If you’ve ever woken up with a stomach that feels like it’s housing an expanding balloon, you know all too well that bloating is no fun. That bloated feeling in your stomach can make you feel like crawling back in bed instead of heading out for the day. But with recent warnings from British doctors that some women are confusing the symptoms of ovarian cancer with bloating during their menstrual cycle, a lot more of us are on edge about that full-belly feeling. So when are you experiencing normal bloating, and when do you need to call the doctor? And if it’s just a bloated stomach, do you know how to get rid of bloating with fast home remedies that will have you getting on with life in 24 hours (or less)? We talked to the experts to get you the answers you need.
What’s going on?
Bloating is uncomfortable, and it can send folks running for their doctors’ offices, but it’s not technically a disease. Instead, bloating is a symptom that can accompany various diseases and conditions. It can be a sign that you’ve eaten too much, had too much to drink, or even inhaled too much air. If you were to describe what it means to feel bloated, words like bleeech and ugh would fit in nicely. But medical practitioners—not surprisingly—have a more clinical vocabulary when it comes to defining bloating. “Bloating is a sensation of fullness in the upper abdomen,” says Alexandra Guillaume, MD, director of the Gastrointestinal Motility Center at Stony Brook Medicine and assistant professor in the Long Island, New York, university’s department of medicine. That sounds simple enough, right? If the top of the belly feels extra full, you’re bloated. But that’s where the simplicity ends and the confusion can begin. That feeling of increased abdominal pressure is often accompanied by what’s called “abdominal distentions,” or a visible enlargement of the waistline. As anyone who has a pair of Thanksgiving pants knows, sometimes the two go together, sometimes they don’t. But it turns out you don’t need that distended-belly look to feel absolutely miserable…or to be bloated. In one study published in the medical journal Gastroenterology, researchers measured abdominal girth in relation to pressure complaints, and just 48 percent of patients with bloating had measurable distention in their torsos. The other 52 percent were still bloated, but doctors couldn’t see the physical signs on the outside. And theirs wasn’t the only study to come to this conclusion. What’s more, while some people experience bloating and gas at the same time, the two don’t have to go hand in hand. “Bloating can be the result of having an increased or intolerable amount of gastric and/or intestinal gas, as some individuals experience the symptom of bloating with normal amounts of gas,” Guillaume says. Then again, bloating can be the result of anything from increased fluid in the abdomen to bowel wall inflammation to what Guillaume calls “malabsorbed food substrates” (parts of the food that haven’t broken down and been absorbed into the body yet). In other words: You can be bloated without flatulence or burping, and you can have gas without being bloated. So how do you know it’s really bloating and not, say, gas or weight gain that’s affecting your abdomen? And how do you know it’s not that virus that’s been going around your office?
Let’s start with where it hurts.
“Most people feel this sensation between the belly button and up to the middle of the rib cage,” says Boston-based dietitian Kate Scarlata, author of The Complete Idiot’s Guide to Eating Well with IBS. Gas, on the other hand, tends to occur in the large intestine or lowest segment of the gastrointestinal (GI) tract. Another defining feature of bloating? There are just a handful of typical causes:
Swallowed Air or Aerophagia (Excessive Swallowing of Air)
We need air to breathe, but there really is too much of a good thing, Guillaume says. Excess swallowing can occur when you’re sucking on hard candies, chewing gum, or experiencing anxiety, which may cause you to suck in large amounts of air. “Carbonated beverages such as soda, seltzer, and beer can also generate excess gastric and intestinal air,” Guillaume warns, adding, “This is usually brief.” The good news? All that extra air may cause bloating, but it’s typically easily expelled, so you can get rid of bloating fast. “Air advancing from the stomach into the upper small bowel is usually promptly cleared,” Guillaume says. “Carbon dioxide and oxygen rapidly diffuse through the intestinal wall. Nitrogen gas is poorly absorbed, but is rapidly propelled towards the colon and expelled through the anus.” In other words, you’ll probably burp and fart it out.
Food Intolerance and Carbohydrate Malabsorption
If you’ve ever felt like your dinner just didn’t agree with you, you might be right. Food doesn’t have to be spoiled or laced with a toxin to bother our systems. Nor does it have to be unhealthy. Eating a lot of fiber or carbohydrates such as bran, cabbage, beans, broccoli, or similar foods can all cause discomfort in your abdomen. Bloating after a meal can also be a sign of a food intolerance or disease, Guillaume warns. If you experience bloating after consuming lactose, your body may be lacking the enzyme lactase, which is required to digest lactose, a sugar found in milk, certain cheeses, or ice cream. People with undiagnosed celiac disease may also bloat as their body struggles to absorb wheat, barley, and rye products. Some foods, known as FODMAPs, are also common culprits when you’re feeling bloated. Carbohydrates found in everyday—and relatively healthy—foods like apples, pears, watermelon, wheat, cauliflower, onion, garlic, to name a few, FODMAPs are rapidly fermented by gut microbes and can also pull water into the gut, Scarlata says. “The aftermath of excess water and/or fermentation of these carbs in the gut can contribute to the sensation of bloating in those with FODMAP sensitivities,” she warns.
Underlying Constipation
If you’re feeling “backed up,” that general feeling of pressure may, well, back up, spreading from the intestines north into the abdomen. Not surprisingly, this can be tied to foods as well, as excessive amounts of fiber can cause simultaneous constipation and bloating.
Small Intestinal Bacterial Overgrowth (SIBO)
This condition occurs when there’s an excess of normal bacteria in the small intestine. “These intestinal bacteria play a key role in bloating and flatulence through carbohydrate fermentation and gas production,” Guillaume says. “Patients with altered anatomy due to surgery, those with diabetes, or those with certain rheumatologic disease may be at an increased risk of bacterial overgrowth in the small intestine.”
Hormones
No, you’re not imagining that puffy feeling in the lead-up to your period. “Feeling bloated is a real concern in the week prior to actually menstruating,” says Latasha Murphy, MD, an OB-GYN at the gynecology center at Mercy Medical Center in Baltimore. The reason? Your hormones fluctuate. “The progesterone drops and the estrogen levels rise,” Murphy explains. “This can lead to sluggish bowel motility and water retention that leads to the bloating sensation.” Although those are the most typical causes, Guillaume says if you’re trying to figure out if you’re feeling uncomfortable because you’re coming down with that virus that’s been floating around your office or just feeling bloated, it may be both! Because bloating is a symptom and not a disease, it can be a precursor to worse symptoms ahead. “An acute infectious enteritis may be associated with severe bloating and distention in the early stages, even before diarrhea occurs,” Guillaume warns. That said, if you’re feeling abdominal pain that’s accompanied by fever, vomiting, diarrhea, weight loss, joint pains, or an abnormal rash, it’s wise to call your doctor. Those symptoms can be a sign of trouble.
Fight the bloat.
Let’s face it: No matter what’s causing it, you want to get rid of that bloated-belly sensation as soon as possible. How to do it—and how fast it can be done—comes down to the cause. That bloating from slurping down a soda too fast during your super short lunch break can disappear on its own in less than an hour. If a virus is causing the bloat, you might just have to wait it out, as viral conditions typically have to run their course. If the problem is your impending period, it’s time to get up and move, and change up what you’re eating and drinking. Exercise will promote bowel motility, Murphy says, which can help you feel less backed up, and drinking a lot of water can help, too. Abdominal massage can help move the gas into the lower GI tract so that it is easier to pass, Scarlata advises, and there are medicines that can help get things moving, too. “The herbal supplement Iberogast can help the intestinal move more efficiently, lessening bloating,” Scarlata notes, “Some find simethicone supplements helpful. Simethicone reduces the surface tension of gas bubbles, making the gas bubbles smaller and easier to move through the GI tract for elimination.” If you’ve been eating any gas-inducing foods (beans, cabbage, and the like), cutting back can help you fight the bloat. But sometimes figuring out just what is making it happen can require a bit of trial and error…and hyper vigilance. “Maintain a food journal for at least one month and list what you experience after eating a variety of foods and food groups,” Guillaume suggests. “Also, be cognizant of your bowel habits and pattern and how this affects your perception of bloating or visible abdominal distention.”
When to Call the Doctor
If you’re feeling bloated after one meal or days before you’re expecting your period, there’s likely no cause for concern. Occasional bloating happens. It’s when you feel bloated for days on end or there are other symptoms—such as fever, diarrhea, vomiting, feeling a constant need to urinate or defecate—that you need to call your doctor. Among the diseases that may be causing bloating along with these symptoms are celiac disease, ovarian cancer, and irritable bowel syndrome. Although those sound scary, frequent bloating is not always a sign of serious disease. It could simply be an indicator that you have a food intolerance. Treating it could be as simple as cutting a single food out of your diet, which is why it’s important to keep a food journal and bring it with you to your doctor’s office. “Measures to reduce bloating should be determined and implemented depending on the cause of bloating,” Scarlata notes. “It really is not a one-size-fits all approach. [You need to] work with a healthcare provider to better gauge the reason for the bloating to develop a more tailored approach to treatment.”
Bye Bye, Bloating
Let’s face it: Life is a lot easier if we just avoid bloating altogether. While that’s not always possible (see also: disease causes), there are some preventative measures that work for a number of cases. If you regularly suffer from menstrual bloating, increasing your water intake and cutting gassy foods from your diet in the days leading up to your period can help, Murphy says, along with kicking your exercise routine into high gear. If you don’t have a diagnosed food intolerance but know that eating a hot dog smothered in onions is going to make you gassy (and bloated), you can avoid the food entirely. Or you can indulge your cravings while trying to stave off the bloat with a dose of an over-the-counter remedy such as simethicone (aka Gas-X) or alpha-d-galactosidase, the generic of Beano. If you’re looking to go in the opposite direction by upping the healthy quotient on your foods, dive into fibrous eats with a dose of caution. It’s good to increase bran foods and beans, but do so slowly, lest your new health kick make you feel like Violet Beauregarde from Willy Wonka. Probiotics work for some folks as well, but Guillaume warns that the data in medical literature is mixed, and there’s no consistent evidence that shows that probiotics are effective at relieving bloating, distention, or flatulence. One piece of advice that doctors routinely give patients when advising on general health applies when it comes to bloating, too: Exercise regularly and maintain a healthy weight.
