Bloating is a common digestive complaint that affects people of all ages. Most individuals have experienced this uncomfortable feeling of being full before or after a meal or during a period of stress. Hence, in many cases, bloating is harmless and very temporary in nature and is linked to overeating, and consumption of gas producing foods.
But persistent bloating must not be dismissed as being indigestion. Bloating is a bodily response, but chronic bloating may be an early indicator of an underlying gastrointestinal condition and in rare cases, it can be a symptom of a condition that can affect the organs outside the digestive system. This makes it significant to understand the difference between infrequent discomfort and a symptom that could prompt for a medical attention for an early diagnosis.
Bloating is a sensation of increased abdominal pressure; it can be fullness or tightness. Individuals also notice visible abdominal swelling while some will experience discomfort without the swelling. Temporary bloating is considered normal in cases such as:
After consumption of large meals
Swallowing excessive air when eating too quickly
Consumption of carbonated drinks
Eating gas forming foods such as cabbage, onions, and broccoli
For women during the time of menstruation, due to hormonal fluctuations
Due to constipation
Persistent bloating can sometimes last for several weeks, and it worsens with time, this needs immediate evaluation. It is also significant to understand that it must not be ignored if it starts to interfere with your day-to-day activities and to also understand if it is being accompanied by other symptoms.
When to seek immediate medical attention ?
Bloating that is frequent and lasts for 2-3 weeks
Increase in abdominal size as time progresses
Weight loss
Severe abdominal cramping
Difficulty in swallowing
Consistent constipation or diarrhoea
Blood in stools or black tarry stools
Abdominal pain that is often associated with fever
Iron deficiency
These symptoms indicate that the individual needs further investigation rather than a treatment meant for only indigestion. The individual must also look into whether they have a family history of gastrointestinal cancers or even inflammatory bowel disease.
Some conditions that are present with persistent bloating are:
Irritable bowel syndrome (IBS): This is the most common bloating in which patient tend to experience abdominal discomfort that is associated with constipation, diarrhoea or bowel habits.
Food intolerances: All digestive symptoms are not due to food allergies; some are due to excessive gas production and bloating.
Coeliac diseases: This is an autoimmune disease condition where consuming gluten tends to damage the small intestine in which many individuals experience persistent bloating, fatigue, and nutritional deficiencies.
Chronic constipation: Constipation is overlooked due to bloating, but when the stool remains in the colon for prolonged period, the gas accumulates and the abdomen feels tightened or distended.
Small intestinal bacterial growth: Excessive bacterial growth leads to fermentation of food before it is absorbed by the body, this results in bloating, excessive gas. Individuals with diabetes or any previous abdominal surgery are at an increased risk.
Gastrointestinal cancers: This is much less common than functional digestive disorders but persistent bloating can be early symptom of colorectal, pancreatic, or small bowel cancers mainly when it is accompanied by weight loss, appetite loss, and anaemia along with gastrointestinal bleeding.
In rare cases, the problem is not the gut, since not all bloating originates from the digestive tract, there are several medical conditions affecting other organs and can cause abdominal swelling. These include ovarian disorders that includes ovarian cancer, heart failure that causes fluid retention, kidney diseases, and hormonal disorders such as hypothyroidism.
Some helpful measures are:
Avoiding overeating
Reducing stress
Staying hydrated
Staying physically active
Limiting the consumption of carbonated drinks
Eating food slowly and chewing it thoroughly
Bloating becomes frequent or persistent or is associated with concerning symptoms then it is important to seek expert evaluation for timely intervention.
(The writer Piyush Bawane is a clinical lead, Medical Gastroenterology, at Kauvery Hospital)
