IBS Bloating and Stomach Distension: How to Find Relief

Diet changes and medication may help

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People with irritable bowel syndrome (IBS) often experience bloating and abdominal distension, which visible outward swelling. While these symptoms can affect anyone from time to time, IBS bloating and stomach distension can be persistent.

This article discusses the root causes and underlying mechanisms behind IBS bloating and distention. It also details medications to treat uncomfortable IBS symptoms and home remedies that can bring relief.

Woman with bloated belly

Waridsara Pitakpon / EyeEm / Getty Images

Bloating

Bloating is defined as the perception of increased pressure in the abdomen. Bloating is a fairly universal phenomenon, reported more frequently by females than males, with an estimated 16 to 31% of the general population experiencing it at some point.

Up to 90% of people who are diagnosed with IBS report bloating, and the percentage is even higher for those with constipation-predominant IBS (IBS-C).

While it's most common in IBS-C and mixed-type IBS, about half of those with diarrhea-predominant IBS (IBS-D) experience it, too.

However, bloating isn't listed as part of the Rome IV criteria for diagnosing IBS.

What Is Rome IV?

Rome IV includes diagnostic criteria for IBS. It is periodically updated to incorporate new research. The first version came out in 1988 at the 13th International Congress of Gastroenterology in Rome, Italy, hence the name "Rome criteria."

Distension

Distension differs from bloating in that it involves a measurable change in abdominal circumference (the measurement around your waist at the largest part).

Distension typically worsens as the day wears on. You may also find that your abdomen gets more distended after you have eaten.

It's estimated that approximately half of all people who have IBS experience distension. Distension and bloating often occur simultaneously, but it is thought that they result from different bodily processes.

Why Does IBS Make My Belly Swell?

Studies show that excessive gas is responsible for about 25% of the bloating associated with IBS and other functional gastrointestinal (GI) disorders.

Several underlying mechanisms are being investigated as possible causes of IBS bloating. It's possible that many of them are interrelated.

Some possible underlying mechanisms include:

  • Disruption of the brain-gut axis: A complex interaction between the brain and gut bacteria suggests that psychological stress can impact the balance of bacteria and vice versa.
  • Increased intestinal permeability ("leaky gut"): Improper function of the intestinal lining may allow bacteria and small molecules of partially digested food to leave the digestive system, trigger inflammation, and interfere with the balance of gut bacteria.
  • Intestinal immune activation: Low-grade inflammation may be due in part to abnormal activity of the immune system.
  • Visceral hypersensitivity: People with this problem tend to feel bloated and have other symptoms when the digestive system is only mildly irritated. It usually occurs without distension.
  • Gastrointestinal dysmotility (impaired movement): This causes gas to get trapped in the first and middle parts of the colon.
  • Impaired abdominal wall response to pressure: This occurs with chronic bloating and distension, as the reaction of the diaphragm and abdominal wall muscles to pressure from gas is the opposite of what it should be.

Evidence also suggests that bloating may especially be a problem for people who have other digestive issues in addition to IBS.

These include:

People who have IBS-C are more likely to have bloating and distension if it takes longer for digested material to travel through the colon.

Bloating and Quality of Life

Bloating has a negative impact on quality of life. In surveys, it runs neck-and-neck with abdominal pain as the most severe symptom of IBS. In one survey, a quarter of people with IBS-C ranked it as their most bothersome symptom.

What Relieves IBS Bloating?

Bloating is a notoriously difficult symptom to treat. However, you do have several options to explore to get rid of bloating.

IBS is different for everyone, so expect to do a lot of experimentation before finding what works best for you. Try not to get frustrated when your experience doesn't match that of other people with this condition.

IBS Medications

No treatments are definitively proven to improve IBS bloating. Common drugs that doctors may recommend include:

  • Antispasmodic drugs, including Menoctyl (otilonium) and Bentyl (dicyclomine), may help calm spasms in the intestinal walls that can trap gas
  • Antidepressants to help correct the brain-gut dysfunction, including tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs)
  • Prosecretory drugs, a kind of prescription laxative, including Linzess (linaclotide) and Trulance (plecantide)
  • Viberzi/Truberzi (eluxadoline), which alters the activity of certain cell receptors in the nervous system and improves symptoms of IBS-D
  • Serotonergic agents such as Lotronex (alosetron), as the hormone/neurotransmitter serotonin is involved in digestive motility, sensation, and secretion
  • Antibiotics, which may be helpful for those with SIBO, including Xifaxan (rifaximin) and Biaxin (clarithromycin)
  • Bulk laxatives, available over-the-counter (OTC), to help you expel gas and feces
  • Gax-X (simethicone), an OTC medication that can help you eliminate gas

Other IBS Treatments

While medications may help, they may not alleviate all of your symptoms. Many people with IBS include other types of treatments in their regimen, including:

  • Dietary changes, especially a low-FODMAP diet or elimination of trigger foods
  • Probiotic or prebiotic supplements, which may help balance gut bacteria
  • Peppermint oil, which is a natural antispasmodic (see warning below)
  • Psychological therapies including cognitive behavioral therapy, relaxation therapy, and hypnotherapy
  • Exercise and physical fitness, which studies show may help ease symptoms

Warning: Peppermint Oil

Peppermint oil is soothing to the muscle cells that line much of your GI tract, which can ease IBS symptoms. However, it can also relax the sphincter between your stomach and esophagus, which often leads to heartburn and reflux. To avoid this, be sure to take peppermint oil capsules that are enteric-coated, as the coating won't dissolve until it reaches your intestines.

While they've received less scientific attention than other types of treatments, some evidence supports the use of mind-body treatments for IBS.

Frequently Asked Questions

  • How long does an attack of IBS bloating last?

    An IBS flare-up typically lasts two to five days. In addition to bloating, you might experience constipation or extreme diarrhea, cramping, and emotional symptoms such as anxiety.

  • How do I get rid of IBS stomach distension?

    Treat constipation. Laxatives and stool softeners are commonly used. In particular, polyethylene glycol (PEG) is often recommended for people with IBS-C. It works to retain water in the stools, softening them. This helps increase bowel movements. 

  • What foods cause bloating in IBS?

    While every person with IBS is different, foods that commonly cause bloating and stomach irritation in people with IBS include:

    • Caffeine
    • Carbonated beverages
    • Certain fruits that are high in fructose, including apples and pears
    • Dairy products, including milk, cheese, and ice cream
    • High fructose corn syrup, which is common in soft drinks and candy
    • Sugar-free gum and candy made with sugar alcohols, such as sorbitol and xylitol
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lacy BE, Cangemi D, Vazquez-Roque M. Management of chronic abdominal distension and bloatingClin Gastroenterol Hepatol. 2021;19(2):219-231.e1. doi:10.1016/j.cgh.2020.03.056

  2. Safaee A, Moghimi-Dehkordi B, Pourhoseingholi MA, et al. Bloating in irritable bowel syndrome. Gastroenterol Hepatol Bed Bench.

  3. Schmulson MJ, Drossman DA. What is new in Rome IVJ Neurogastroenterol Motil. 2017;23(2):151-163. doi:10.5056/jnm16214

  4. International Foundation for Gastrointestinal Disorders. Understanding bloating and distention.

  5. Moser G, Fournier C, Peter J. Intestinal microbiome-gut-brain axis and irritable bowel syndrome. Intestinale Mikrobiom-Darm-Hirn-Achse und Reizdarmsyndrom. Wien Med Wochenschr. 2018;168(3-4):62-66. doi:10.1007/s10354-017-0592-0

  6. Cozma-Petruţ A, Loghin F, Miere D, Dumitraşcu DL. Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients! World J Gastroenterol. 2017;23(21):3771-3783. doi:10.3748/wjg.v23.i21.3771

  7. Harvard Medical School, Harvard Health Publishing. Leaky gut: What is it, and what does it mean for you?

  8. Lazaridis N, Germanidis G. Current insights into the innate immune system dysfunction in irritable bowel syndromeAnn Gastroenterol. 2018;31(2):171-187. doi:10.20524/aog.2018.0229

  9. Chey WD, Lembo AJ, Rosenbaum DP. Efficacy of tenapanor in treating patients with irritable bowel syndrome with constipation: A 12-week, placebo-controlled phase 3 trial (T3MPO-1)Am J Gastroenterol. 2020;115(2):281-293. doi:10.14309/ajg.0000000000000516

  10. Issa B, Morris J, Whorwell PJ. Abdominal distension in health and irritable bowel syndrome: The effect of bladder fillingNeurogastroenterol Motil. 2018;30(11):e13437. doi:10.1111/nmo.13437

  11. Ford AC, Moayyedi P, Chey WD, et al. American College of Gastroenterology monograph on management of irritable bowel syndromeAm J Gastroenterol. 2018;113(Suppl 2):1-18. doi:10.1038/s41395-018-0084-x

  12. Alammar N, Wang L, Saberi B, et al. The impact of peppermint oil on the irritable bowel syndrome: A meta-analysis of the pooled clinical dataBMC Complement Altern Med. 2019;19(1):21. Published 2019 Jan 17. doi:10.1186/s12906-018-2409-0

  13. Lakhan SE, Schofield KL. Mindfulness-based therapies in the treatment of somatization disorders: A systematic review and meta-analysisPLoS One. 2013;8(8):e71834. Published 2013 Aug 26. doi:10.1371/journal.pone.0071834

  14. Palsson OS, Baggish J, Whitehead WE. Episodic nature of symptoms in irritable bowel syndrome. American Journal of Gastroenterology. 2014;109(9):1450-1460.doi:10.1038/ajg.2014.181

  15. American Society for Gastrointestinal Endoscopy. Understanding irritable bowel syndrome with constipation (IBS-C).

  16. Johns Hopikins Medicine. 5 Foods to avoid if you have IBS.

Additional Reading

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.