Expert care in digestive health

Gas/bloating

Bloating is a very common symptom for a lot of people. Bloating refers to a sensation of fullness in the abdomen. This can be caused by intestinal gas or food accumulation in the stomach. Intestinal gas can also cause belching, abdominal pain or excessive flatulence.

What are the causes of bloating?

In some people bloating is simply caused by swallowing of excess air while eating, sucking on hard candy, chewing gum, anxiety, drinking carbonated beverages such as soda or beer.

  • Dietary intolerance: Some carbohydrates are hard to digest and pass into the colon undigested where the bacteria metabolize them to hydrogen and carbon dioxide gases. Some of the examples of such food or beans, broccoli, cabbage, cauliflower, etc. Lactose intolerance is another common cause especially in some ethnic groups such as Asians and African Americans.
  • Severe constipation
  • Irritable bowel syndrome
  • Celiac disease

What kind of testing do I need?

It really depends. If you have any other associated symptoms such as abdominal pain, bloating, change in her bowel habits, you may need following tests-

Blood tests to check your blood count and thyroid function

X-ray or CT scan of the abdomen

Breath test to see if you have lactose intolerance or bacterial overgrowth in the small intestine.

If you just have bloating without any other symptoms, I may recommend dietary changes or over-the-counter medications/supplements.

How do I manage bloating or gas?

Diet changes-

Diet change is the first thing I recommend.

Before you do anything, I recommend laying off dairy products (milk, cheese, yogurt and ice cream) completely for 2 weeks to see what happens.

If it doesn’t work, then avoid or minimize foods that can cause excess gas- beans, lentils, broccoli, brussels sprouts, salads, cabbage, apples, pears, artificial sweeteners especially sorbitol, high fiber sources such as bran cereal, etc.,

One misconception is that if you have IBS, you need to eat lot of fiber which is not necessarily true. Fiber may actually make your gas/bloating worse.

Raw vegetables in general cause more gas. Cooking the vegetables, especially boiling will eliminate some of the chemicals that cause gas.

If you are a big chewing gum user, avoiding it may help. You suck lot more air if you are drinking or eating too fast. So slow down.

Low-FODMAP diet-

FODMAPs are different sugars in our foods that are hard to digest and can ferment in the gut to produce excess gas. Foods low in FODMAPs may help minimize the gas. This diet is little hard to follow in the beginning but if you already tried all of the above, you may need to go on this special diet.

Activated Charcoal-

Charcoal tablets sometimes help absorb the excess gas.

Probiotics-

Trial of probiotics such as Align or IBplus may help in some people.

Digestive Enzymes-

Try digestive enzyme tablets that are available over the counter to see if they help. You will know it within few days if it is helping or not.

Small Intestinal Bacterial Overgrowth (SIBO)-

In some cases, especially if you had abdominal surgery in the past, you may have excess bacteria in your small intestine that can produce gas. Taking certain antibiotics may help relieve excess gas at least for few months.

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