Abdominal bloating and distension are common gastrointestinal issues that can cause discomfort and affect an individual’s quality of life. In this article, we will explore the causes, symptoms, and remedies for abdominal bloating and distension, providing valuable insights into this condition
What is Abdominal Bloating?
Abdominal bloating refers to a sensation of fullness or tightness in the abdomen, often accompanied by visible swelling. It is a common symptom that can occur due to various factors, including excessive gas production, fluid retention, or underlying medical conditions.
Understanding Abdominal Distension
Abdominal distension refers to the physical enlargement or swelling of the abdomen. It can be a result of bloating or other factors such as weight gain, pregnancy, or abdominal tumors. Abdominal distension can cause discomfort, pain, and a feeling of heaviness.
Frequency of Reporting Abdominal Bloating in Individuals with FGIDs
The prevalence of abdominal bloating in people with functional gastrointestinal disorders (FGIDs) varies across different conditions. The occurrence rates are as follows:
Irritable bowel syndrome (IBS): 23% to 96%
Functional dyspepsia: 50%
Chronic constipation: 56%
Individuals with FGIDs and motility disorders often experience bloating and distension as symptoms. It’s important to note that functional bloating, characterized by fullness or distension of the abdomen without changes in bowel movements, is also prevalent.
The causes of abdominal bloating and distension have been subject to various explanations, yet no definitive answer has been found.
Possible factors contributing to abdominal bloating and distension include:
Imbalance of microorganisms residing in the bowel (dysbacteriosis), sometimes resulting from antibiotic use
Heightened perception and sensitivity to digestive tract processes
Increased curvature of the lumbar region of the spine (lumbar lordosis), which reduces abdominal gas capacity
Bloating and Gastroparesis
Gastroparesis, a motility disorder characterized by impaired muscle contractions in the digestive tract, leads to delayed stomach emptying.
Reports from specialized medical centers that frequently treat severe gastroparesis cases suggest that bloating is a common symptom. Bloating severity appears to correlate with the intensity of other gastroparesis symptoms, regardless of gastric emptying rates. Certain medications such as antiemetics, probiotics, and antidepressants with significant norepinephrine reuptake inhibitor activity may provide relief.
Bacterial overgrowth (SIBO), which can occur alongside gastroparesis, commonly manifests as bloating. Careful administration of antibiotics and probiotics can help manage these symptoms.
Treatment Options for Abdominal Bloating and Distension
The approach to treating abdominal bloating and distension depends on identifying the underlying cause. Here are some common treatment options:
Medications: Over-the-counter remedies like antacids, simethicone, or digestive enzymes can alleviate bloating and gas.
Dietary Modifications: Adjusting the diet to avoid gas-producing foods, increasing fiber intake, and following a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet can offer relief.
Probiotics: Taking probiotic supplements or consuming probiotic-rich foods promotes gut health and reduces bloating.
Stress Management: Employing stress-reducing techniques such as mindfulness meditation or yoga helps alleviate bloating and distension associated with stress or anxiety.
Dietary Changes to Alleviate Abdominal Bloating
Implementing specific dietary changes can significantly reduce abdominal bloating. Consider the following tips:
Avoid Gas-Producing Foods: Limit the consumption of legumes, broccoli, cabbage, onions, carbonated beverages, and chewing gum.
Increase Fiber Intake: Gradually incorporate fiber-rich foods like fruits, vegetables, whole grains, and legumes into the diet. Sufficient fiber intake promotes regular bowel movements and reduces bloating.
Stay Hydrated: Consume an adequate amount of water throughout the day to support healthy digestion and prevent constipation.
Eat Small, Frequent Meals: Opt for smaller, more frequent meals instead of large, heavy ones to prevent overburdening the digestive system.
Collaborating with a Physician
Open and honest communication with your physician is crucial for accurately conveying your experiences and symptoms. FGIDs present communication challenges due to their vague symptoms and sensitive nature. While there is no diagnostic test exclusively for bloating or distension, your doctor may conduct various tests to rule out underlying issues or associated disorders. These tests include:
Small transit follow through
Gastric emptying tests
Esophageal, gastroduodenal, or anorectal manometry
Colonic transit studies
Colonoscopy with biopsies
To assist your physician, provide precise and concise descriptions of your complaints. Regarding abdominal bloating and distension, consider asking these important questions and sharing the following details with your healthcare provider (keeping track of triggering factors can be helpful in finding answers):
Did you know that Spanish and some other languages don’t have a word for “bloating”? People use the words “swelling” and “inflammation,” or describe it as “feeling pregnant.” Using the balloon analogy can be the most helpful. Let your doctor know exactly whether you have the sensation of having a balloon in your abdomen (bloating), the truly visible increase in your abdominal girth (distension), or both.
Important Questions to Ask Your Doctor:
Am I experiencing bloating?
Am I experiencing distension?
Am I experiencing both bloating and distension?
Important Details to Share with Your Doctor:
Is the symptom localized in the upper or lower abdomen?
Does it concentrate in a specific area?
Is your bloating or distension accompanied by burping?
Does bloating or distension correlate with passing gas or changes in bowel habits (diarrhea, constipation, or alternating between the two)?
Are your symptoms related to particular foods?
If so, which ones? Do the symptoms occur immediately after eating?
Do the symptoms worsen throughout the day or improve during nighttime?
Medications and other therapies
Certain medications and treatments can alleviate the symptoms of abdominal bloating and distension. Depending on your symptoms and overall health, your doctor may discuss some of the following options:
Antispasmodics: These medications relax the bowel muscles, providing relief. Examples include dicyclomine (Bentyl) and hyoscyamine (Levsin) in the United States, otilonium bromide or pinaverium bromide available in Latin America and some European and Asian countries, and a combination of pinaverium bromide with simethicone (Alevian Duo) in some Latin American countries.
Probiotics: Dietary supplements containing live bacteria can help rebalance intestinal bacteria. Some over-the-counter options or yogurt varieties contain a relatively low level of probiotic bacteria. Bifidobacterium infantis 35624 is recommended for individuals with irritable bowel syndrome (IBS) in general, and Bifidobacterium animalis DN-0173 10 is recommended for patients with IBS with constipation (IBS-C).
Rifaximin: This antibiotic is minimally absorbed and can be used for short durations. It is sometimes used off-label to alleviate bloating in individuals with IBS whose symptoms do not include constipation, or in those with small intestinal bacterial overgrowth.
Prokinetics: These medications improve the transit time of food through the digestive tract. Some prokinetics have been shown to alleviate bloating. The suitability of these therapies and their availability vary depending on a person’s age, health, and other considerations, and they may differ from country to country.
Antidepressants: These medications impact receptors in the gut and the brain. When administered at lower doses than those used for treating depression, they have been found to help relieve bloating and distension. For instance, citalopram (Celexa), an SSRI (selective serotonin reuptake inhibitor), has been shown to improve bloating in individuals with IBS. Amitriptyline (Elavil), a tricyclic antidepressant, is commonly used to manage pain, discomfort, and diarrhea, and may be beneficial for bloating.
Other options: Medications that increase fluid content in stools, such as lubiprostone (Amitiza) or linaclotide (Linzess), may also be used. Psychological therapies: Treatments like hypnotherapy and cognitive-behavioral therapy can be valuable in managing symptoms and mood.
Natural Remedies for Abdominal Bloating and Distension
Several natural remedies can provide relief from abdominal bloating and distension. These include:
Peppermint Oil: Peppermint oil capsules or peppermint tea can help relax the muscles of the gastrointestinal tract, reducing bloating.
Ginger: Consuming ginger tea or taking ginger supplements may aid digestion and alleviate bloating.
Chamomile Tea: Chamomile tea has soothing properties that can relieve abdominal discomfort and reduce bloating.
Activated Charcoal: Activated charcoal tablets or capsules can help absorb excess gas in the digestive system and alleviate bloating.
What are FODMAPs?
Low FODMAP diet: Working with a doctor or registered dietitian to determine a diet low in FODMAPs is an option for alleviating abdominal bloating and distension symptoms. Foods that are rich in FODMAPs include:
FODMAPs are short-chain carbohydrates that are poorly absorbed in the small intestine and rapidly fermented by bacteria in the gut.
Fruits such as mangoes, apples, pears, avocados, blackberries, and plums
Dairy products like cow, sheep, and goat milk, as well as yogurt, ice cream, and soft cheeses including cottage cheese, cream cheese, and mascarpone
Vegetables and legumes such as asparagus, bell peppers, broccoli, Brussels sprouts, cabbage, cauliflower, eggplant, onion, garlic, baked beans, kidney beans, and lentils
Sweeteners like sorbitol and maltitol (frequently used in gum and other candies)
For specific guidance regarding personal health questions, we advise consultation with a qualified healthcare professional familiar with your particular circumstances. Be sure to thoroughly discuss treatment options and the use of any medications for treatment with your physician. When prescribed a medication, disclose the use of all other drugs or supplements (whether prescription or over-the-counter) with your physician.
Bloating and distension are both very common, for the general population and those with FGIDs and motility disorders. Either of the two may be very bothersome to individuals that are experiencing the symptoms, as well as challenging to those trying to treat them. There is not a conclusive cause for bloating or distension, nor is there a universally effective treatment. With the help of a physician, individuals can find different treatment options that may help alleviate their symptoms.
Frequently Asked Questions (FAQs)
Q: Can stress cause abdominal bloating?
A: Yes, stress can contribute to abdominal bloating and discomfort. Stress can affect the functioning of the gastrointestinal system and lead to symptoms like bloating.
Q: Are there any medications specifically for treating bloating?
A: Over-the-counter medications like antacids or simethicone can provide temporary relief from bloating. However, it’s important to address the underlying cause of bloating for long-term management.
Dr. Ahmed Raza, a renowned gastroenterologist with over 20 years of experience, is the dedicated founder of LifeWithNoGallbladder. With a passion for improving gallbladder health, Dr. Raza shares extensive insights, records, and guidance through his blog, providing individuals with the necessary information to make informed decisions.