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What’s Really Causing Your Gas and Bloating?

Date: August 1, 2015      Publication: Bottom Line Health      Source: Douglas A. Drossman      Print:

7 hidden triggers of GI distress…

Ugh! Here comes another gas attack. Or maybe it’s bloating that’s got you feeling so out of sorts. If you’re lucky, you can avoid gas and/or bloating by forgoing the usual triggers—carbonated drinks…some high-fiber foods such as beans…chewing gum…and artificial sweeteners and the fruit sugar fructose.

But sometimes the source of this all-too-common gastrointestinal (GI) discomfort isn’t so obvious. If your symptoms don’t ease within a few weeks…or they have no apparent reason and tend to come and go, you and your doctor may need to do some investigating. The following health problems can cause gas and/or bloating but often go undetected—especially in the early stages…

Aerophagia (air swallowing). Swallowing too much air can stretch the stomach and cause bloating. This often occurs when people are experiencing anxiety or can even become an unconscious habit. It can also happen when chewing gum, using a straw or drinking carbonated beverages.

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What to do: Consider stress-reducing activities like deep breathing, meditation or yoga. If symptoms are severe, see a counselor for stress-management techniques.

• Irritable bowel syndrome (IBS). As many as one in five adults experiences the chronic symptoms of IBS—abdominal pain, bloating, gas, diarrhea and/or constipation—to some degree. IBS can have many causes, but typically nerves in the GI tract are extremely sensitive to food and gas passing through the bowel, triggering discomfort.

What to do: An IBS diagnosis includes regular abdominal pain that is relieved by a bowel movement, along with symptoms of bloating, diarrhea and/or constipation.

If you have IBS, your doctor may prescribe antispasmodics, such as dicyclomine (Bentyl) and hyoscyamine (Levsin), that may help relieve your symptoms. Since stress can trigger IBS symptoms, try to manage it with yoga, massage, meditation and counseling, if needed.

• Functional dyspepsia. After eating, the stomach in a healthy adult can expand in volume up to four times its normal size. But with functional dyspepsia, the muscles don’t relax properly and the stomach remains small, leaving you feeling full and bloated after just a few bites.

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What to do: If symptoms are stress-related, relaxation techniques, such as deep breathing or biofeedback, may be effective. An antianxiety drug, such as buspirone (BuSpar), can also help because it helps to relax the stomach.

• Celiac disease. People with celiac disease are sensitive to gluten, a protein in wheat, barley and rye that can produce inflammation in the bowel, resulting in bloating, gas, abdominal cramps and diarrhea.

What to do: If you suffer from the digestive symptoms described above—especially if you also have any nutritional deficiencies and/or experience frequent fatigue—see your doctor. Celiac disease is diagnosed with a blood test followed by an endoscopic biopsy. By avoiding foods and products that contain gluten, most sufferers can eliminate symptoms. For a list of hidden sources of gluten, go to Celiac.org.

More serious but less common causes of gas and/or bloating…

• Diverticulitis. This condition occurs when small pouches in the walls of the colon become inflamed and/or infected—often due to small tears caused by stool trapped in the pouches. It not only causes gas and bloating but also pain in the lower left side of the pelvis, where pouches get infected.

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What to do: If you’re having severe abdominal pain with fever and vomiting, see your doctor right away—you could have a serious infection that requires antibiotics and possibly emergency surgery. Sometimes, however, diverticulitis is mild, and symptoms may improve if you apply heat to the painful area…go on a liquid diet—including clear broth, clear fruit juice (such as apple), gelatin and plain tea—for a few days to “rest” your digestive system…and/or take antibiotics if needed to treat an infection.

• Gallstones. They often cause no symptoms, but if gallstones block the duct where the gallbladder empties, the gallbladder stretches, resulting in distension and pain, as well as bloating and gas.

What to do: If you suffer bloating and gas, pain in the upper-right abdomen (where the gallbladder is located), nausea and fever, see your doctor. He/she will perform an ultrasound to check for gallstones. Gallstone removal, which is routinely performed via laparoscopic surgery or, in some cases, endoscopy, is often recommended.

• Certain cancers. With advanced colorectal cancer, the bowel can become blocked, which leads to gas, bloating and blood in the stool. Ovarian cancer often causes subtle symptoms that may include bloating and feeling full quickly.

What to do: With colorectal cancer, regular colonoscopies after age 50 (or after age 40 if a close family member has had the disease) will catch suspicious polyps before a malignancy develops. Women who experience the symptoms described above for more than two or three weeks—especially if they are accompanied by pelvic pain and/or an urgent or frequent need to urinate—should see a gynecologist.

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QUICK RELIEF 

If your gas and/or bloating is only occasional, consider trying…

• Probiotics, which promote the growth of “good” bacteria in the bowel. One study found that Lactobacillus acidophilus and Bifidobacterium lactis helped bloating by replacing the bad (gas-causing) bacteria with good (gas-relieving) bacteria in people with bowel disorders, such as IBS or functional dyspepsia. In another study, probiotics were found to relieve intestinal gas.

What to do: Try a daily probiotic in supplement form or via probiotic-rich fermented foods and beverages such as kefir, miso or kimchi.

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Source: Douglas A. Drossman, MD, codirector emeritus at the University of North Carolina Center for Functional GI and Motility Disorders and professor emeritus of medicine and psychiatry at the University of North Carolina School of Medicine in Chapel Hill. He is also the president of the Rome Foundation, an international nonprofit group that develops guidelines for the diagnosis and treatment of functional GI disorders.

  • Silvia Fernandez

    I enjoyed your article very much. It provided intell of information on bloating problems, will follow up with a daily probiotic, thank you.