Chronic Abdominal Bloating: Causes and Solutions - Gastroenterology and Hepatology

Chronic abdominal bloating?

Hello, doctor.
Around December of last year, I underwent an endoscopy, and the doctor mentioned that I had bloating.
I didn't pay much attention to it, but in early January and February, I still experienced bloating.
I visited two gastroenterology clinics; one suggested considering taking probiotics to see if it would help, while the other recommended trying medication first and then deciding if I wanted to undergo a colonoscopy.
My family doctor conducted a fecal occult blood test, and the results were normal.
I am still experiencing bloating, but it is not something I feel; I only notice it when I tap my abdomen.
Sometimes, I pass gas frequently, and I have regular bowel movements at least every two days.
I have always felt the urge to use the restroom when I am anxious, and I am unsure if this is irritable bowel syndrome since one of the doctors told me it is not.
I also read online that allergies and eating too quickly can lead to bloating, which I have been doing.
I am not sure if this is the cause or if I need to undergo further testing.
Could you please help me with this? Thank you.
🙏

Ayz, 20~29 year old female. Ask Date: 2021/03/05

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is advisable to first adjust the timing and dosage of medication, take a short walk after meals, and avoid prolonged sitting.
If there is still no improvement, then a colonoscopy should be considered.

Reply Date: 2021/03/05

More Info

Chronic abdominal bloating can be a frustrating and uncomfortable condition, and understanding its potential causes is essential for effective management. Based on the information provided, it appears that you have been experiencing persistent bloating since December, despite undergoing various evaluations and treatments. Let's explore the possible causes and solutions for your symptoms.

Possible Causes of Chronic Abdominal Bloating
1. Dietary Factors: One of the most common causes of bloating is related to diet. Foods that are high in fiber, such as beans, lentils, and certain vegetables (like broccoli and cabbage), can lead to gas production in the intestines. Additionally, consuming carbonated beverages can introduce excess air into the digestive system, contributing to bloating. Eating too quickly can also cause you to swallow air, leading to discomfort.

2. Food Intolerances: Lactose intolerance (difficulty digesting dairy products) and gluten sensitivity (reaction to gluten found in wheat and other grains) are common culprits of bloating. If you suspect that certain foods may be causing your symptoms, consider keeping a food diary to track your intake and any associated symptoms.

3. Irritable Bowel Syndrome (IBS): IBS is a functional gastrointestinal disorder characterized by symptoms such as bloating, abdominal pain, and changes in bowel habits (diarrhea or constipation). Stress and anxiety can exacerbate IBS symptoms, leading to increased bloating and urgency to use the bathroom.

4. Gut Microbiome Imbalance: The gut microbiome plays a crucial role in digestion and overall health. An imbalance in gut bacteria can lead to bloating and gas. Probiotics, which are beneficial bacteria, may help restore balance and alleviate symptoms.

5. Gastrointestinal Disorders: Conditions such as gastroparesis (delayed stomach emptying), small intestinal bacterial overgrowth (SIBO), or other gastrointestinal disorders can cause chronic bloating. These conditions may require further evaluation, including imaging studies or specialized tests.

Solutions and Management Strategies
1. Dietary Modifications: Start by identifying and eliminating potential trigger foods from your diet. Consider a low-FODMAP diet, which restricts certain fermentable carbohydrates that can cause bloating. Gradually reintroduce foods to pinpoint specific triggers.

2. Eating Habits: Practice mindful eating by taking your time during meals, chewing thoroughly, and avoiding talking while eating to minimize air swallowing. Smaller, more frequent meals may also help reduce bloating.

3. Probiotics: Since one of the gastroenterologists suggested trying probiotics, consider incorporating them into your routine. Probiotics can help improve gut health and may alleviate bloating over time.

4. Stress Management: Since you mentioned that stress triggers the urge to use the bathroom, incorporating stress-reduction techniques such as yoga, meditation, or deep-breathing exercises may help manage both your stress levels and gastrointestinal symptoms.

5. Further Evaluation: If your symptoms persist despite dietary changes and lifestyle modifications, it may be beneficial to pursue further evaluation. A gastroenterologist may recommend tests such as a hydrogen breath test for SIBO or a comprehensive stool analysis to assess gut health.

6. Medication: If bloating is severe, your doctor may prescribe medications to help alleviate symptoms. Antispasmodics can relieve cramping, while simethicone can help reduce gas buildup.

Conclusion
Chronic abdominal bloating can stem from various causes, including dietary habits, food intolerances, and gastrointestinal disorders. By making dietary adjustments, practicing mindful eating, and managing stress, you may find relief from your symptoms. However, if bloating persists, further evaluation by a healthcare professional is warranted to rule out underlying conditions. Remember, it’s essential to communicate openly with your healthcare provider about your symptoms and any changes you experience.

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