BLOATING

Patients who report difficulty with bloating typically describe themselves as having a “swollen stomach” or “distended belly”. They may also complain of abdominal discomfort, belching (burping), flatulence (passing gas), nausea and bowel irregularity. As mentioned previously, most causes of boating are harmless and can be effectively treated with lifestyle and/or dietary adjustments. Some of the more innocuous conditions that can lead to bloating include:

• Constipation
• Increased Intestinal Gas (often due to aerophagia, food intolerances and carbonated beverages)
• Overeating
• Gut Hypersensitivity (a.k.a Irritable Bowel Syndrome or “IBS”)
• Small Intestine Bacterial Overgrowth (“SIBO”)
• Gastroparesis (poor emptying of the stomach which is often related to either advanced diabetes or medication side-effects)
• Celiac Disease (a.k.a. Gluten Intolerance)

Now that some of the more benign causes of bloating have been identified, how can the situation be rectified? As mentioned above, solutions are typically simple and frequently involve treating the underlying issue:

• If constipation is the root cause, fiber supplements, stool softeners, OTC laxatives (i.e. Miralax) and, occasionally, prescription laxatives may help to resolve the issue
• If excess gas is the cause, dietary modification and/or the use of anti-gas agents such as Simethicone or Beano may be helpful.
• For conditions such as Celiac Disease, SIBO, Gastroparesis and IBS, dietary adjustments can frequently result in significant improvement; however, it is not uncommon for a more defined treatment plan involving input and supervision from a gastroenterologist to be needed, as well

Although most causes of bloating are relatively harmless, occasionally, more serious underlying medical conditions may be present. These conditions frequently require the assistance of a physician to treat them. Some of the more serious conditions that can cause bloating include:

• Bowel obstructions (frequently due to intra-abdominal adhesions from prior surgeries)
• Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s Disease)
• Infections (i.e. food poisoning, gastroenteritis and diverticulitis)
• Advanced Liver Disease
• Intestinal and intra-abdominal tumors

Taking all of the above information into account, when should someone seek medical attention? Although there are no strict criteria on when it is appropriate to seek out medical care, it is probably best to schedule an appointment with a physician if any of the following symptoms are present:

• Severe, unrelenting abdominal pain
• Persistent vomiting
• Ongoing fever
• Gastrointestinal bleeding (i.e. bloody stools or vomiting blood)
• Inability to eat or drink anything
• Inability to have a bowel movement
• Unexplained weight loss
• Jaundice

We hope the above information has been helpful. If you have further questions or concerns, please feel free to schedule an appointment with us. We look forward to seeing you!

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