Bloating
Bloating is the feeling of being stretched from the inside: the tummy feels full and tight, visibly bigger by the evening, rumbling, and along with it come…
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Medicines commonly prescribed for Bloating
For informational purposes only. Always consult a doctor before taking any medication.
Dosage form: RECTAL LIQUID, 4 gActive substance: mesalazineManufacturer: Ferring S.A.U.Prescription requiredDosage form: CAPSULE, 240 mgActive substance: siliconesManufacturer: Uriach Consumer Healthcare S.L.Prescription not requiredDosage form: TABLET, 500 mgActive substance: mesalazineManufacturer: Faes Farma S.A.Prescription required
Bloating is the feeling of being stretched from the inside: the tummy feels full and tight, visibly bigger by the evening, rumbling, and along with it come wind, belching and a dull discomfort. The sensation is unpleasant but almost always harmless in itself — food, habits and the way the bowel is working are behind it far more often than any disease. It is still worth getting to the bottom of, partly because bloating responds well to simple measures, and partly because there is a short list of signs that turn it into something else entirely. Those are worth knowing in advance.
What it actually feels like
People describe quite different things under the word "bloating", and it helps a doctor to know which one you mean:
- the tummy feels full and tight although nothing has changed from the outside;
- the tummy genuinely grows: a waistband that fastens loosely in the morning is digging in by the evening;
- rumbling and gurgling, a sense of movement inside;
- wind passing more often than usual, with belching;
- a dull discomfort or cramping that eases after opening the bowels.
These are different faces of one thing, and together they build the picture a doctor is after: whether the sensation tracks meals, the time of day, or bowel movements. It is also worth separating bloating from what resembles it: an abdomen that grows gradually over months without any feeling of tightness usually has to do with weight or with a build-up of fluid, and that is approached differently.
Why the tummy swells up
The causes are nearly always everyday ones, and they stack on top of each other:
- too much, too fast. A large portion stretches the stomach on its own, and eating in a hurry or talking with your mouth full adds swallowed air; chewing gum, smoking and drinking through a straw do the same;
- gas-producing food. Pulses, cabbage of every kind, onions, bran, sweeteners such as sorbitol and xylitol, and fizzy drinks. None of these are bad for you — part of them is simply digested by gut bacteria, and gas is the by-product of that work;
- constipation. Contents held up in the bowel ferment for longer, and that is when the tummy feels most distended. It is the commonest cause and the easiest to sort out;
- irritable bowel syndrome. Bloating is one of its central symptoms, alongside pain that eases after opening the bowels and an alternation of diarrhoea and constipation;
- lactose intolerance and intolerance to other sugars: bloating, gurgling and loose stool an hour or two after dairy;
- hormonal changes. Many women notice bloating in the days before a period; that is ordinary and needs no treatment in itself.
Less often coeliac disease, bacterial overgrowth in the small bowel, or problems with the pancreas or the thyroid lie behind it. Those get looked for when simple measures have not worked or when other symptoms are present.
What actually helps
Starting small is the sensible approach, and for most people it is enough:
- eat more slowly and in smaller portions. A dull piece of advice that outperforms half the pharmacy shelf: chew properly, do not eat on the move, do not talk with your mouth full, eat at a table rather than over a keyboard;
- drop fizzy drinks and chewing gum. The first delivers gas directly; the second keeps you swallowing air all day;
- deal with constipation. More fibre, but introduced gradually, because a sudden switch to bran is itself bloating; enough fluid; a regular, unhurried toilet routine. If that is not enough, discuss a laxative with a doctor or pharmacist;
- keep moving. An ordinary walk after a meal speeds contents along the bowel and noticeably reduces bloating; regular physical activity does better still;
- keep a food diary. For two or three weeks, write down what you ate and when things got worse. It is the only way to find the food that affects you in particular, and it also spares you pointless bans: usually two or three foods are to blame, not "everything";
- do not lie down straight after eating and do not push your main meal into the late evening.
From the pharmacy, simeticone preparations sometimes help with a one-off episode, and antispasmodics help when there is cramping. They ease the sensation without removing the cause, so they make sense as a temporary measure rather than a standing habit.
The low FODMAP diet
This is an eating plan that temporarily restricts the carbohydrates that are poorly absorbed and readily fermented by bacteria: lactose, fructose, certain sweeteners and a proportion of vegetables, pulses and grains. In irritable bowel syndrome the diet genuinely works and clearly reduces bloating in most people.
It comes with two conditions that are often forgotten. First: it is done alongside a doctor or a dietitian, because the list of restrictions is long and it is easy to end up on a poor diet without guidance. Second: it is not a diet for life. The strict phase runs for a few weeks, after which foods are reintroduced one at a time and the reaction watched — the whole point is to end up eating as freely as possible, cutting out only what genuinely troubles you. Starting it on your own before a diagnosis is unwise: if coeliac disease is what lies behind the symptoms, an altered diet blurs the picture and gets in the way of finding it.
What there is no need to do
A whole industry has grown up around bloating, and most of what it sells is money wasted:
- "cleanses", detox programmes, colonic irrigation. The bowel does not need cleaning out and manages perfectly well by itself; procedures of this kind do not help, and washing out the colon is not always safe;
- digestive enzymes with no indication. Enzymes are for proven pancreatic insufficiency and lactase is for confirmed lactose intolerance. Taking them "for digestion" just in case achieves nothing;
- long lists of banned foods drawn up from blood tests for "food intolerance". Those tests are not validated as a diagnostic method, and the outcome is usually the same: the diet gets poorer and the bloating stays;
- cutting out gluten by yourself. If coeliac disease is suspected, the tests come first and the diet afterwards: on a gluten-free diet the results stop being reliable.
Probiotics sometimes help in irritable bowel syndrome, but the result is unpredictable and depends on the particular strain; if there is no difference after a month, there is no point continuing.
When bloating needs a doctor
This is precisely the subject where warning signs get lost: bloating is so ordinary that people put it down to food for years. See a doctor if even one of these applies:
- the tummy is bloated constantly rather than coming and going, has grown in size, and has been like that for weeks. In a woman, persistent bloating of this kind is a reason to rule out ovarian cancer, particularly if pelvic pain, feeling full very quickly and needing to pass urine often have joined it. An ovarian tumour goes a long time without causing anything else, and continuous bloating is sometimes its only early sign;
- bloating has appeared for the first time in later life, roughly past fifty, with nothing of the sort before;
- weight loss with no clear cause and growing weakness;
- blood in the stool, or black stool;
- a sustained change in bowel habit: looser, more frequent, thinner stool, or stubborn constipation instead, going on for more than a few weeks;
- difficulty swallowing, a sense of food sticking;
- vomiting, especially repeated, or persistent nausea;
- filling up very quickly — a few spoonfuls are enough where a normal portion used to be;
- a lump you can feel in the abdomen, pain that wakes you at night, fever;
- bowel, stomach or ovarian cancer in close relatives together with new, persistent bloating.
Call an ambulance (in Spain, Italy, Portugal, Poland and Ukraine the single number is 112) if the abdomen has swollen suddenly and hurts badly, the abdominal wall is hard and painful to touch, there is vomiting, and neither stool nor wind is passing. That is how bowel obstruction presents, and there the clock runs in hours.
Online consultation
An online doctor can separate ordinary bloating from the kind that needs investigating: going through when exactly it gets worse, what your bowels are doing and whether any warning signs are present, and advising which tests are worth having before you change how you eat. They can explain how to keep a food diary properly and how to read it, judge whether a low FODMAP diet fits your case and whether now is the time to start it, and talk through the treatment you have been given if the bloating has turned out to be part of irritable bowel syndrome.
This material is for information only and does not replace medical advice.
Consult with a doctor about Bloating
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Online doctors for Bloating
Discuss your symptoms and possible next steps for Bloating with a doctor online.
