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What is meant by bloating?
Bloating is a feeling that the abdomen is tight, swollen, or distended. In some people, it is clearly visible that the abdomen becomes larger במהלך the day, while others mainly experience discomfort, pressure, or gas without any actual increase in abdominal size. Gas forms naturally in the intestines when we swallow air, for example when eating quickly or talking while eating. Gas is also produced when intestinal bacteria break down carbohydrates that have not been fully absorbed in the small intestine.
Why does the stomach become gassy and tight?
The intestines move food and gas forward through rhythmic muscle contractions. If these movements are slow or irregular, gas can remain in the intestines longer and cause discomfort. In some individuals, the intestines are also extra sensitive. In IBS, the intestines react more strongly to stretching, which means that even normal amounts of gas can feel uncomfortable.
Common causes of a bloated stomach
The most common cause is so-called functional gastrointestinal disorders. This means that the intestines function differently, but no inflammation, ulcers, or other visible damage can be found. IBS is the clearest example. Functional dyspepsia, which causes discomfort in the upper abdomen without evidence of a stomach ulcer, also belongs to this group. Some people also swallow air unconsciously, especially during stress or when eating quickly, which can contribute to gas and a feeling of pressure.
Diet often plays a major role. Certain carbohydrates are more difficult to break down and can start to ferment in the intestines, leading to increased gas production. In people with lactose intolerance, milk sugar is not properly digested, which can cause both bloating and diarrhea. Carbonated drinks as well as large and late meals can also worsen symptoms.
Constipation is another common cause. When stool remains in the colon for a long time, gas production and pressure in the abdomen increase. Hormonal changes also affect the intestines. Many people experience more swelling before or during menstruation, and during pregnancy both hormone balance and bowel movements change.
Less common causes
In some cases, bloating may be caused by disease. This may include inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, celiac disease, stomach ulcers, or liver disease. In women, changes in the ovaries can lead to increased abdominal size. Fluid in the abdomen, known as ascites, is uncommon but can cause noticeable swelling. Acute conditions such as bowel obstruction, however, cause severe pain and general illness and require immediate medical care.
Other symptoms that may occur
Bloating is often accompanied by a feeling of pressure, belching, and increased gas. Some people experience abdominal cramps or a dull ache. Bowel habits may change, resulting in constipation, diarrhea, or alternating between the two. Nausea and a feeling of becoming full quickly are more common with symptoms originating from the upper abdomen.
When do symptoms suggest IBS?
Symptoms often suggest IBS if they have been present for a long time, vary in intensity, and improve after a bowel movement. It is also typical that blood tests and other basic examinations are normal and that no warning signs are present.
When should you seek medical care?
You should contact healthcare services if you lose weight without trying, notice blood in your stool, have persistent or worsening pain, or develop a fever. The same applies if the abdomen rapidly becomes more swollen or if new digestive symptoms appear after the age of 50. In cases of sudden and severe abdominal pain, especially if combined with vomiting, you should seek emergency medical care.
How is bloating investigated?
The evaluation usually begins with a discussion of symptoms, a physical examination, and blood and stool tests. These tests can show signs of inflammation, anemia, gluten intolerance, or infection. In some cases, a gastroscopy is performed, where a thin camera is passed through the mouth to examine the esophagus, stomach, and upper part of the small intestine.
Imaging investigations
Abdominal ultrasound is a gentle examination that uses sound waves to assess organs such as the liver, gallbladder, kidneys, and ovaries. It is particularly useful for detecting gallstones, cysts, or fluid in the abdomen, but it does not show details from inside the intestines. An magnetic resonance imaging (MRI) of the abdomen provides more detailed images of soft tissues and may be used when there is suspicion of inflammatory bowel disease or a tumor. In typical IBS cases without warning signs, it is rarely needed.
Treatment and self-care
For functional disorders, regular meals in a calm environment are an important foundation. Eating slowly and reducing the intake of gas-producing foods for a period may help. Daily physical activity stimulates bowel movements and can reduce the feeling of bloating. Constipation should be treated, and stress management as well as good sleep can also reduce symptoms.
If an underlying disease is identified, treatment is directed at the specific cause, such as a gluten-free diet for celiac disease or anti-inflammatory medication for inflammatory bowel disease.
