Do you ever feel like you have a balloon in your belly? Or perhaps your stomach looks and feels distended? We all suffer from bloating sometimes. More often than not, bloating and distension go together…but you can have one without the other. The real question is, how to make it stop.
Bottom Line Personal asked gastrointestinal specialist Brooks D. Cash, MD, to explain why we suffer bloating…and how to get rid of it for good.
Bloating after eating can occur simply because you ate too much at a meal, causing your digestive tract to play catch up. But if you experience bloating on a regular basis, it could be from any number of causes, including…
A poop backup can cause distention and the feeling of bloating. You also may have a sense of incomplete evacuation…have to strain to evacuate…and/or have hard lumpy stools or a feeling of obstruction. About 20% to 30% of people with chronic constipation actually have pelvic floor dysfunction, tight muscles that don’t move as needed when you have gas.
How to get rid of bloating due to constipation: In 2023, the American Gastroenterological Association released practical guidelines that aim to relieve bloating. Treating constipation tops the list. That sounds simple, but it’s not just about taking laxatives, which may help but may not alleviate all the symptoms or may overshoot and cause diarrhea. One of the best ways to alleviate constipation is to increase your activity level to help get things moving. You also might need to gradually increase soluble fiber intake. Another possible cause of constipation: Pelvic floor dysfunction, which may require physical therapy with a specially trained therapist.
There are several food-related maldigestion syndromes, meaning that the body has a hard time processing proteins, sugars and starches. Most people are aware of lactose intolerance, which affects 30% to 40% of the US population. But there are other food intolerances that can cause bloating. Some people don’t easily absorb fructose, the primary sugar in fruits, while others have difficulty digesting sucrose, or table sugar. Among many other symptoms, gluten intolerance causes bloating, especially for people with celiac disease, but simply eating too many high-fiber foods also can cause bloating in some people.
How to get rid of bloating from food sensitivities or intolerances: Work with a dietitian to identify the foods that could be causing your bloating—it’s not an easy process, and when people try to do it on their own, they risk being overly restrictive and even creating an eating disorder.
The complex microbial environment of the gut consists primarily of bacteria, fungi and viruses. There are a multitude of factors that can affect the microbiome’s balance, including baseline metabolism, genetics, the immune system, diet, medications, activity level and obesity, to name a few. An altered microbiome can lead to changes in the way food and waste products are handled in the gut. Specifically, more fermenting (or anaerobic) bacteria in the gastrointestinal tract may promote the fermentation of poorly digested carbohydrates and produce gases like hydrogen, hydrogen sulfide and methane, which in turn can lead to changes in gut motility and bloating.
How to get rid of bloating from microbiome alterations: Work with your health-care provider and a dietitian who can craft a non-inflammatory diet for you and see whether probiotic-rich foods can help. There are some medications approved for irritable bowel syndrome that may modify the microbiome to decrease a person’s propensity to experience bloating.
These include irritable bowel syndrome (IBS)—50% to 60% of people with IBS will have constipation as a symptom, and that’s likely what’s behind the bloating and distension.
How to get rid of bloating from IBS: If you’ve been diagnosed with IBS with diarrhea, the drug rifaximin often can help with bloating.
Another disorder is functional bloating syndrome—bloating that occurs without any change in bowel habits.
How to get rid of bloating from functional bloating syndrome: Treatment is multifaceted and may include changes to your diet, taking medication and trying biofeedback, a form of physical therapy.
Less well-known is a condition called abdominophrenic dyssynergia. This is a reversal of the muscle action that’s supposed to occur when you eat—meaning that the abdominal muscles relax instead of contracting and the diaphragm contracts instead of relaxing. This abnormal muscular reflex can lead to bloating and distention that may also be associated with shortness of breath.
How to get rid of bloating from abdominophrenic dyssynergia: Abdominophrenic dyssynergia can be successfully treated with biofeedback—patients learn breathing techniques as well as how to reset abdominal muscular contractions.
Many women experience bloating when they menstruate or during menopause. While often blamed on hormones, the cause of bloating related to gynecologic issues is poorly understood. Endometriosis also can cause bloating along with intense pain, and bloating may be the only early sign of ovarian cancer.
How to get rid of bloating from gynecologic issues: Similar to other causes of bloating, avoiding foods that produce gas (such as beans and cruciferous vegetables) and treating constipation can be effective in some patients. Bloating that is reliably associated with menstruation or other gynecologic symptoms should be brought to your health-care provider’s attention.
For many people, bloating is more of a nuisance symptom, and bloating relief therapies such as relieving constipation can help. But bloating sometimes can be a sign of a condition that needs more specific treatment. We call the following signs of gastrointestinal disorders “alarm features” because they should prompt a doctor visit—there’s no reason to suffer in silence…
