses have been ruled out, Dr Lee explained.

Some of these are:

  • Aerophagia – excessive swallowing of air when eating or talking
  • Anorexia and bulimia – restricting the intake of food leads to atrophy (shrinkage) of the muscles of the digestive tract
  • Gastroparesis – partial paralysis of the stomach
  • Gastric outlet obstruction – any medical condition that results in a mechanical blockage to the stomach emptying
  • Functional Dyspepsia – indigestion that occurs for no obvious reason
  • Dietary factors – Lactose intolerance, fructose intolerance, artificial sweeteners such as sorbitol, high carbohydrate intake, gluten sensitivity

  • Coeliac disease – this causes inflammation of the digestive tract
  • Chronic constipation – if the stool sits for too long in the large bowel, the bacteria start to ferment.
  • Irritable bowel syndrome – IBS affects the gut microflora, resulting in too much gas.
  • Small intestinal bacterial overgrowth (SIBO) – This is a serious condition in which abnormal bacteria grow in the small intestines.
  • Abnormal small intestinal motility – Many different neurological conditions can affect gut motility.
  • Diverticulitis – This can affect the passage of gut contents through the affected area.
  • Ovarian cancer – Although rare, bloating can be a sign of ovarian cancer.

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