Medications And Other Therapies
Some medications and other treatments have been found to help ease the symptoms of bloating and distension. Your doctor may talk to you about some of these options, depending on your symptoms and other health related considerations.
Antispasmodics: These can relax the muscles of the bowel and provide relief. Examples include dicyclomine and hyoscyamine in the United States and otilonium bromide or pinaverium bromide available in Latin America and some countries in Europe and Asia and a combination of pinaverium bromide with simethicone in some Latin America countries.
Probiotics: These dietary supplements contain live bacteria that help balance out the existing bacteria of the intestines. Some that include a relatively low level of probiotic bacteria are available over the counter or in yogurt varieties. Other options include Bifidobacterium infantis 35624 for individuals with irritable bowel syndrome in general, and Bifidobacterium animalis DN-0173 10 for patients with IBS with constipation .
Rifaximin: This antibiotic is only slightly absorbed and can be used for short periods of time. Usually it is used to lessen bloating in people with IBS whose symptoms do not include constipation, or in those with small intestinal bacterial overgrowth.
Other options: Medications that increase fluid content in stools, lubiprostone or linaclotide for example, may also be used.
Possible Reasons For Bloating And Distension Include:
- Too much gas in the intestine
- Abnormal levels of bacteria in the small intestine
- Imbalance of microorganisms that usually live in the bowel sometimes the result of taking antibiotics
- Food intolerance
- Increased perception and sensitivity to what is happening in the digestive tract
- Increased curvature of the lumbar region of the spine , which decreases the capacity of the abdomen to hold gas
What Does Abdominal Distension Indicate
A distended abdomen is either an organic or a functional problem. An organic problem can be explained by physical evidence, like a disease. Functional problems are observable but unexplained.
Organic causes of abdominal distension might include:
- Menstruation, which causes water retention.
- Significant recent weight gain, which tends to be stored as intra-abdominal fat and may restrict digestion.
- An obstruction of the small or large bowel, causing a build-up of gas and waste matter.
- Partial paralysis of the stomach causing a build-up of digestive contents.
- Inflammation of the abdominal lining .
- A build-up of fluid in the abdomen caused by liver disease .
- Organ enlargement from inflammation or a growth.
- Internal bleeding .
Functional reasons for a distended abdomen tend to involve digestive problems that cause gas and/or digestive contents to accumulate. Causes might include:
- Constipation causing a build-up of feces and back-up of digestive contents.
- Urinary retention causing a build-up of urine.
- A disorder of the muscle contractions involved in digestion , causing digestive contents to back up.
- Abdominal muscle weakness, which causes the abdominal contents to sag outwards and downwards .
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Are There Tests To Diagnose The Cause Of Bloating
In most cases, bloating is diagnosed after a healthcare provider performs a physical exam and takes a medical history. Talking about diet, lifestyle, and medications with your provider can help shed light on what is going on with your digestive system. An exam of the abdomen to look for any tender spots or anything abnormal is also done.
Its also helpful to describe how often the bloating happens and if its related to anything else.
If the bloating is chronic or associated with other conditions, your provider may decide to do some tests to see if there is anything serious happening. One or more of these tests might be used to determine whats causing the bloating:
Are Fodmaps Bad For Everyone
Not at all. In fact, our digestive systems are designed to process some foods that we cant fully digest ourselves for example, dietary fiber, which has an important place in digestive health. And feeding the bacteria in our gut is part of our symbiotic arrangement with those bacteria. But some people with sensitive guts experience a level of indigestion from these foods that significantly impacts their quality of life. For these people, the byproducts of fermentation cause chronic symptoms of gas, bloating, abdominal pain and distension. The extra water drawn by the small intestine may cause diarrhea in excess, or constipation if there isnt enough.
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When Should I Be Worried About Abdominal Bloating
See your healthcare provider if your bloated stomach:
- Gets progressively worse.
- Persists for more than a week.
- Is persistently painful.
- Comes with symptoms of illness, such as fever, vomiting or bleeding.
A note from Cleveland Clinic
A bloated stomach is not a pleasant feeling. While its a common experience and usually temporary, you may become weary of the cycle. Spending a little focused attention on the problem to identify the cause can be well worthwhile. Try recording your symptoms and possible triggers in a journal. Note diet, hormonal and stress factors. When in doubt bring your notes to a specialist for professional guidance. The different factors that contribute to bloating can be complex and difficult to parse, but medical testing can help. As always, seek medical attention if your symptoms are persistent or severe.
How Are These Symptoms Treated
Even severe symptoms usually improve over time with diet and lifestyle changes. Your doctor can help you decide which treatments are best for you.
Diet: Eat and drink more slowly to swallow less air. Limit fatty and spicy foods. Avoid caffeine, carbonated drinks, and artificial sweeteners. Avoid common gas-causing foods, such as beans, peas, lentils, cabbage, onions, broccoli, cauliflower, and whole grains. Try removing one food at a time from your diet to see if your gas improves.
Fiber: Fiber has many benefits, although too much fiber may increase the amount of gas in your intestines.
Exercise: Regular daily exercise often reduces symptoms in the stomach and intestines.
Laxatives: Over-the-counter laxatives, such as polyethylene glycol , may help with constipation but probably not with stomach pain.
Antidiarrheal medicines: Over-the-counter loperamide may help with diarrhea but probably not with stomach pain.
Probiotics: Probiotics are found in some over-the-counter supplements and yogurts. Common probiotics are Lactobacillus and Bifidobacterium.
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Natural And Other Remedies For Gas
Two products on the market can help with food-related gas and bloating. Both products are packaged forms of the enzymes needed to break down the problematic carbohydrates. Lactase, found in products such as Dairy Ease and Lactaid, can be taken with dairy foods to help break down lactose and lessen gas. Beano helps digest the indigestible carbohydrate in beans and other gas-producing vegetables.
Natural remedies for gas include:
- Peppermint tea
When Should I Be Worried About Bloating
Anything that is chronic should lead you to make changes. Only when you have symptoms of serious concern such as bleeding, nausea, and fever should you be concerned enough to seek medical attention immediately. However, if you are struggling with the pain and other symptoms of bloating on a regular basis, it is a sign that something needs to change.
It is my job to determine what is causing your bloating and make a plan to alleviate your symptoms through lab work, dietary, and lifestyle changes so you can finally enjoy meals and daily life again, pain-free.
As one of the first functional medicine telehealth clinics in the world, we provide webcamhealth consultations for people around the globe.
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BY DR. WILL COLE
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Causes Of Bloating And Abdominal Pain
In some cases, abdominal pain and bloating are not a cause for concern and can often be relieved with simple dietary and lifestyle changes. Other times, abdominal bloating can be a sign of something more serious, and therefore further action is needed to treat the root of the problem.
Bloating is often a problem with digestion, and many things can affect gut health and the bodys ability to properly metabolize food and eliminate waste.
Gas is thought to be the most common cause of bloating, especially after eating a meal or drinking too fast. Gas builds up in the GI tract when you swallow air or when undigested food gets broken down.
Excessive gas is due to inadequate protein digestion, imbalances in gut bacteria, and the inability to fully break down carbohydrates and sugar.
This section will detail 32 potential causes of abdominal bloating and pain, which are often related to digestive disorders, food sensitivities, parasitic infections, bowel obstruction, hormonal changes like pregnancy, and a number of cancers like stomach cancer, ovarian cancer, or non-Hodgkins lymphoma.
Lets get started.
What Should I Do Before Starting The Low
Consult a reliable healthcare provider. Whether youve already been diagnosed with a gastrointestinal disease or you are just beginning to explore possible causes and cures for your symptoms, a registered dietitian or GI specialist can help set you in the right direction. They may have alternative ideas to test before you try the diet. They can also help guide you through the nuances of the diet, provide shopping and menu guides and troubleshoot when questions or problems arise. Theres a lot to keep track of with this diet, including different quantities and portion sizes for different foods. Its easier to follow successfully if you have a guide who knows the way around.
Plan ahead. This is a temporary diet, but its a significant investment of time and trouble in the meantime. Make sure you reserve a chunk of time to complete it when it wont conflict with other important events or obligations. You cant cheat on an elimination diet the whole experiment collapses if you do. Make an intentional commitment to yourself to complete the process before you start. Be deliberate about setting the stage. Clear your fridge and pantry of high-FODMAP foods and prepare some menu plans in advance. Make sure you have ingredients for a few simple standby meals that you know you can prepare and enjoy easily.
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How To Know If You Have A Food Allergy Or Intolerance
Your healthcare provider can help you find out whether you have an allergy or intolerance and then work with you to establish a plan to help control your symptoms.
If your symptoms are keeping you from your activities of daily living like if youre chronically having to plan where youre going and how long youll be gone because youre going to need a bathroom its time to see a professional, Jaeger advises. For many of us, we have these symptoms for so long that we start to think theyre normal.
Here are some of the ways that food allergies, intolerances and sensitivities are diagnosed.
1. Allergy tests
Allergy skin testing can identify your bodys reaction to allergens. A blood test can pinpoint elevated levels of allergy antibodies that your immune system produces.
But determining the cause of food intolerance or sensitivity isnt an exact science. Aside from the hydrogen breath test to diagnose lactose intolerance, there arent any proven skin or blood tests for these issues.
There are some tests available that can help guide us, but they dont provide the whole picture, Jaeger says. They can be parts of what puts your puzzle pieces together, but they arent definitive.
2. Keep a food diary
You can keep a food diary to record what you eat, when you have symptoms and what they are. If you notice that a food or ingredient consistently gives you discomfort, its likely an intolerance.
3. Try an elimination diet
Dyspepsia Or Upset Stomach
Dyspepsia is also called upset stomach or indigestion. It is a condition characterized by a painful or burning feeling in the upper abdominal region or stomach.
The most common dyspepsia symptoms include abdominal pain and bloating, cramping in the stomach, a growling stomach, nausea and vomiting, gas and belching, constipation, diarrhea, and a burning sensation in the stomach or upper abdomen.
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It Could Be Constipation
While youre spending a lot of time at home, you may not be moving as much as you usually do. You may also be eating different foods. This can lead to constipation. You may be constipated if you experience:
- Fewer bowel movements than normal for you
- Stool that is lumpy or looks like pebbles
- Difficulty passing stool or a feeling that you still need to go after youre finished
Fortunately, you can make a number of at-home changes to help relieve your constipation. These include:
Gastroesophageal Reflux Disease And Acid Reflux
Gastroesophageal reflux disease is known more commonly as acid reflux. It occurs when contents from the stomach are pushed into the esophagus, causing a burning sensation. One of the most common effects of GERD is abdominal bloating. Other symptoms include a dry cough, heartburn, hiccups, nausea, and sore throat.
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What Is The Treatment For Ibs
There is no cure for IBS, but there are things you can do to feel better. Treatment may include:
- Changing your diet
Your doctor may give you medicine to help with symptoms:
- Fiber supplements such as psyllium to help control constipation.
- Anti-diarrheal medications, such as loperamide , to help control diarrhea.
- Antispasmodic agents such as peppermint oil or dicyclomine to slow contractions in the bowel, which may help with diarrhea and pain.
- Antidepressant medications such as a tricylcic antidepressant or a selective serotonin reuptake inhibitor if symptoms include pain or depression.
- IBS medication. A medication known as Lubiprostone is approved by the FDA for women with severe IBS-C .
Take your medicine exactly as your doctor tells you to. All drugs have side effects and may affect people differently. Tell your doctor about any over-the-counter medicines you take.
How Do Healthcare Providers Treat Abdominal Distension
If you seek medical care for your distended abdomen, your healthcare provider will work to isolate the cause. Theyll start by asking you questions about your symptoms and examining your abdomen to see where it’s distended. The location of the outward curve, whether it’s uniform across your abdominal cavity or more pronounced in a particular region, helps them determine which organs are involved and narrow down the list of likely causes. They may also feel the area with their hands or tap it and listen to the sound it makes to determine the presence of fluids, gasses or solids.
The internal organs of the abdomen can be classified as either solid or hollow. Solid organs include the liver, spleen, kidneys, adrenals, pancreas, ovaries and uterus. These can become enlarged due to inflammation or growths such as a tumor, abscess or cyst. Your healthcare provider might be able to feel that they are enlarged, or they might need to look at an image of the internal organs to tell. A large growth might be palpable through the skin. Your healthcare provider will confirm your condition with imaging tests, then follow up with additional testing and treatment depending on the condition.
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What Is A Bloated Stomach
A bloated stomach is first and foremost a feeling of tightness, pressure or fullness in your belly. It may or may not be accompanied by a visibly distended abdomen. The feeling can range from mildly uncomfortable to intensely painful. It usually goes away after a while, but for some people, its a recurring problem. Digestive issues and hormone fluctuations can cause cyclical bloating. If your bloated stomach doesnt go away, you should seek medical care to determine the cause.
Counseling And Stress Relief
Many people who seek care for IBS also have anxiety, panic, or depression. Stress is also an issue for people with IBS because it can make the symptoms worse. Research shows that psychological therapy can help ease IBS symptoms. Therapies that can help reduce feelings of stress and anxiety include:
- Cognitive behavioral therapy , a short-term treatment that mixes different types of therapies and behavioral strategies. The type of CBT used to treat IBS may focus on managing life stress. Or, it may focus on changing how a person responds to anxiety about IBS symptoms.
- Dynamic psychotherapy, an intensive, short-term form of talk therapy. It may focus on in-depth discussions about the link between symptoms and emotions. The therapy may also help people identify and resolve interpersonal conflicts.
- Hypnotherapy, where people enter an altered state of consciousness. Visual suggestions are made to imagine pain going away, for example.
General stress relief is also important. Exercising regularly is a good way to relieve stress. It also helps the bowel function better and improves overall health. Meditation, yoga, and massage may also help.
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How To Manage Your Bodys Reactions To Food
Figuring out the source of your symptoms and preventing them in the future can be tricky. But once youve identified the culprit of your issues, heres how to prevent and manage your symptoms:
- Cut out the offending foods: Avoidance is the best prevention method for keeping most allergies and intolerances in check, Jaeger says. In other words, steer clear of the substances that bother you.
- Try an over-the-counter medication: In some cases, medication can help with subtle cases of food intolerance. For lactose intolerance, over-the-counter options like Lactaid® can allow you to occasionally enjoy dairy foods like milk, cheese and ice cream without the negative side effects.
- Carry an epinephrine auto-injector: If you know you have an allergy to a specific food, carry an epinephrine auto-injector such as AUVI-Q® or EpiPen® with you at all times, Jaeger advises, and be sure that both you and the people closest to you know how to use it.