Bloating & Excessive Gas

Bloating is a common problem that affects up to 30% or more of healthy adults. It is a result of air or gas filling the gastrointestinal (GI) tract, and often presents as fullness, tightness, or pressure in the stomach, possibly accompanied by an obviously swollen or ‘hard’ abdomen, or pain in the abdomen. Bloating can make you feel anywhere between slightly uncomfortable to tremendously painful. The bloatedness can last for a short while or subside only after several hours. Recurrent bloatedness may be the case for those who experience digestive problems and hormonal fluctuations.

Why does bloating happen?

Bloating is often the result of excessive intestinal gas.

The body produces Intestinal gas naturally, as a result of gut bacteria digesting carbohydrates, in a process called fermentation. Unlike the gas you ingest either through consuming air or carbonated drinks, which you would pass out by belching even before the air reaches your intestines, too much intestinal gas points to an issue with your digestion. 

Excessive fermentation happens when a great number of carbohydrates are not absorbed naturally during digestion. As a result, a correspondingly excessive amount of intestinal gas is produced.

What conditions do bloating and excessive gas point to?

Intestinal gas could build up when you eat too much or too fast for normal digestion, consume a food you are intolerant towards, or due to a gastrointestinal disease. 

Carbohydrate Malabsorption

Some carbohydrates, such as fructose and lactose, are difficult to break down and can lead to gas and bloating. A specialist will be able to help identify if you are sensitive to any carbohydrates. Avoiding these carbohydrates or consuming them moderately should reduce the extent of bloating you feel.

Functional Digestive Disorders

If you struggle with digestion without an explainable reason, you may have functional digestive disorders such as Functional dyspepsia and Irritable Bowel Syndrome (IBS). In Singapore, almost one in 10 suffers from IBS. Other typical symptoms of such disorders include diarrhoea or constipation, vomiting or nausea and abdominal bloatedness

Bowel Obstruction

Both your large and small bowels can become blocked by tumours, scar tissue, strictures, stenosis, or hernias. This presence of obstruction prevents movement of faeces and hence build up of air

Visceral Hypersensitivity 

People who feel bloated when their levels of gas are normal have what is known as a visceral hypersensitivity. This condition is often correlated with IBS and disorders associated with gut-to-brain nerve pathways. There are also cases in which people develop an undesirable reaction to create more room to accommodate gas where the abdominal muscles stick outwards when normal levels of gas are present.

Small Intestinal Bacterial Overgrowth 

Bacterial overgrowth in the small intestine happens when a particular population or subtype of bacteria predominates and displaces the normal intestinal flora. This overgrowth can in turn lead to build up of gases 

Weight Gain

Recent weight gained, especially in the belly, can impact your abdominal capacity. Weight gained in the belly leaves smaller room for digestion, so a regular meal may make you feel unusually bloated. Weight gain can also cause water retention throughout your body including your abdominal cavity. 

Hormones

Up to 3 in 4 women experience bloating during their periods, making it prevalent among women who menstruate. Female hormones not only cause bloating but can also make you feel more sensitive to the feeling of bloating.

When should I seek help?

Bloating should go away on its own but if it persists for more than a week, and is constantly painful, you should see your healthcare provider. Another sign to see your healthcare provider is if and when bloating becomes progressively worse and you begin developing other symptoms like fever, vomiting or bleeding. 

What are the investigations for bloating and excessive gas?

While bloating is a very common symptom, it is no easy feat to treat because there is no one treatment that has proven to be effective.

To identify the cause of your bloating or any underlying condition, you may undergo a colonoscopy and/or gastroscopy. 

To relieve the discomfort, you may be prescribed probiotics that will help improve intestinal microbial balance. This would restore the bacteria balance in your gut which, in turn, manages the excessive gas present. Another medication that helps the body expel gas quickly is simethicone – an anti-foaming agent.

If your bloating is a result of a specific food intolerance, you may undergo an elimination diet to identify which foods. Avoid overconsuming these foods and you should experience a correspondingly reduced feeling of gassiness and bloating. Some medications can aid in breaking down complex carbohydrates as well.

Fibre can sometimes be the culprit for bloatedness and reducing fibre intake, particularly bran fibre may help with abdominal bloating. 

Other simple ways you can adopt to alleviate the bloat includes moving, especially after a meal. This would move the gut along and reduce bloating as well.

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