Bloating: Pain, Heaviness, Tightness, and Swollen Abdomen

Amber J. Tresca
·9 min read

Medically reviewed by Robert Burakoff, MDMedically reviewed by Robert Burakoff, MD

Bloating in the digestive system can cause pain and discomfort. The abdomen may become distended (stick out) and cause symptoms such as a feeling of fullness, pressure, or tightness in the stomach. The symptoms of bloating can range from mild to severe. In some cases, it lasts a long time and disrupts daily life.

This article covers symptoms and causes of bloating, lifestyle factors that may affect symptoms, and when to see a healthcare provider for tests or treatment.

<p>Illustration by Mira Norian for Verywell Health</p>

Illustration by Mira Norian for Verywell Health

Quick Bloating Remedies for Relief

You can manage bloating in many different ways at home. If possible, it may help to know what is causing the bloating. Some over-the-counter (OTC) remedies, supplements, or exercises could help when bloating has started. 

Some of these are:

  • Antacids: This type of over-the-counter remedy may work to loosen up trapped gas. However, antacids could contribute to bloating, so there may be a need to try different ones to find what works for you.

  • Exercise: Exercises like walking or yoga may help keep the digestive system working properly. Regular movement can move gas out of the bowels and relieve constipation (hard and/or infrequent stools), which can lead to bloating.

  • Herbal teas: Some people find drinking tea with peppermint, chamomile, ginger, turmeric, or fennel helps release gas. However, it's important to avoid artificial sweeteners, which may contribute to bloating.

  • Magnesium supplements: Constipation is a potential cause of bloating. Magnesium may help keep water in the intestines, which can soften stools and relieve constipation.

  • Peppermint oil capsules: Peppermint relaxes the smooth muscles in the digestive system. It is also used to treat irritable bowel syndrome (IBS), a common cause of bloating. IBS is a chronic functional disorder in which your brain and gut do not communicate well, which can result in diarrhea and/or constipation.

  • Probiotics: Beneficial strains of bacteria, called probiotics, are available as supplements and can also be found in certain types of fermented foods. Different types (strains) are available, and it's not well understood which ones might work better. However, long-term use may help manage the bloating associated with IBS.

  • Psyllium fiber: Constipation and diarrhea could be associated with bloating. A psyllium fiber supplement may help keep stools soft and make them easier to pass, relieving digestive symptoms.

Why Does Bloating Hurt?

Gas production is a normal part of digestion. It's produced when bacteria in the gut help break down food. Too much gas or gas that causes bothersome bloating affects between 16% and 31% of the general population.

Swallowing air, acid reflux, or eating a large meal or high-fiber foods could lead to bloating. Having a menstrual period may also cause digestive symptoms. These are usually reasons for temporary bloating.

Extra gas or stool trapped in the digestive system could lead to pain or discomfort. Constipation could also cause bloating, which could be either temporary or chronic (long-lasting). The discomfort may improve after a bowel movement or passing gas through the bottom.

Severe Bloating

About half of people with bloating also have distention, in which the stomach looks bigger, sticks out, and is uncomfortable.

Distention is associated with several conditions, including common ones like IBS, inflammatory bowel disease (IBD), and constipation. Inflammatory bowel disease are a group of diseases with inflammation in the digestive system, including Crohn's disease and ulcerative colitis. When the digestive system isn't working as well as it should, you may experience bloating, distention, and pain in the abdomen.

Less common reasons for bloating include cancer, a blockage in the bowel, infection, or liver disease. These may cause symptoms of bloating and pain that become chronic.

Bloating Changes: How Symptoms Look

Bloating is common and often goes away without any special treatment when it is not related to an ongoing digestive condition. Common symptoms associated with bloating can include:

  • Abdominal discomfort or pain

  • Abdominal distension (increased girth)

  • Abdominal noises (gurgling)

  • Belching (burping)

  • Feeling full

  • Gas

If the symptoms associated with bloating are not bothersome, they might not need to be diagnosed or treated by a healthcare provider. However, sometimes bloating can cause severe symptoms that can impact daily life or go on for a long time. 

Seeing a Provider for Ongoing Stomach Bloat

In some cases, ongoing problems with bloating and distention are a reason to see a healthcare provider. Symptoms that should be evaluated include:

  • Bloating that gets worse over time

  • Bloating along with fever, vomiting, or when bowel movements have stopped

  • Blood in or on the stool

  • Pain that gets worse over time

  • Symptoms that go on for several days without relief

A physical exam and medical history are often the first steps in finding a reason for bloating. Sharing information about your diet, lifestyle, and medications with a healthcare provider is also important. Knowing how often bloating occurs is also helpful information.



Talking With Your Healthcare Provider

Communicating clearly and effectively with healthcare providers about symptoms of bloating and other digestive problems is essential. Although discussing these personal issues can feel uncomfortable, remember that healthcare providers talk with many people about bowel or digestive issues and will not be surprised by the conversation.

It may help to write down a list of symptoms or questions so that you remember to address them during an appointment.

Bringing a trusted family member or friend along may ease tension, and they can prompt you to bring up important information.

Some healthcare providers might be available by email or through a patient portal to answer questions, which can help bring up more challenging problems in a neutral way.



Some of the tests that might be used when bloating becomes a problem include:

  • A1c: This blood test shows the average blood sugar level over the last three months. It is used to diagnose and monitor diabetes. Diabetes is one possible cause of gas and bloating. This test might be used if symptoms occur within 30 minutes of eating.

  • Blood tests: Other blood tests also can help narrow down the cause of your bloating. Calcium and thyroid-stimulating hormone levels may be checked, especially if constipation is a problem.

  • Rectal exam: In this test, a healthcare provider quickly inserts a gloved, lubricated finger into the rectum. Your provider will feel for abnormalities in and around the anus and rectum. This test might be used in the case of constipation to see how the anus is working and if anything is physically blocking bowel movements.

  • Anorectal manometry: This test is used to assess the muscles in the digestive system. It can show if the muscles are not working properly to move stool through and out of the anus. This test might be used when constipation, gas, and bloating are a problem.

  • Celiac testing (serological tests): This blood test looks for antibodies that could indicate celiac disease. This condition causes damage to the lining of the small intestine after eating gluten (a protein found in some grains, including wheat). Celiac disease may be suspected if bloating occurs more than 30 minutes after eating.

  • Colonoscopy: A flexible tube with a light and a camera is inserted into the anus and up into the rectum and colon to look for any problems in the large intestine. This test might be recommended when there is gas and bloating with constipation.

  • Gastric emptying study: During this nuclear medicine test, a meal with a small amount of radioactive tracers included monitored as it passes through the digestive system. This can detect if food is moving too slowly or too fast through the body. This test might be recommended if symptoms appear within 30 minutes of eating.

  • Hydrogen breath testing: This is used to see if the body is making too much hydrogen. Excess hydrogen could mean an infection or another problem with digestion is causing the bloating. This test might be used if bloating is occurring more than 30 minutes after eating.

  • Upper endoscopy (esophagogastroduodenoscopy, or EGD): In an EGD, a small tube is inserted into the mouth, down through the esophagus, and into the stomach. The inside of these organs is examined to determine a reason for the bloating. This test might be used if bloating occurs within 30 minutes of eating.

Prescribed Bloating Treatments

The treatment for bloating will depend on the cause. For bloating not associated with an underlying condition, the following may help:

  • Using over-the-counter remedies

  • Eating smaller meals

  • Adjusting the type or amount of fiber in the diet

  • Making other dietary changes

When a condition causes bloating, medications used may include.

How to Manage Chronic Bloating

Chronic bloating is a reason to seek care from a healthcare provider. Management might start with some dietary and lifestyle changes, including:

  • Avoiding carbonated beverages and chewing gum

  • Avoiding artificial sweeteners

  • Avoiding milk products if lactose intolerant

  • Chewing food slowly and carefully

  • Eating smaller meals

  • Evaluating medications and supplements with a healthcare provider for their potential to cause bloating

  • Making sure dentures fit properly

  • Slowly increasing the amount of fiber in the diet

  • Quitting smoking

  • Seeking mental health care for mood disorders

  • Working with a dietitian to try a low-FODMAP (low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol) diet

When making changes to diet and lifestyle doesn't help prevent or control bloating and/or gas in the digestive system, seeking help from a healthcare provider is the next step.

Summary

Bloating is a common problem, and many people experience it from time to time. In many cases, the symptoms can be traced back to something like a large meal or a fizzy drink. However, when it becomes painful and consistent and it is accompanied by other symptoms, there may be an underlying condition.

Many common conditions can cause bloating. Treatment will usually address the underlying cause.

Read the original article on Verywell Health.