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Five causes of a bloated belly

17 April 2023 dot 5-minute read
Healthy Body Celiac disease Diet and nutrition Listicle Bloated stomach Eat Well
Your abdomen may feel bloated without looking visibly distended. (Credit: Shutterstock)
Nearly everyone has experienced a bloated stomach or a full, tight sensation in the abdomen. The International Foundation for Gastrointestinal Disorders describes the feeling as having an inflated balloon in the gut.
 
The most common cause of bloating is excessive intestinal gas. When you speak or eat too quickly, you tend to swallow more air, which builds up in your intestines.
 
Certain foods can also play a part in a bloated stomach. Beans, broccoli, apples and milk can produce excess gas when ingested, although their gassy effect varies from person to person.
 
Menstruating women may also experience bloating as a symptom of their monthly period. Changes in oestrogen and progesterone levels cause water retention, making the stomach feel swollen.
 
Bloating is typically alleviated when you pass gas and avoid gas-inducing foods. Period bloating also eases for women by the end of their menstrual cycles. If your experience with trapped gas is persistent or painful, it may be time to consult your doctor.

Five causes of a bloated stomach

Eating processed foods, often high in sodium, may cause water retention and lead to bloating. (Credit: Shutterstock)
The abdomen or belly contains digestive organs such as the stomach, small intestine and large intestine, which comprise the gastrointestinal tract. It also carries the liver, pancreas and gallbladder.
 
Mount Sinai says you may feel abdominal pain between your chest and groin, often called the stomach region. However, pain in more than half of your belly suggests a stomach virus, indigestion or gas.
 
Studies published in Gut and Gastroenterology & Hepatology showed abdominal bloating is one of the most reported chronic symptoms of gut-brain or gastrointestinal (GI) problems. A bloated and distended belly can also be a symptom of endometriosis, a serious gynaecological condition.

1. Irritable bowel syndrome

One of the most common stomach and gastrointestinal tract issues is irritable bowel syndrome (IBS). You can have diarrhoea, constipation or both with IBS. In addition, abdominal pain that has recurred at least a day each week for three months may accompany either symptom.
 
Abdominal bloating was the top complaint in a study of 30,000 Japanese with IBS, according to BioPsychosocial Medicine. This study also revealed that those who experienced IBS with constipation endured bloating after meals and during times of stress.

2. Small Intestinal Bacterial Overgrowth

Bacteria in your intestines help you break down and digest your food. Small intestinal bacterial overgrowth (SIBO) can occur when your bacteria balance gets disturbed.
 
SIBO leads to abdominal bloating with distension, diarrhoea, flatulence and weakness. In severe cases, it can cause weight loss and vitamin deficiencies.
 
A paper on SIBO published in the Indian Journal of Gastroenterology has linked SIBO to conditions like IBS, non-alcoholic fatty liver disease (NAFLD), chronic pancreatitis, Celiac disease, obesity and inflammatory bowel disease (IBD).

3. Gastroparesis

Food can stay in the stomach for about two to four hours before emptying into the small intestine. You may have gastroparesis if your gut takes longer to pass digestive contents despite the absence of bowel obstruction.
 
Symptoms of gastroparesis include a bloated belly, abdominal pain, nausea and vomiting. You may also have difficulty finishing a meal or feel full after eating a small amount of food. These symptoms may come and go and vary in severity.
 
Diabetes is one of the most well-known causes of gastroparesis, according to the Asian Neurogastroenterology and Motility Association.

4. Celiac disease

Gluten is the enemy of Celiac disease, a chronic autoimmune intestinal disorder. Eating gluten triggers the immune system to attack the small intestine's tissues, resulting in damage.
 
You may experience bloating, abdominal pain, chronic diarrhoea, constipation and nausea if you have Celiac disease. Other symptoms include mouth ulcers, itchy, blistery skin rashes and joint pain.
 
Celiac disease can prevent the body from absorbing nutrients and lead to malnutrition. Based on a study published in Nutrients, people with untreated Celiac disease may lack iron, folic acid, calcium, zinc oxide and vitamins D and B12.

5. Endometriosis

Women shed the endometrium (the lining of their uterus) during menstruation. With endometriosis, endometrial-like tissue spreads outside the uterus, planting itself in the intestines, the rectum or the appendix. It can cause inflammation in the abdomen, resulting in swelling, water retention and bloating. Scientists are still unclear on why this happens.
 
Endometrial tissue growing outside the uterus will react to hormones during a woman's period. Besides gynaecological symptoms, this response has caused gastrointestinal issues in up to 90 per cent of women with endometriosis, Reproductive Sciences says.
 
Besides nausea, constipation or diarrhoea, many women with endometriosis contend with "endo belly", painful bloating and a distended abdomen before and during menstruation.

How to treat a bloated stomach

Exercise can help improve how the gut muscles move food along the digestive tract. (Credit: Shutterstock)
Whether a GI or gynaecological issue is behind your bloated belly, your doctor will likely recommend dietary changes and physical activity.

FODMAP diet

Research has shown a low FODMAP diet can reduce gas, particularly in IBS. FODMAPs (an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols) are a group of carbohydrates your gut can't absorb or digest well.
 
This diet is designed to uncover your food triggers and how much of these you can tolerate without setting off gastrointestinal symptoms. According to Australia's Monash University, a low FODMAP diet can relieve abdominal pain, constipation, diarrhoea and bloating in people with IBS. It requires supervision by a doctor or dietitian because it is not meant to be followed as a long-term diet.
 
Here are a few high-FODMAP foods and their corresponding low-FODMAP alternatives
 
Vegetables
  • High FODMAP: Asparagus, cauliflower, garlic, onion
  • Low FODMAP: Bok choy, bell pepper, carrot, lettuce
 
Fruits
  • High FODMAP: Apples, dried fruit, mango, watermelon
  • Low FODMAP: Cantaloupe, kiwi, orange, pineapple
 
Dairy
  • High FODMAP: Cow's milk, evaporated milk, ice cream, soy milk made from whole soybeans
  • Low FODMAP: Almond milk, hard cheeses, lactose-free milk, soy milk made from soy protein
 
Protein sources
  • High FODMAP: Legumes, marinated meats/poultry/seafood, processed meats
  • Low FODMAP: Eggs, firm tofu, tempeh, plain cooked meats/poultry/seafood
 
Bread and cereals
  • High FODMAP: Wheat/rye/barley-based bread, breakfast cereals, biscuits
  • Low FODMAP: Bread free of wheat/rye/barley, oats, rice or quinoa noodles, plain rice cakes

Physical activity

Physical activity like walking or biking may help speed up your digestion unless you have an underlying gastrointestinal condition.
 
Yoga poses like Pavanamuktasana (a head-to-knee pose) and Balasana (child's pose) stretch the lower back and hips. These poses massage the abdominal wall to relieve bloating.
 
A bloated stomach should be a temporary condition. However, if the issue increases in frequency and affects your daily life, it may be time to seek assistance. For a holistic approach to self-care, check out AIA Vitality and its network of healthcare professionals.
This wellness programme can customise a treatment plan and empower you to embrace your overall wellbeing. Most importantly, it provides a supportive community for you and your health journey.
 
 
References:
 
American Heart Association. 2022.  Effects of Excess Sodium Infographic. [online]  [Accessed on 23 March 2023]
 
HealthDirect. 2020. Irritable bowel syndrome (IBS) - symptoms, triggers, management. [online]  [Accessed on 25 November 2022]
 
Gastroenterology & Hepatology. 2022.  A Practical Approach to the Diagnosis and Treatment of Abdominal Bloating and Distension. [online]  [Accessed on 25 November 2022]
 
 
Nutrients. 2022. Nutrition in Patients with Lactose Malabsorption, Celiac Disease, and Related Disorders [online]  [Accessed on 25 November 2022]
 
Journal of Neurogastroenterology and Motility. 2021.  Knowledge, Attitude, and Practice Survey of Gastroparesis in Asia by Asian Neurogastroenterology and Motility Association. [online]  [Accessed on 25 November 2022]
 
Endometriosis Foundation of America. 2021.  Managing 'Endo Belly' (Severe Bloating). [online]  [Accessed on 25 November 2022]
 
Reproductive Sciences. 2021.  Associations Between Endometriosis and Gut Microbiota. [online]  [Accessed on 25 November 2022]
 
 
Advances in Therapy. 2019.  Bloating and Abdominal Distension: Clinical Approach and Management. [online]  [Accessed on 25 November 2022]
 
Journal of the Canadian Association of Gastroenterology. 2019.  Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS). [online]  [Accessed on 25 November 2022]
 
Gut. 2019. Gastroparesis: A turning point in understanding and treatment. [online]  [Accessed on 25 November 2022]
 
 
Journal of Neurogastroenterology and Motility. 2016. Clinical Dimensions of Bloating in Functional Gastrointestinal Disorders. [online]  [Accessed on 25 November 2022]
 
Monash University. High and low FODMAP foods. [online]  [Accessed on 25 November 2022]
 
 
International Foundation for Gastrointestinal Disorders. Understanding Bloating and Distension. [online]  [Accessed on 25 November 2022]
Disclaimer:
This is general information only and is not intended as financial, medical, health, nutritional or other advice. You should obtain professional advice from a financial adviser, or medical or health practitioner in relation to your own personal circumstances.