Intestinal bloating: symptoms, causes, and when to see a doctor

Your belly feels distended, your jeans suddenly feel tight, and your mind has already lined up a queue of scary diagnoses. Let's sort this out without panic: bloating is a very common complaint, and most often the explanation is more prosaic than it seems. But there are situations where you shouldn't wait, and we'll talk about those too.

What intestinal bloating is

Bloating is when your abdomen feels full and uncomfortable. It may seem larger than usual and look swollen, as if it's being distended from within.

Let me clarify right away what bloating is not. It is not a separate diagnosis but a symptom that has a cause, and most often that cause is related to gas in the intestines.

A few numbers for scale. A healthy adult has about a liter of gas in the stomach and intestines, and roughly 0.1–0.5 liters is naturally expelled per day. With meteorism, the volume of gas expelled can reach three or more liters.

Symptoms of intestinal bloating

The picture is recognizable: the abdomen feels full or larger than usual, pain or discomfort appears, the abdomen rumbles and "gurgles," and more gas is passed than usual. Visually, the abdomen may also look distended.

Added to this are belching, hiccups, a feeling of heaviness and distension, bouts of cramping pain that disappear after passing gas, nausea, an unpleasant taste in the mouth, and decreased appetite. Sometimes bowel movements go in circles: diarrhea alternates with constipation.

Possible causes of bloating

The most common cause is a large amount of gas in the intestines. Gas comes from food and drinks, such as certain vegetables and soda, or from air that we swallow while eating.

The second large group is digestive problems: constipation, food intolerance, celiac disease, irritable bowel syndrome. Bloating can also occur around menstruation.

The list is broader than it seems: it includes reflux, lactose intolerance and difficulty digesting other foods, overeating, small intestinal bacterial overgrowth, weight gain, and increased sensitivity of intestinal nerves. Some medications, products with lactulose or sorbitol, and foods high in fructose can also cause bloating.

There are also more serious conditions where bloating is one of the signs: ascites and abdominal tumors, dumping syndrome, ovarian cancer, pancreatic enzyme insufficiency. By mechanism, doctors divide gas intake into external, about 90%, and internal, roughly 10%. A separate group is impaired gas passage.

How a doctor determines the cause

Next, the doctor may refer you to a dietitian if general dietary changes don't help, or to a specialist for tests to find the cause of the bloating. The set of tests depends on the picture.

Why bloating can be dangerous

Bloating is very common, but if it is persistent, it is sometimes a sign of a more serious disease, such as ovarian cancer. Therefore, a persistent complaint is a reason to see a doctor.

When to see a doctor

There is a routine reason and an urgent one. See a doctor routinely if:

• bloating recurs regularly;
• you have tried changing your diet, but the distension persists;
• bloating is combined with unintentional weight loss;
• blood has appeared in the stool;
• there is abdominal pain or the stool has become dark and tarry.

Without delay — if bloating comes with vomiting, diarrhea or constipation, with abdominal pain, with a high fever or a feeling of heat, cold and chills, with swelling or a lump in the abdomen, with inability to urinate, have a bowel movement, or pass gas, and also with burning behind the breastbone due to reflux of acidic contents.

Bloating by itself is not a reason to call an ambulance. You should call 103 or 112 if the abdomen is bloated and there is very severe pain that came on suddenly; if vomiting of blood has started or the vomit resembles coffee grounds; if marked shortness of breath has appeared — the person is gasping and cannot speak.

This material is for reference: it helps you understand what is happening and what to ask the doctor, but it does not replace a consultation — a diagnosis is made by a specialist after an examination.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer