Bloated stomach feels tight, full and often painful. You might feel bloated even if you don’t have a distended abdomen. Bloating is usually a digestive issue, though hormones and stress also play a part. Sometimes there is an underlying medical condition. 

Bloated Stomach?

Stomach bloating primarily entails a sensation of tightness, pressure, or fullness in the abdominal area. This sensation might or might not be accompanied by visible abdominal distension (swelling). The degree of discomfort can range from mildly uneasy to intensely painful. While it generally subsides over time, some individuals experience recurring episodes. Bloating can be triggered by digestive issues and hormonal fluctuations, leading to cyclical patterns of discomfort. If persistent, seeking medical attention is advised to identify the underlying cause.

Why is my stomach bloated?

Excessive intestinal gas is the most prevalent cause of stomach pain and bloating. If bloating occurs after eating, it could signify a digestive problem. This could be due to overeating too quickly, a food intolerance, or other conditions that cause gas and digestive contents to accumulate. Hormonal fluctuations during the menstrual cycle can also lead to temporary bloating. At times, a bloated stomach might indicate a more serious medical condition.

How common is stomach bloating?

Approximately 10% to 25% of generally healthy individuals report occasional episodes of abdominal bloating. Around 75% describe their symptoms as moderate to severe, and approximately 10% report regular occurrences. Among those diagnosed with irritable bowel syndrome (IBS), this figure can rise to as high as 90%. Up to 75% of women experience bloating before and during their menstrual periods. Interestingly, only 50% of individuals experiencing bloating also report visible abdominal distension.

POSSIBLE CAUSES

Gas

While gas is a natural byproduct of digestion, an excess of intestinal gas indicates an imbalance in the digestive process. While you can ingest gas through activities like swallowing air or consuming carbonated beverages, most of these gases are released through belching before they reach the intestines. Gases produced in the intestines are primarily a result of gut bacteria breaking down carbohydrates through fermentation.

Excessive fermentation can occur due to various reasons, such as:

• Carbohydrate malabsorption: Certain carbohydrates (sugars) can be difficult for many to digest. Lactose, fructose, and carbs found in wheat and beans are common culprits. This intolerance can be specific or a result of general difficulties in processing complex carbohydrates. Identifying dietary sensitivities with the help of a nutritionist or GI specialist can be beneficial.
• Small intestinal bacterial overgrowth (SIBO): This happens when bacteria from the colon migrate into the small intestine, leading to an imbalance in gut bacteria. The overgrowth can disrupt the balance between different bacteria types, affecting the absorption of gases produced during digestion.
• Functional digestive disorders: Conditions like IBS and functional dyspepsia are diagnosed when digestion is impaired without clear reasons. Symptoms often involve gas and bloating after eating. Look out for alarm symptoms like diarrhea, constipation, nausea, vomiting, fever, bleeding, anemia, and unintended weight loss.
• Visceral hypersensitivity: Some individuals experience a bloated feeling even with normal gas volume. This condition often corresponds with IBS and disorders involving gut-to-brain neural pathways. In certain cases, the abdominal muscles can overreact, creating room for gas by protruding outward even with normal gas volume.
• Digestive Contents: These encompass solids, liquids, and gas. Accumulation of digestive contents within the digestive system can result from obstructions or restrictions in the tract or impaired movement of digestive contents due to muscular issues. Such accumulation reduces the space available for normal gas processing, causing discomfort.

 Possible causes of content buildup include:

• Constipation: Occasional or chronic constipation can arise from dietary or lifestyle factors. This leads to a backlog of fecal matter in the colon, causing recently-digested food to remain longer in the intestines. This extended presence expands the abdominal space, leading to bloating.
• Bowel obstructions: Tumors, scar tissue, strictures, stenosis, or hernias can block both the large and small intestines. Inflammatory conditions like Crohn’s disease and diverticulosis can also cause damage, resulting in constriction and slower passage of digestive contents.
• Motility disorders: These conditions impact the muscles and nerves responsible for sensing and moving digestive contents. Conditions like intestinal pseudo-obstruction mimic obstructions without any physical blockage. Gastroparesis involves partial paralysis of stomach muscles, while pelvic floor dysfunction affects pelvic muscles responsible for digestion.
• Recent weight gain: A recent weight gain, especially within a year, is often concentrated in the abdominal area. An increase of around ten pounds or more affects abdominal volume, limiting space for normal digestion and leading to bloating. Fluid retention associated with weight gain can exacerbate the sensation of bloating.
• Hormones:  Fluctuations in hormones, particularly in women, can lead to bloating patterns that align with their menstrual cycles. As many as 3 out of 4 women report experiencing abdominal bloating before and during menstruation. Hormonal changes during perimenopause can also induce temporary bloating. Female hormones play a significant role in stomach bloating, impacting fluid retention, gas, digestive movement, and sensitivity to these factors.
• Estrogen:  contributes to water retention, with spikes causing fluid-related bloating. This, combined with the natural expansion of the uterus before menstruation, can lead to a bloated feeling. Hormones also influence digestive processes, affecting the speed of motility and sensitivity to visceral factors. Estrogen receptors in the gastrointestinal tract influence visceral sensitivity, contributing to the perception of bloating.

Other Causes

Intermittent bloating is usually attributed to digestive or hormonal factors, or a combination of both. These causes are generally not serious if symptoms eventually subside. However, persistent or worsening bloating, or the presence of additional symptoms like fever or vomiting, should prompt medical consultation to rule out more severe underlying causes, such as:

• Ascites: Gradual accumulation of fluid in the abdominal cavity, usually linked to liver disease, kidney failure, or heart failure.
• Pancreatic insufficiency: Impaired pancreatic function, leading to inadequate production of digestive enzymes crucial for digestion.
• Inflammation of the stomach (gastritis) or intestines (enteritis): Often caused by bacterial infections (commonly H. pylori) or excessive alcohol consumption. This can also relate to peptic ulcers.
• Cancer (ovarian, uterine, colon, pancreatic, stomach, or mesenteric): Regular check-ups with a primary care physician are essential for cancer screening.

CARE AND TREATMENT

How long does stomach bloating last?

If bloating results from diet, hormonal fluctuations, or mild digestive issues, it should subside within hours to a few days. Constipation-related bloating will continue until bowel movements are normalized. Staying hydrated, engaging in physical activity, and consuming herbal teas can help alleviate symptoms. However, if bloating persists or worsens, seeking medical attention is crucial.

How can I relieve bloating?

The appropriate approach to relief depends on the underlying cause of bloating. Home remedies can help alleviate immediate discomfort or prevent future episodes:

Herbal teas like peppermint, chamomile, ginger, turmeric, and fennel aid digestion and gas processing. Dandelion tea is effective for reducing water