bloating

Bloating is a subjective sensation of abdominal fullness, pressure, or tightness. It is sometimes accompanied by a visibly enlarged abdomen (distension), but distension is an objective finding, whereas bloating is a sensation reported by the person.

Common causes include swallowing air (from eating or talking while chewing), gas produced by gut bacteria during digestion, constipation, and food intolerances such as lactose or fructose intolerance. High-fiber foods, carbonated beverages, sorbitol-containing products, and rapid dietary changes can contribute. Functional disorders like irritable bowel syndrome and small intestinal bacterial overgrowth are also associated. Less frequently, conditions such as celiac disease, pancreatic insufficiency, ovarian masses, ascites, or other abdominal diseases may cause persistent bloating and require evaluation.

Diagnosis typically starts with a medical history and physical examination. If red flags are present or symptoms are persistent, investigations may include blood tests, stool tests, imaging (such as ultrasound), or endoscopy to rule out other conditions. Distinguishing bloating from abdominal distension is helpful in guiding evaluation.

Management focuses on the underlying cause and lifestyle adjustments. Dietary changes such as a trial of low-FODMAP foods or identification of triggering items, gradual increases in dietary fiber, adequate hydration, and regular physical activity can help. Reducing intake of carbonated drinks and chewing gum may lessen air swallowing. Over-the-counter options like simethicone or lactase supplements can provide relief for some people. Probiotics have mixed evidence. Medical treatment may target specific conditions (for example, treating constipation, SIBO, or malabsorption). Severe or persistent bloating with weight loss, fever, vomiting, or a new abdominal mass warrants prompt medical evaluation.