Bloating and Gas: Causes and Solutions for Digestive Issues

Gas expulsion issues

Hello, Doctor: Every day after I wake up until noon, I experience a lot of gas in my stomach, and I find it very easy to pass gas (about every 10 minutes) and burp.
However, by the afternoon and evening, everything seems normal.
The condition only improves if I avoid consuming drinks, bread, and similar foods; otherwise, I feel uncomfortable all day.
I have consulted two gastroenterologists, and one of them performed an ultrasound, which came back normal.
Taking medication has not helped either, and I am really troubled by this.
What could be causing these symptoms? I can't possibly go my whole life without eating bread, right? What can I do to improve this situation? Are probiotics effective? This has been going on for over six months, and I sincerely hope you can provide some answers as I am really distressed.

A, 10~19 year old female. Ask Date: 2022/05/10

Dr. Chen Shidian reply Gastroenterology and Hepatology

Individual constitution can only be adjusted through dietary changes.
Probiotics can be tried as they are generally harmless, but they may not necessarily be effective.

Reply Date: 2022/05/10

More Info

Bloating and excessive gas can be quite uncomfortable and frustrating, especially when they interfere with daily activities. Based on your description, it seems that you experience significant bloating and gas primarily in the morning and early afternoon, which improves later in the day. This pattern, along with your sensitivity to certain foods like bread and beverages, suggests that you may be dealing with a form of food intolerance or digestive dysfunction.

Possible Causes of Bloating and Gas
1. Food Intolerances: Many individuals experience bloating and gas due to intolerances to certain foods. Common culprits include lactose (found in dairy), gluten (found in wheat products), and high-FODMAP foods (which include certain fruits, vegetables, and sweeteners). Since you mentioned that consuming bread leads to discomfort, gluten intolerance or sensitivity could be a possibility.

2. Irritable Bowel Syndrome (IBS): IBS is a functional gastrointestinal disorder characterized by symptoms like bloating, gas, abdominal pain, and changes in bowel habits. It can be triggered by stress, certain foods, or hormonal changes. The fact that your symptoms improve later in the day could align with IBS, as many individuals with this condition report symptom variability throughout the day.

3. Gut Microbiome Imbalance: An imbalance in gut bacteria can lead to excessive gas production. This can occur due to a diet low in fiber, high in processed foods, or after a course of antibiotics. Probiotics may help restore balance, but their effectiveness can vary from person to person.

4. Gastroesophageal Reflux Disease (GERD): If you experience burping along with bloating, it could indicate GERD, where stomach acid flows back into the esophagus. This can lead to discomfort and bloating, especially after meals.

5. Constipation: If bowel movements are infrequent, this can lead to a buildup of gas and bloating. Ensuring regular bowel movements is crucial for reducing bloating.

Solutions and Recommendations
1. Dietary Modifications: Keeping a food diary can help identify specific triggers. Consider eliminating gluten-containing foods (like bread) temporarily to see if symptoms improve. You might also want to explore a low-FODMAP diet, which has been shown to help many individuals with IBS.

2. Hydration: Ensure you are drinking enough water throughout the day. Dehydration can lead to constipation, which exacerbates bloating.

3. Probiotics: Incorporating probiotics into your diet may help improve gut health. Look for strains like Lactobacillus and Bifidobacterium, which are commonly found in yogurt and supplements.

4. Regular Exercise: Physical activity can help stimulate digestion and reduce bloating. Aim for at least 30 minutes of moderate exercise most days of the week.

5. Mindful Eating: Eating slowly and chewing food thoroughly can help reduce the amount of air swallowed, which can contribute to gas. Avoid carbonated beverages, which can introduce additional gas into the digestive system.

6. Consultation with a Specialist: Since you have already seen gastroenterologists, consider asking for further testing, such as a hydrogen breath test for lactose or fructose intolerance, or a comprehensive stool analysis to assess gut microbiome health.

7. Stress Management: Since stress can exacerbate digestive issues, incorporating relaxation techniques such as yoga, meditation, or deep breathing exercises may be beneficial.

Conclusion
While it can be disheartening to deal with ongoing digestive issues, there are many strategies you can employ to alleviate symptoms. It’s essential to approach this holistically, considering dietary changes, lifestyle adjustments, and possibly further medical evaluation. Remember, you don’t have to live with discomfort, and with the right approach, you can find relief and enjoy a varied diet once again. If symptoms persist, continue to work closely with your healthcare provider to explore all possible avenues for diagnosis and treatment.

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