Bloating

Bloating is a common problem that affects the digestive system. It happens for a variety of reasons, and can cause the abdomen to become distended (stick out). Bloating may cause symptoms such as feeling fullness, pressure, or tightness in the stomach. It can be mild and not last very long or it could be severe and more painful and disruptive.

This article discusses the symptoms and potential causes of bloating. It also covers lifestyle factors that may affect bloating and when to seek tests or treatment for symptoms.

Symptoms of Bloating

Bloating can include a variety of signs and symptoms affecting the abdomen.

Symptoms of bloating can be:

• Abdominal discomfort
• Abdominal noises (gurgling)
• Burping
• Feeling full
• Stomach pain
• Gas
  

Causes of Bloating

Some of the causes of bloating come from everyday situations like eating a big meal. But others stem from a disease or condition.

Common reasons for bloating are:

• Acid reflux: Stomach acid that leaks backs up into the food tube (esophagus) and irritates it
• Constipation: Hard, infrequent bowel movements that are difficult to pass
• Eating a large meal
• Gastroesophageal reflux disease (GERD): Chronic acid reflux
• Menstruation
• Weight gain
  

More serious or uncommon reasons for bloating include:

• Cancer: Abnormal growth in the ovaries, colon, pancreas, stomach, or uterus
• Bowel blockage: When stool can’t pass through the intestines 
• Infection: When bacteria or viruses cause disease in the body
• Inflammation in the digestive system: Swelling and redness in the organs in the abdomen
  
• Inflammatory bowel disease (IBD) including Crohn’s disease and ulcerative colitis: Chronic conditions of inflammation in the lower digestive system
• Irritable bowel syndrome (IBS): A condition that affects the colon and can cause abdominal pain or discomfort
• Pelvic inflammatory disease (PID): Inflammation in the organs of the pelvis
• Liver disease: Infection or diseases of the liver
  

What Medications Can Cause Bloating?

Some supplements and medications can cause bloating. In the case of fiber supplements, bloating can be a temporary problem. The body will adjust to the increase of fiber in the body, and the bloating may decrease over time.

This can include:

• Aspirin
• Antacids
• Fiber supplements, including Citrucel, Fiberall, and Metamucil
• Antidiarrheal medications, such as Imodium (loperamide), Kaopectate (bismuth subsalicylate), and Lomotil (diphenoxylate/atropine)
• Iron supplements
• Multivitamins
• Opioids
  

How to Treat Bloating

There are ways to treat the common causes of bloating at home. Knowing what caused the bloating in the first place can help determine where to start with treatments, which include:

• Antacids: Antacids help by acting on inflammation and allowing trapped gas to pass. However, they can also contribute to symptoms of burping and bloating.
• Herbal teas: For some people, drinking a tea with peppermint, chamomile, ginger, turmeric, or fennel may help release gas.
• Magnesium supplements: Magnesium may relax the muscles and loosen stools, which could help relieve constipation.
• Peppermint oil capsules: Peppermint helps by relaxing the smooth muscles in the digestive system. It may be used for treating IBS or other conditions.
  
• Probiotics: Probiotics (beneficial bacteria) are an active area of research, and there are still many unknowns about their use. However, they may be helpful with some causes of bloating, such as IBS, when used long term.
• Psyllium fiber: Fiber supplements containing psyllium may help with constipation and diarrhea by softening stools, making them easier to pass.
• Exercise or yoga: Walking or doing exercises that engage your core muscles can help shift gas in the digestive system and make it easier to pass.
  

For bloating that becomes chronic or is caused by or associated with another condition, a healthcare provider may suggest other treatments. These treatments won’t be used for uncomplicated bloating that isn’t because of an underlying condition:

• Antidepressants: Low doses of antidepressants have been helpful in treating some causes of bloating, such as from IBS.
  
• Antispasmodics: Medications that relax the bowel muscle might be used for certain causes of bloating. This could include Bentyl (dicyclomine) and Levsin (hyoscyamine).
  
• Biofeedback: Biofeedback is a type of therapy that can help retrain the digestive system. It may be especially helpful for chronic constipation, which can cause bloating. 
  
• Dietary changes: There are many different diets used to treat medical conditions. For bloating, especially from IBS or if it may be related to food, a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet may be prescribed. In this diet, certain carbohydrates and sugars are eliminated for a time to see if symptoms improve.
  
• Hormone therapy: For menstruating people who have bloating associated with premenstrual syndrome (PMS), their period, or perimenopause (the transition to menopause), treatment with hormonal birth control might be used. Hormone replacement therapy (HRT) with estrogen and progesterone is prescribed by a healthcare provider and may be a treatment that’s helpful for some people.
• Medications to lower stomach acid: Antacids, H2 blockers, or proton pump inhibitors might be used to treat acid reflux or GERD.
• Prokinetics: These medications may help food move faster through the digestive system. This could be helpful if digestion is moving too slowly and that is a cause of bloating.
  
• Xifaxan (rifaximin): This antibiotic has shown some promise in treating bloating, constipation, and small intestine bacterial overgrowth.
  

Are There Tests to Diagnose the Cause of Bloating?

In most cases, bloating is diagnosed after a healthcare provider performs a physical exam and takes a medical history. Talking about diet, lifestyle, and medications with your provider can help shed light on what is going on with your digestive system. An exam of the abdomen to look for any tender spots or anything abnormal is also done.

It’s also helpful to describe how often the bloating happens and if it’s related to anything else.

If the bloating is chronic or associated with other conditions, your provider may decide to do some tests to see if there is anything serious happening. One or more of these tests might be used to determine what’s causing the bloating:

• Abdominal X-rays: A plain X-ray might show if there are any problems with the abdominal organs.
  
• Barium enema: X-rays are taken after barium is inserted into the rectum with a tube. This can show if there are any problems with the lower digestive tract.
  
• Barium swallow: Drinking barium can help better show the structures of the upper gastrointestinal tract on an X-ray and give a clue as to any possible problems.
  
• Blood tests: Blood tests can’t help diagnose anything in terms of bloating but they can give a picture of overall health or if there is inflammation somewhere in the body.
  
• Breath test: A breath test can be used to see if the body is making too much of certain gases. This could mean that there is an infection or another problem with digestion that’s causing the bloating.
  
• Colonic transit tests: These tests are used to measure how long it takes food to go through the digestive system. It can be done by swallowing a capsule or eating food that’s been treated with radioactive isotopes.
• Colonoscopy: A flexible tube with a light and a camera is inserted into the anus and up into the rectum and the colon to find any issues there.
• Gastric emptying study: In this test, radioactive substances are given in food and then images are taken of the digestive system while the food is digested. 
  
• Manometry: This test finds out how the muscles in the digestive system are working and if they’re not being effective in moving food through.
• Stool tests: A stool test can show if bacteria or parasites are causing a problem. Looking for other substances in the stool that are associated with particular diseases might also be done.
• Upper endoscopy: Inserting a small tube down through the esophagus and into the stomach can show the inside of these organs and if there is a reason for the bloating.
  

When to See a Healthcare Provider

Bloating is common and usually is not serious. However, if there are more serious symptoms or symptoms that go on for a long time, it’s time to talk to a healthcare provider. Some of the reasons to see a healthcare provider include:

• Bloating that gets worse over time
  
• Bloating that is accompanied by a fever, vomiting, or the absence of bowel movements
• Blood in the stool
• Pain that is getting worse
• Symptoms that go on for several days without relief
  

Summary

Bloating is common and can happen even when there is no underlying digestive problem. If it doesn’t go away on its own, or there doesn’t seem to be a reason for it, a healthcare provider can help.

A Word From Verywell

Most people deal with bloating at some point. A big meal or eating more fiber than usual can lead to mild symptoms of bloating. However, these everyday things shouldn’t lead to problems like a big distended belly or severe pain. There are many ways to prevent or treat bloating that aren’t too difficult or require extensive testing.