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Bloating is one of the most common health complaints. Almost everyone would experience some bloating during the year. However, it could be a cause of concern if it happens too frequently.
Bloating is often a sign of some gastrointestinal issues. It may be a symptom of severe and less severe disorders. Bloating may occur with other symptoms like abdominal discomfort, stomach pain, and changes in intestinal motility.
Here we discuss some of the most common causes of bloating. Some of them are chronic disorders that need medical attention, but many disorders can be managed via lifestyle interventions. However, many of these conditions remain unidentified for years, and people often seek medical attention too late. Thus, if bloating is frequent, it needs to be taken seriously.
It is a most common health issue and yet poorly understood. All people differ, and they have different food choices. Similarly, all people find it difficult to digest certain foods causing bloating and abdominal distress.
Here is essential not to confuse food intolerance with celiac disease or food allergies. Celiac disease is a condition when a person cannot tolerate gluten, resulting from autoimmunity. Wheat is the primary dietary source of gluten in most people.
Similarly, some people might be allergic to a particular food, which may cause significant abdominal distress after those foods.
However, food intolerance causes much milder reactions, unlike celiac disease or allergies. For example, some may develop bloating after dairy products, others after eating legumes. In addition, unlike food allergies, food intolerances primarily occur due to enzymatic defects and not due to immune reaction1.
Regretfully, as people consume more wheat and baked products, gluten intolerance is becoming common. As already mentioned above, it differs from food intolerances or allergies. It is an autoimmune reaction to gluten2. The primary source of gluten is wheat and wheat products like pasta, semolina, biscuits, etc.
In some cases, celiac may start with more benign signs like bloating and mild gastrointestinal symptoms. However, continued exposure to gluten may make things worse.
Irritable Bowel Syndrome (IBS)
It is the most common gastrointestinal health issue. Studies show that an estimated 10% of adults are living with IBS3.
IBS is quite challenging to identify and remains a poorly understood condition. It occurs due to many reasons like stress, changes in gut microbiota, altered neural pathways (gut hyperresponsiveness), and much more.
Even doctors have difficulty diagnosing the condition as there is no single test that can work, and the disease diagnosis is clinical. It may cause bloating, constipation, diarrhea, other changes in gut motility. If you are experiencing bloating along with changes in stool frequency for more than three months, it may be IBS4.
Functional Gastric Disorders
Almost 40% of all gastrointestinal complaints are due to functional gastrointestinal disorders. However, these are difficult to diagnose disorders, and most medical tests would be normal, and doctors generally diagnose these conditions based on clinical history. Thus, IBS, food intolerances, gut changes due to anxiety or neural disorders are all examples of functional disorders5.
Doctors often struggle to diagnose these conditions as they occur for many reasons, like altered gut microbiota, changes in the brain, altered immunity, and much more. In some cases, bloating may remain undiagnosed as doctors struggle to identify the cause.
Overeating & Indigestion
These days overeating is a significant problem in the developed world. One of the reasons for bloating could be wrong food choices. Many fast foods or ultra-processed foods might be tempting, but they are not suitable for gut health and are packed with calories.
The human gut may struggle to digest so many calories. Just take an example of a large burger with multiple beef patties and whole lots of cheese and fries. It may sound mouthwatering, but digesting so many calories may be difficult for the gut. As a result, it may simply run out of digestive enzymes.
Studies show that obese people are more likely to have digestive issues and functional gastric disorders. It is because high-calorie intake means delayed gastric emptying and a greater risk of bloating6.
About one-fifth of the population would experience constipation during the year7. It is more likely to occur in older adults.
There could be many reasons for constipation. In young adults, the most likely cause could be low consumption of dietary fiber and resulting motility disorders. Consumption of a diet rich in fats may also cause constipation. In some people, the cause of constipation could be not drinking enough water.
Causes of constipation may differ in older adults. In this population group, it could be due to emotional stress, aging, neurodegenerative diseases, weakening of the body, and much more.
Laxatives may help get rid of constipation and bloating in such cases. However, a better way could be to increase dietary fiber consumption, engage in increased physical activity, and drink more water.
GERD or Reflux Disorder
GERD (gastroesophageal reflux disease) is the most common gastrointestinal disorder, affecting almost one-fourth of the population8. Causes of GERD could be many, from wrong dietary choices to changes in gut motility. Most people will experience GERD intermittently, but it may be a severe and persistent problem for many.
GERD often leads to poor food movement in the digestive tract, digestive issues, changes in appetite, abdominal pain, and bloating.
If GERD is occasional, it may be managed by maintaining a healthy body weight and increasing physical activity. One can also treat it with over-the-counter antacids that may also help relieve bloating. However, more severe cases would need medical treatment.
Swallowing Too Much Air
A pretty benign and common cause of bloating is swallowing too much air. It may be due to stress, certain eating habits, chewing gum, smoking, eating too fast, etc.
Constipation, menstruation, drinking carbonated drinks, eating substantial meals may all lead to increased swallowing of air and bloating.
Bloating is the most common sign of a gastrointestinal issue. In many cases, bloating may be the only sign or predominant symptom of gastrointestinal problems. Fortunately, in most instances, it is readily managed without medications or with the help of over-the-counter remedies. However, if bloating persists, one should seek medical attention as it may be a sign of something more severe or chronic.
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- Ortolani C, Pastorello EA. Food allergies and food intolerances. Best Practice & Research Clinical Gastroenterology. 2006;20(3):467-483. doi:10.1016/j.bpg.2005.11.010
- Sollid LM, Jabri B. Is celiac disease an autoimmune disorder? Curr Opin Immunol. 2005;17(6):595-600. doi:10.1016/j.coi.2005.09.015
- Wilson S, Roberts L, Roalfe A, Bridge P, Singh S. Prevalence of irritable bowel syndrome: a community survey. Br J Gen Pract. 2004;54(504):495-502.
- Lacy BE, Patel NK. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017;6(11):99. doi:10.3390/jcm6110099
- Functional GI Disorders - IFFGD. Accessed March 6, 2022. https://iffgd.org/gi-disorders/functional-gi-disorders/
- Ho W, Spiegel BMR. The Relationship Between Obesity and Functional Gastrointestinal Disorders. Gastroenterol Hepatol (N Y). 2008;4(8):572-578.
- Vazquez Roque M, Bouras EP. Epidemiology and management of chronic constipation in elderly patients. Clin Interv Aging. 2015;10:919-930. doi:10.2147/CIA.S54304
- Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. In: StatPearls. StatPearls Publishing; 2022. Accessed March 6, 2022. http://www.ncbi.nlm.nih.gov/books/NBK441938/