Bloating is one of the most common and frustrating conditions that patients present to the gastroenterologist with. We would estimate that at least 30% of our patients present with bloating as their major complaint. The vast majority of these patients have a type of functional bowel disorder called Irritable Bowel Syndrome and further information may be given to you if our doctors feel that this is the primary problem. However, bloating can be associated with many other conditions and it is for that reason that further tests may be required to exclude those conditions as the cause for your bloating.
Bloating can occur when there is a blockage to the lower bowel and thus colonoscopy may be required to exclude that. Similarly, blockage of the stomach or weakness of the muscular contraction of the stomach can cause bloating after meals and thus tests may be required to exclude those conditions.
Certainly many causes of bloating are dietary related, specifically associated with the ingestion of fizzy drinks and numerous types of vegetables. The doctor may have given you a list of things to try and avoid in order to try and relieve the bloating that you have. Lactose intolerance can also be associated with bloating and tests may be required to exclude that condition.
Many people with lower abdominal bloating make their own symptoms worse by not passing intestinal wind. We all make intestinal gas and we all pass it, however some people, especially women, seem reluctant to pass the quantity of wind that they actually produce because of social circumstance or embarrassment. Certainly opportunities should be taken advantage of, where possible, to release trapped intestinal wind and this may relieve the degree of lower abdominal bloating that they have.
Some of the food exclusions tried in patients with bloating include dairy products, diet soft drinks, diet chewing gum or lollies, and chewing gum of any sort because of the air swallowed during chewing. Some vegetables associated with excess intestinal gas production include onions, capsicum, broccoli, cauliflower, canned beans, brussels sprouts, cabbage and chick peas.
Many patients feel that wheat causes bloating and this is often because they have Irritable Bowel Syndrome – not because they have an intolerance to wheat. True wheat intolerance is extremely rare and is excluded by biopsies from the small bowel during an endoscopic examination. Excess wind is made because of sluggishness of areas of the bowel which cause the carbohydrates to be present for longer than they otherwise would be – followed by fermentation of that carbohydrate by the bacteria that are normally present in the bowel.
Patients with bloating from Irritable Bowel Syndrome often do not have excess gas when this is measured scientifically, but their bowel perceives there to be excess gas and this is called hypersensitivity. If the doctor feels that you have Irritable Bowel Syndrome, further information will be given to you. Approximately 1 in 5 women have symptoms that are Irritable Bowel in nature, but of course, of varying severities. This is a benign and irritating condition and does not predispose the patient to any form of or sinister gastrointestinal problem, but it is a life-long condition and one that requires life-long management and a firm diagnosis.