We've all been there—feeling perfectly fine one moment and then suddenly our stomach swells up like a balloon, leaving us uncomfortable and often in pain. Stomach bloating is a common issue that affects millions of people worldwide, yet its causes are often misunderstood. It’s that tight, full feeling you get in your abdomen that can make your clothes feel snug and can sometimes be downright painful. This sensation can occur at the most inconvenient times, whether you’re about to give an important presentation, enjoying a meal with friends, or simply relaxing at home.

For some, bloating is a minor inconvenience that passes quickly. But for others, it can be a recurring problem that significantly impacts their daily lives, leading to a constant search for relief. The unpredictability of bloating can make it even more frustrating, as it seems to strike without warning or clear cause. But why does this happen? Is it something we ate, a sign of a more serious health issue, or just our bodies being unpredictable?

In this blog, we will explore the common triggers and underlying factors that lead to stomach bloating. By discovering these reasons, we aim to provide you with a better understanding of this uncomfortable condition and offer practical advice on how to manage it. Whether you experience occasional bloating or it’s a regular occurrence, gaining insight into the causes can help you take control and find relief.

1. Dietary Causes of Bloating

Understanding the dietary causes of bloating is crucial in managing and preventing this uncomfortable condition. Here’s how these common dietary factors cause bloating and affect your digestive system.

• Common Gas-Producing Foods
  Certain foods are known to produce more gas during digestion, which may result in bloating. These include:
  • Beans and lentils: rich in fibre and complex carbohydrates, beans [1] and lentils [2] can be difficult for the digestive system to break down completely. They contain oligosaccharides, which are fermented by gut bacteria, producing gas as a byproduct.
  • Cruciferous vegetables: vegetables like broccoli, cauliflower, cabbage, and Brussels sprouts are high in fibre and sulfur compounds [3]. While they are highly nutritious, their fermentation process in the gut can result in significant gas production.
  • Carbonated drinks: sodas and sparkling waters [4] contain dissolved carbon dioxide, which can lead to gas build-up in the stomach. This excess gas can cause a bloated feeling as it accumulates in the digestive tract.
  • Artificial sweeteners: sweeteners such as sorbitol, mannitol, and xylitol [5], found in sugar-free gum, candies, and some diet foods, are not fully absorbed by the body. As they pass into the colon, they are fermented by bacteria, producing gas and leading to bloating.

• Food Intolerances
  Food intolerances can cause significant digestive distress and bloating. Two common intolerances are:
  • Lactose intolerance: lactose intolerance occurs when the body lacks the enzyme lactase, which is needed to break down lactose, the sugar found in milk and dairy products. Consuming lactose can lead to bloating, gas, diarrhoea, and abdominal pain as undigested lactose ferments in the colon [6].
  • Gluten intolerance and celiac disease: Non-celiac gluten sensitivity can cause bloating, gas, and discomfort after consuming gluten-containing foods like wheat, barley, and rye [7]. Celiac disease is an autoimmune disorder where ingestion of gluten leads to damage in the small intestine [8]. Symptoms include severe bloating, diarrhoea, and malabsorption of nutrients.

2. Lifestyle Factors That Cause Bloating

Our lifestyle choices play a significant role in our overall digestive health and may contribute to the frequency and severity of bloating. These are some common lifestyle factors that may result in digestive issues, such as bloating:

• Stress and digestion: the gut and brain are connected through the gut-brain axis, which means that psychological stress can directly impact gastrointestinal function [9]. Stress can lead to various digestive issues [10], including bloating, by causing the stomach to produce more acid, altering gut motility, and increasing gut sensitivity. Moreover, stress can exacerbate conditions like Irritable Bowel Syndrome (IBS) [11], where bloating is a common symptom.
• Sedentary lifestyle: regular physical activity helps stimulate the natural contractions of your intestinal muscles, which helps facilitate efficient movement of food and gas through the digestive tract. A sedentary lifestyle can slow down these contractions, which can result in sluggish digestion and increased bloating. 
• Eating Irregularly and Its Impact on Bloating
• Certain eating behaviours can increase the likelihood of one developing consistent bloating. These include;
  • Inconsistent meal times: skipping meals or eating at irregular times can disrupt the body's natural digestive rhythm. Your digestive system functions best when it operates on a regular schedule and processes food predictably. Irregular eating patterns can cause digestive disturbances, which may result in bloating.
  • Mindless eating and overeating: eating while distracted, such as watching TV or working, can lead to overeating and swallowing excess air, both of which can contribute to bloating. Contrary to this, eating mindfully, paying attention to your food, and chewing thoroughly can improve digestion and reduce the likelihood of bloating.
  • Large meals and late-night eating: consuming large meals or eating late at night can overload the digestive system and slow down digestion. On the other hand, more frequent meals can help keep your digestive system functioning smoothly and prevent bloating.

3. Medical Conditions That Present Symptoms of Bloating

While diet and lifestyle factors are common contributors to bloating, certain medical conditions can also play a significant role. Here are some key medical conditions associated with bloating:

• Irritable Bowel Syndrome (IBS): IBS is a chronic digestive disorder characterised by symptoms such as abdominal pain, cramping, diarrhoea, constipation, and bloating. The exact cause of IBS is unknown, but it is believed to involve a combination of gut-brain axis dysfunction, increased gut sensitivity, and irregular gut motility. These factors can lead to excessive gas production and irregular bowel movements, which may contribute to bloating [12]. Managing IBS-related bloating often involves dietary modifications, stress management, and sometimes medication.
• Small Intestinal Bacterial Overgrowth (SIBO): SIBO occurs when there is an abnormal increase in the number of bacteria in the small intestine. This overgrowth can interfere with nutrient absorption and lead to digestive issues. The excess bacteria ferment ingested food, producing gas that accumulates in the intestines, which may cause bloating [13], abdominal pain, and discomfort. 
• Hormonal changes: hormonal changes, particularly in women, can also lead to bloating. Many women experience bloating as a symptom of premenstrual syndrome (PMS) due to hormonal fluctuations that cause the body to retain more water and salt. Conditions like polycystic ovary syndrome (PCOS) and menopause can also cause hormonal imbalances affecting digestion and fluid retention [14]. Managing hormone-related bloating often involves lifestyle changes, dietary adjustments, and sometimes medication to address the underlying hormonal imbalance.

Practical Tips to Manage and Prevent Bloating

Managing and preventing bloating effectively often requires a combination of dietary adjustments, lifestyle changes, and improved eating habits. Here are some practical tips to help you beat the bloat and maintain a comfortable digestive system.

1. Over-the-counter medication: luckily, most of the causes of stomach bloating listed can be treated easily. A doctor may prescribe over-the-counter antacids [15] as bloating relief when your bloated stomach is caused by certain food intolerances and excessive gas.  If your stomach pain and bloating are caused by constipation, fibre supplements or laxatives may be prescribed to help ease bowel movement and reduce bloating.

• Change in diet: attempting to identify your bloating triggers can help you navigate recurring bloating issues with a sense of predictability. For patients with celiac disease, removing gluten [16] from their diet completely is often advised by medical professionals to prevent exacerbating their condition. If you have been diagnosed with IBS, avoiding high-gas food (carbonated and alcoholic beverages) and abiding by a low-FODMAPS diet [17] can prove efficient in reducing bloating.
  
  FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. This diet guides on to identify and avoid hard-to-digest carbohydrates that can be found in certain grains, vegetables, fruits, and dairy products, including fructose, fructans, and lactose. A low-FODMAP diet cuts out some or all of the following:

• Abdominal massage: massaging your abdomen gently [18] can relieve bloating by softening your stomach muscles and speeding up digestion. It allows gas to pass through your digestive tract more easily and helps to move stool along the inside of your colon.
• Physical activity: being physically active including practising yoga can stimulate digestion [19] and reduce bloating. Physical activities work by improving blood flow to the digestive organs and promoting relaxation which helps to ease gas and enhance gut motility.

• Herbal teas: research [20] suggests that herbal teas, such as peppermint and ginger tea, can be effective in reducing bloating. These teas help relax the digestive muscles, reduce gas, and improve overall digestion, offering a natural remedy for bloating relief.

When to Seek Medical Advice

While occasional bloating is common and usually not a cause for concern, there are times when it may signal a more serious underlying issue that requires professional attention. Recognising the red flags and understanding the diagnostic tests and treatment options can help you take the necessary steps towards better health. It is important to know when bloating goes beyond a simple digestive inconvenience. 

If you experience persistent bloating that doesn’t improve with dietary and lifestyle changes, or if it’s accompanied by severe abdominal pain, weight loss, vomiting, or changes in bowel habits such as chronic diarrhoea or constipation, it’s time to seek medical advice. Other symptoms that warrant a doctor’s visit include blood in the stool, fever, and difficulty swallowing. These could be signs of more serious conditions such as gastrointestinal infections, inflammatory bowel disease, or even certain cancers.

When you consult a healthcare professional about persistent bloating, they may recommend a variety of diagnostic tests to determine the underlying cause. These can include gut screenings to check for infections and inflammation or stool tests to identify parasites or further investigate the presence of blood.  Imaging tests such as ultrasounds, CT scans, or endoscopy (insert link to service page) may also be used to get a closer look at your digestive tract.

Based on the results, your doctor will suggest appropriate treatment options. These may range from dietary modifications and medications to manage symptoms to more specific treatments for conditions like IBS, SIBO, or celiac disease. In some cases, referral to a gastroenterologist for specialised care may be necessary.

Conclusion

Bloating can be a persistent issue that affects both comfort and quality of life, but it’s often within our power to manage effectively. By making thoughtful dietary choices—such as steering clear of known gas producers and embracing gut-friendly foods—you can significantly reduce bloating incidents. Likewise, adopting healthy lifestyle habits, including regular exercise and effective stress management, supports optimal digestion.

However, if bloating becomes severe or chronic, it’s crucial to seek medical advice, as it may indicate a more serious underlying condition. With the right approach, you can achieve a more comfortable and balanced digestive system, which can help ensure a healthier and more enjoyable life.

References

1. “Why Do Beans Cause Gas?” Verywell Health, https://www.verywellhealth.com/why-do-beans-cause-gas-1942947.  Accessed 21 June 2024.
2. Bellini, Massimo, et al. “Low Fermentable Oligo- Di- and Mono-Saccharides and Polyols (FODMAPs) or Gluten Free Diet: What Is Best for Irritable Bowel Syndrome?” Nutrients, vol. 12, no. 11, Nov. 2020, p. 3368. PubMed Central, https://doi.org/10.3390/nu12113368. 
3. “Worst Foods for IBS Sufferers.” Advanced Endoscopy & Surgical Center, LLC, https://advancedendoscopy.com/news/worst-foods-for-ibssufferers. Accessed 21 June 2024.
4.  “Is Carbonated (Sparkling) Water Good or Bad?” Healthline, 3 Nov. 2019, https://www.healthline.com/nutrition/carbonated-water-good-or-bad. 
5. Lenhart, Adrienne, and William D. Chey. “A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome.” Advances in Nutrition, vol. 8, no. 4, July 2017, pp. 587–96. PubMed Central, https://doi.org/10.3945/an.117.015560. 
6. Robles, Luelle, and Ronny Priefer. “Lactose Intolerance: What Your Breath Can Tell You.” Diagnostics, vol. 10, no. 6, June 2020, p. 412. www.mdpi.com, https://doi.org/10.3390/diagnostics10060412. 
7. Roszkowska, Anna, et al. “Non-Celiac Gluten Sensitivity: A Review.” Medicina, vol. 55, no. 6, June 2019, p. 222. www.mdpi.com, https://doi.org/10.3390/medicina55060222. 
8. Lebwohl, Benjamin, and Alberto Rubio-Tapia. “Epidemiology, Presentation, and Diagnosis of Celiac Disease.” Gastroenterology, vol. 160, no. 1, Jan. 2021, pp. 63–75. ScienceDirect, https://doi.org/10.1053/j.gastro.2020.06.098. 
9. Labanski, Alexandra, et al. “Stress and the Brain-Gut Axis in Functional and Chronic-Inflammatory Gastrointestinal Diseases: A Transdisciplinary Challenge.” Psychoneuroendocrinology, vol. 111, Jan. 2020, p. 104501. ScienceDirect, https://doi.org/10.1016/j.psyneuen.2019.104501. 
10. Oroian, Bianca Augusta, et al. “New Metabolic, Digestive, and Oxidative Stress-Related Manifestations Associated with Posttraumatic Stress Disorder.” Oxidative Medicine and Cellular Longevity, edited by Juan F. Santibanez, vol. 2021, Dec. 2021, pp. 1–18. DOI.org (Crossref), https://doi.org/10.1155/2021/5599265. 
11. Balmus, Ioana-Miruna, et al. “Irritable Bowel Syndrome and Neurological Deficiencies: Is There A Relationship? The Possible Relevance of the Oxidative Stress Status.” Medicina, vol. 56, no. 4, Apr. 2020, p. 175. www.mdpi.com, https://doi.org/10.3390/medicina56040175. 
12. Serra, Jordi. “Management of Bloating.” Neurogastroenterology & Motility, vol. 34, no. 3, Mar. 2022, p. e14333. DOI.org (Crossref), https://doi.org/10.1111/nmo.14333. 
13. Takakura, Will, and Mark Pimentel. “Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update.” Frontiers in Psychiatry, vol. 11, July 2020. Frontiers, https://doi.org/10.3389/fpsyt.2020.00664. 
14. Kałużna, Małgorzata, et al. “Are Patients with Polycystic Ovary Syndrome More Prone to Irritable Bowel Syndrome?” Endocrine Connections, vol. 11, no. 4, Apr. 2022. ec.bioscientifica.com, https://doi.org/10.1530/EC-21-0309. 
15. Booth, Stephanie. “Remedies for Bloating.” WebMD, https://www.webmd.com/digestive-disorders/remedies-for-bloating.  Accessed 21 June 2024.
16.  Medicine, Northwestern. “Celiac Disease vs. Gluten Intolerance (Infographic).” Northwestern Medicine, https://www.nm.org/healthbeat/healthy-tips/celiac-disease-vs-gluten-intolerance-infographic.   Accessed 21 June 2024.
17. FODMAP Diet: What You Need to Know. 29 Dec. 2021, https://www.hopkinsmedicine.org/health/wellness-and-prevention/fodmap-diet-what-you-need-to-know. 
18. Contributors, WebMD Editorial. “What to Know About Belly Massage for Digestion.” WebMD, https://www.webmd.com/digestive-disorders/what-to-know-about-belly-massage-for-digestion.  Accessed 21 June 2024. 
19. D’Silva, Adrijana, et al. “Yoga as a Therapy for Irritable Bowel Syndrome.” Digestive Diseases and Sciences, vol. 65, no. 9, Sept. 2020, pp. 2503–14. Springer Link, https://doi.org/10.1007/s10620-019-05989-6. 
20. Sattar, Tabinda. “Would Some Herbal Teas Play a Medicating Role for Certain Diseases?” Current Nutrition & Food Science, vol. 17, no. 2, Feb. 2021, pp. 176–88. IngentaConnect, https://doi.org/10.2174/1573401316666200514224433.