Bloating is a common abdominal symptom and people with functional bowel syndromes, such as irritable bowel disease, experience it often.
According to Dr Ng Yi Kang, Consultant, Gastroenterology and Hepatology Service, SKH, bloating is the result of a build-up of gas in the digestive system. “Everyone has 100 to 200cm3 of gas in the intestinal tract and we may get more gas and feel bloated when we swallow air, drink carbonated beverages, or through the neutralisation of acid or alkali in the tract.”
Certain carbohydrates in the food we eat may cause bloating, cramps and other gastrointestinal symptoms. These are identified as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), commonly found in foods like fruit and vegetables, legumes and pulses, and processed foods.
Bloating can also be caused by an imbalance of intestinal bacteria due to conditions like irritable bowel syndrome (IBS). “We have around 500 species of bacteria naturally in our large intestine. An imbalance will produce excessive gases such as hydrogen sulphide that gives farts their distinctive pungent smell.”
Other conditions, such as diabetes or constipation, slow the movement of food and faeces through the intestinal tract, causing bloating. This builds up faeces and also increases fermentation time, leading to bloating and more gas.
Dr Ng says that some people are also hypersensitive to changes in their intestines — the same volume of gas in the gut will have different levels of bloating for each individual.
The oral contraceptive pill has been well-documented to cause bloating. For some patients, other medications that could cause bloating are laxatives, prebiotics and probiotics used to treat IBS, as well as opioid-based analgesics.
Dr Ng assures that bloating is common. However, bloating with early satiety, loss of appetite, unexplained weight loss, difficulty in swallowing food or vomiting, or bloating that interferes with sleep or activities of daily living may require prompt medical attention.
Seek medical advice if you notice blood or mucous in the stools, or feel a hard lump in the abdomen. If blood tests show anaemia, vitamin or iron deficiencies, your doctor will send you for further investigations.
The ‘butterflies in your stomach’ that you feel when you’re stressed or anxious is related to your gut. Stress and anxiety can trigger gastrointestinal upset due to the brain-gut connection; that’s why you may feel like you’re going to have diarrhoea or vomit before a big test or presentation!
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