Bloating and Gas: Common Causes, Home Care and When to Be Seen

What it involves

MedlinePlus defines abdominal bloating as a condition in which the belly feels full and tight and may look swollen. Gas is air in the intestine that is passed through the rectum, and air that moves up through the mouth is belching. MedlinePlus says gas is normally formed in the intestines as the body digests food, and that it can cause bloating and crampy pains.

Who this is for

• Adults with a full, tight belly that keeps coming back
• Patients with a lot of gas or belching after meals
• Patients who notice bloating together with constipation, diarrhea, or heartburn
• Patients unsure whether their symptoms are a food issue or something to be checked

What to expect

• Questions about what you eat, how fast you eat, and whether your diet changed recently
• A physical exam and a review of your medicines and other symptoms
• A plain explanation of the likely causes and a food and habit plan to try first
• A plan that may include follow-up or a referral for tests if warning signs are present

Common causes of bloating

MedlinePlus lists these common causes:

• Swallowing air, overeating, and weight gain
• Constipation, covered in the [[constipation evaluation|/constipation-evaluation/]]
• Gastroesophageal reflux disease, covered in the [[heartburn and acid reflux guide|/heartburn-acid-reflux-evaluation/]]
• Irritable bowel syndrome and small bowel bacterial overgrowth
• Lactose intolerance and problems digesting other foods
• Visceral hypersensitivity, bloating from oversensitive nerves in the gut

Medicines and foods

MedlinePlus says you may have bloating if you take the oral diabetes medicine acarbose, and that some other medicines or foods containing lactulose or sorbitol may cause it. Many foods high in fructose and related compounds cause gas, and antibiotics are on its list of medicines that can cause gas. Never stop a prescribed medicine on your own, and ask your provider if a new medicine started the problem.

Gas from food and habits

MedlinePlus says foods that are hard to digest, such as fiber, can cause gas, and that adding fiber can cause temporary gas while your body adjusts. Insoluble fiber such as bran causes more gas than soluble fiber such as psyllium. Swallowing air while eating, chewing gum, smoking, carbonated drinks, sugar-free candy, talking while eating, and eating too rapidly all add to it. Many people also get gassy from fructose or from dairy when they cannot tolerate lactose.

More serious causes

MedlinePlus also names disorders that can cause bloating and are not just about food: celiac disease, dumping syndrome, ascites, abdominal tumors, ovarian cancer, and a pancreas that does not make enough digestive enzymes. That list is the reason the warning signs below matter, and the abdominal pain evaluation explains when belly pain needs a visit rather than waiting.

What you can try at home

MedlinePlus suggests avoiding chewing gum and carbonated drinks, eating slowly, chewing thoroughly, and not eating foods high in fructose or sorbitol. It lists gas-producing foods such as Brussels sprouts, turnips, cabbage, onions, garlic, beans, and lentils. It also advises stopping smoking, walking 10 to 15 minutes after eating, and treating constipation, with soluble fiber such as psyllium usually better tolerated than bran. Over-the-counter simethicone may help with gas, and a low-FODMAP diet is recommended for triggers like lactose and fermentable carbohydrates.

Signs you should be seen

MedlinePlus says to contact your provider if bloating or gas comes with:

• Abdominal pain, vomiting, or diarrhea
• Blood in the stools or dark, tarry looking stools, or rectal bleeding
• Heartburn that is getting worse
• Weight loss, or fever
• Oily, foul-smelling, or bloody stools

What a visit involves

MedlinePlus says your provider performs a physical exam and asks what foods you commonly eat, whether your diet or fiber intake changed, how fast you eat, whether the gas is mild or severe, whether it follows milk products, what you take, and whether you chew sugar-free gum or candy. Tests that may be done include blood tests such as a complete blood count, abdominal imaging, a hydrogen breath test, and scopes. Those would be arranged through a referral, and many people need none. The colorectal cancer screening guide explains one of the scope tests.

Sources

• MedlinePlus — Abdominal bloating
• MedlinePlus — Gas, flatulence