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It’s one of the most common complaints your concierge doctors at MD 2.0 in Jupiter, Florida, hear from our patients: “Doctor, I’m so bloated.” 

But what does that really mean? Sometimes people use the term to describe gassiness or constipation, thinking “bloated” sounds more polite. But it can be confusing because, in addition to those two causes, there are many other reasons why a person can be experiencing a feeling of fullness or pressure in the abdomen.

What “bloating” is not

Bloating is not water retention. It is not caused by an excess intake of salt or a hormonal imbalance. Typically, fluid retention is most apparent in the face and extremities and relates to kidney issues. It can also be a sign of high blood pressure.

Bloating is also often used to describe an excess of belly fat, but they are two different things. If bloating is caused by belly fat, it won’t go away without diet and exercise.

Common causes

Distention of the belly or a feeling of fullness in the abdomen is usually caused by excess gas, stool, or even food in the intestine. It can also be caused by a food sensitivity, especially to diary or some fruits and vegetables. Lactose intolerance is a well-known cause of gastrointestinal upset. Another cause can be introducing too much fiber into the diet too quickly, or constipation, which allows food to ferment for longer periods of time, producing excess gas. The artificial sweetener Sorbitol is indigestible, and can be responsible for intestinal upset in many people.

Sometimes the cause is simply overeating, or consuming rich, fatty foods. This is particularly common around this time of year, when we’re attending so many holiday parties. We tend to overeat because of the abundance of food available, as well as the special dishes we don’t see at other times. Since fat takes longer to digest than protein or carbohydrates, it allows food more time to ferment in the digestive tract.

Some physical causes of bloating can include small intestinal bacterial overgrowth (SIBO), intestinal lumen distention, functional dyspepsia (in which the stomach can’t expand enough to accommodate food), or gastroparesis (in which the stomach empties more slowly than normal).

Serious causes

So-called “bloating” can also be a sign of a serious disease. These can include: ovarian, uterine, stomach, colon, or pancreatic cancer; pelvic inflammatory disease (PID); diverticulitis; liver disease; or Crohn’s disease. All of these often—but not always—exhibit additional signs other than bloating, but they are a possibility that we will want to consider.

If you have bloating and any other unusual symptoms such as diarrhea or bloody stools, unintended weight loss, severe abdominal pain, chest discomfort, loss of appetite, or yellowing of skin or eyes (jaundice), see us right away for a definitive diagnosis.

Treatment

An easy method to approach benign bloat in the abdominal area is to maintain a food diary. You may be able to trace your symptoms back to a particular food or group of foods. Foods that cause no problem at all for some people can cause a reaction in others. And some people can develop a sensitivity to a food they’ve eaten without a problem all their lives. A diary can help you see if you are sensitive to any foods, and eliminating them may solve your problem.

Probiotics can be another surprising cause of gas in the intestinal tract. Although many people begin taking them thinking they’ll help resolve their digestive issues, they can in fact create even more problems, especially with gas. Because probiotics introduce additional bacteria to the gut, they promote fermentation of food, causing more gas, distension, and abdominal discomfort in many people.

One of the best ways to help the digestive tract function optimally is through regular exercise. The bending and stretching involved in such regimes as yoga and Pilates are tailor-made to help food move through the intestines more easily. And any type of aerobic exercise—swimming, cycling, brisk walking, tennis—speeds up your metabolism, increases blood flow throughout your body, including the intestines, and prompts more rapid movement of food through the gastrointestinal tract, thus reducing symptoms of bloat.

If these measures don’t help, talk to us. In fact, you should consult us whenever you have a concern of this type, because the word “bloating” can mean so many different things to different people. We can help you pinpoint a cause for the symptoms you are experiencing, as well as create a treatment plan to help resolve them.