- ZAVORAL, Miroslav, ed. Mařatka's gastroenterology: pathophysiology, diagnostics, treatment. Prague: Charles University, Karolinum Publishing House, 2021. ISBN 978-80-246-5002-9.
- solen.cz - Bloating - what drugs cause it and how to treat it. Solen. Eliška Kolmanová
- medicalnewstoday.com - Everything you need to know about bloating. Medical News Today. Yvette Brazier
Abdominal bloating is a relatively common problem. It occurs when there is an excessive amount of gas in the digestive tract. In most cases, it is caused by a dietary error. It can also signal a specific digestive tract disorder. What are the possible causes of bloating?
Bloating and flatulence is a problem arising in the intestinal tract. This condition is usually not serious and will pass in a short time.
The cause can be an inappropriate lifestyle, diet, food intolerance, but also diseases of the digestive system.
Possible causes, symptoms, diagnosis, treatment, home help and much more interesting information can be found in the article.
Bloating: what is it?
The formation of gases (winds) is a physiological part of healthy digestion. Flatulence is the technical name for bloating or flatulence. It is caused by the accumulation of gases in the digestive system.
Flatulence is a problem often associated with the increased production of gases, their accumulation and subsequent lack of outflow (or conversely, excessive flatulence).
The feeling of a bloated abdomen, excessive flatulence, stopped winds or meteroism is most often caused by inappropriate diet, combination, diet composition and improper lifestyle. A disorder or disease of the digestive tract may also be the cause.
Bloating is usually not a sign of serious illness. With prolonged or repeated bloating, sudden severe discomfort and pain, it is advisable to seek medical attention.
The complete breakdown of some food components in the small intestine may take longer. They often pass undigested into the large intestine. There, bacteria are present. Thus, winds are formed primarily in the large intestine as a product of fermentation.
The gases enter the digestive system from the external environment through the ingestion of air, the reaction of stomach acids and the activity of intestinal bacteria. On average, winds leave 12 times a day.
Intestinal gases include :
- nitrogen (59 %)
- hydrogen (9 %)
- carbon dioxide (9 %)
- methane (7 %)
- oxygen (4 %)
Difficulty with flatulence may occur:
- feeling full and satiated
- feeling of bloated abdomen
- pressure in the abdomen (balloon feeling)
- hard abdominal wall
- abdominal cramps
- abdominal twitching
- excessive bloating
- cessation of winds
- constipation or diarrhoea
Etiology and causes
The etiology of flatulence varies. It is a fairly general symptom. The causes can be divided into lifestyle errors and organic causes. These include intolerances and various diseases of the digestive system.
Dietary cause (lifestyle, diet...)
The consumption of certain food components or an inappropriate combination of foods can slow down digestive processes. Bloating is not helped by fast food, gobbling food, insufficient processing of food in the mouth and excessive portions of food.
When eating quickly, there is no time to chew the food properly.At the same time , alarge amount of air enters the stomach. This causes bloating in the intestines.
A common cause of bloating is the consumption of large amounts of carbohydrates and substances contained in legumes or other specific foods. These cause the formation of so-called foam, which prevents the natural passage of intestinal gases.
Our body often does not have enough of the necessary digestive enzymes to fully digest some carbohydrates in the small intestine.
Examples of harder to digest foods are legumes (beans, peas, lentils, chickpeas), some vegetables(broccoli, cabbage, cauliflower, kale), onions/garlic, apples, raisins or prunes.
Beer, dairy products, carbonated drinks, artificial sweeteners, chewing gum and lollipops introduce excessive air into the digestive tract.
Problems with bloating may be related to indigestion of lactose, fructose or preservatives and various food stabilizers.
Summary of bloating risk factors :
- Excessive intake of oligosaccharides
- Excessive intake of legumes
- Excessive intake of more difficult to digest foods
- simultaneous washing down of food with liquid
- consumption of carbonated beverages
- rapid eating and swallowing of food
- inadequate food processing
- insufficient fibre intake
- insufficient daily physical activity
Organic cause (intolerance, disease...)
The feeling of bloating can be a symptom of a specific disease of the digestive tract (functional and structural).
In the case of food intolerances, the most common are intolerance to gluten (gluten), lactose (milk sugar) and milk protein. Food allergens are different, for example, certain types of nuts, fruits or seafood.
A more severe form of gluten intolerance is technically called celiac disease.
In food allergies and intolerances, digestive problems, including bloating, become apparent relatively soon after eating the inappropriate food component.
Bloating can be a symptom of acute and chronic inflammation of the intestines, gastroenteritis(intestinal flu), infectious diseases of various origins(bacteria, virus).
In addition to bloating, pain, cramps, increased temperature or other digestive problems often occur.
In chronic inflammatory bowel disease(ulcerative colitis or Crohn's disease), the absorptive surface of the intestine is reduced and digestion itself is impaired. The consequence is bloating and excessive gas formation.
A possible cause is insufficient production of digestive enzymes and hypofunction of certain organs of the digestive system.
Bloating can be a side effect of drug therapy. Bloating can be caused by drugs and medicines for the digestive tract, constipation, various psychopharmaceuticals or types of antibiotics.
Possible causes of bloating and indigestion :
- Food intolerance (intolerance).
- food allergies
- gastroenteritis of various origins
- inflammation of the digestive tract
- ulcerative colitis
- Crohn's disease
- irritable bowel syndrome
- gallbladder and pancreatic hypofunction
- digestive enzyme deficiency
- disturbed intestinal microflora
- constipation (obstipation)
- stenosis, ileus
Bloating in women in pregnancy
Bloating occurs frequently in women during pregnancy. It is caused by hormonal changes. Increased progesterone levels can slow down bowel motility and digestion itself.
Bloated abdomen occurs due to various hormonal changes, enlargement of the fetus, uterus and oppression of the abdominal digestive organs. Mild bloating and gas are both normal parts of pregnancy.
Watch out for abdominal pain and cramps, frequent painful bloating and other non-specific symptoms. In case of any doubt, a visit to a gynaecologist is always necessary.
Bloating is also related to menstruation andpremenstrual syndrome - PMS The feeling of a bloated abdomen is a frequent accompaniment of the menstrual phase of the cycle and hormonal decline.
Bloating in young children
The digestive tract and intestinal microflora of a young child is getting used to the intake of breast milk and nutrition. The tract gradually gets used to solid food and milk. In this early period, food intolerances, especially to lactose (milk sugar), may already appear.
Bloating is quite common in young children. One reason for this is excessive swallowing of air when crying, screaming or sucking.
Painful flatulence can cause gas retention in the short term. Venting will help relieve discomfort in most cases.
Care should be taken for prolonged gas retention, abdominal pain, lack of appetite and other warning signs. It is advisable to see a paediatrician to rule out diseases of the digestive system.
The child may experience sudden bloating and flatulence with vomiting, pain or difficulty in defecating. In this case, it is necessary to seek medical attention urgently.
It is advisable to follow several preventive measures. These include proper burping after breastfeeding/feeding, gentle peristaltic abdominal massage, bringing the knees to the abdomen, appropriate tea or anti-bloating drops for babies and nursing mothers.
Diagnosis, treatment and help for bloating
Diagnosis of bloating consists of assessing clinical symptoms, taking a medical history and a basic examination of the abdomen by palpation and listening. The doctor is particularly interested in the patient's lifestyle, diet and current drug therapy.
In most cases, an ultrasound examination of the abdominal organs is carried out. Blood or stool sampling may be performed. If other diseases are suspected, the doctor may choose an endoscopic imaging examination (gastroscopy, colonoscopy...).
The exact treatment depends on the cause of the bloating and indigestion. It is divided into conservative treatment through lifestyle and dietary modification, medical treatment and, in rare cases, surgical treatment. Surgical treatment is chosen, for example, for appendicitis.
In the case of food intolerance, allergy or chronic inflammatory bowel disease, pharmacological treatment and long-term dietary modification are the main options.
In gastroenteritis, infections and inflammation of the digestive tract, the main choice is medical treatment with antibiotics, anti-inflammatory and supportive drugs. Short-term diet and lifestyle modification is necessary.
Preventive lifestyle modification is usually chosen for flatulence. Regular physical activity, a balanced diet with less of the more difficult-to-digest foods, slower regular meals, elimination of carbonated beverages, etc.
The doctor may recommend the patient to take charcoal-based drugs, antacids or antispasmodics. These drugs provide temporary relief. They do not address the cause itself.
Probiotics and prebiotics are suitable. They restore the balance of the intestinal microflora and support the digestive process.
It is possible to try the natural help of herbs and spices. For example, peppermint, fennel, sage, ginger, cumin or coriander work very effectively.
Consuming herbal tea, drops or extracts in a dietary supplement can help with bloating. Some spices and herbal powders can be added directly to food. They prevent bloating and flatulence.
Home remedies can be used for quick relief. Peristaltic abdominal massage, local application of heat (thermophore), light physical activity or taking over-the-counter medicines and dietary supplements to aid digestion can relieve your discomfort.
Preventive treatment for bloating :
- Eating smaller portions regularly
- Eating more slowly and without rapid gobbling
- Consistent processing of food through the mouth
- Washing down food slowly and gradually
- eliminating 'problem' foods
- elimination of difficult-to-digest foods
- elimination of carbonated drinks
- regular physical activity
- sufficient dietary fibre intake
- use of probiotics and prebiotics
Legumes should be rinsed and soaked in water for a few hours before eating. Drain the water, rinse the legumes and bring them to a boil. This will rid them of problematic substances and improve the digestibility of the legumes themselves.
Diseases with symptom "Flatulence"
- Addisson disease
- Axial spondyloarthritis
- Bechterev disease
- Burnout Syndrome - Burn-out
- Celiac Disease
- Crohn's disease - Morbus Crohn
- Enteropathic Arthritis
- Fabry disease
- Fatty liver disease
- Gallbladder stones - cholelithiasis
- Inflammation of the Ovaries and Inflammation of the Uterine Appendages
- Irritable bowel syndrome
- Kidney stones
- Liver Cancer
- Ovarian cancer
- Peptic ulcer disease
- Polycystic Ovary Syndrome
- Typhoid fever
- Histamine intolerance
- Sjögren's syndrome