Bloating – the causes and what can help treat it

What is bloating?

Bloating is 1 of the most common digestive symptoms you can have. Reports vary, but research suggests that between 10% and 30% of us feel bloated from time to time – and among people with digestive issues, these figures are much higher.

It’s also something that women have to deal with more often than men, due to hormonal changes. Many women say they feel bloated before and during their period – it’s 1 of the most common symptoms of premenstrual syndrome (PMS) – while both pregnancy and the menopause can also trigger bloating.

Bloating can be really frustrating, especially if it starts to affect your social life and wellbeing. Maybe you’re not enjoying food as much because your tummy feels full, or you can’t fit into your favourite outfit for a night out? It might stop you from getting to sleep or make it hard for you to concentrate because you feel so uncomfortable.

We don’t want bloating to get you down, or stop you living your life to the full. So here’s what you need to know about why you’re getting it and what you can do about it, as well as when to see a doctor.

What are the symptoms of bloating?

It’s common to feel bloated just after you’ve eaten, or if you’re stressed, anxious or hormonal.

You’re likely to be bloated if your tummy feels:

• tight
• uncomfortable
• full, or like there’s pressure on it
• stretched
• a bit painful
• swollen and stuck out (although this doesn’t always happen)

Bloating can also make you burp or fart more, and your tummy might rumble. You may feel like you need to wear looser clothes to be more comfortable.

Bloating: what’s normal and what’s not?

It’s normal if:

• you feel bloated once in a while
• you’re more bloated after you’ve spent a lot of time eating or drinking alcohol
• your bloating symptoms go away on their own within a few days, or improve once you go back to eating a healthy, balanced diet

You might need a doctor’s help if:

• your bloating lasts for more than a few days and doesn’t improve
• you’re getting bloating more frequently, or your symptoms are getting worse
• it’s affecting your daily life
• you notice pain in particular spots – lower tummy pain with bloating is a common symptom of constipation, irritable bowel syndrome (IBS) and diverticular disease, whereas indigestion usually causes pain in the upper half of your tummy
• you also have other symptoms – see below for more information about when to see a doctor

When you get bloating, it’s a good idea to be aware of where on your tummy you feel it. You could create a customised tracker in the Healthily app to help you build a record of your symptoms, then use this during discussions with your doctor if your bloating doesn’t improve.

Find useful information on other areas of gut health with our complete Healthy Gut Guide.

What are the causes of bloating?

There are lots of different reasons why you might get a bloated tummy. In many cases, it happens after you eat too much or eat too fast, which can cause a build-up of gas in your bowels. The good news is that you can often improve bloating by making small changes to your diet and lifestyle.

The most common causes of bloating are:

• trapped wind – this can happen if you swallow too much air by eating a lot in 1 go or eating too fast. What you eat and drink can also have an effect: fizzy drinks, alcohol, chewing gum, high-fibre foods (if you’re not used to them) and other gas-producing foods such as chickpeas and beans can also cause trapped wind, leaving you feeling bloated for a short time
• stress and anxiety – if you’re stressed or anxious, it can trigger your body’s ‘fight-or-flight’ response. This makes you more alert and ready for danger by sending more blood to your muscles and away from your tummy – which means your digestion slows down, and this may cause bloating, pain and constipation. Symptoms should go away once you feel less stressed
• hormonal changes – when you’re on your period, pregnant, or going through menopause, your hormones are changing, which can lead to water retention, slower digestion and a build-up of gas – causing bloating. Period bloating may happen before your period starts and get better a few days into your next cycle, while pregnancy bloating can be common during the 1st trimester. Menopause bloating usually gets better postmenopause, once your body settles at a lower level of hormones
• tummy bugs – if you have a short-term illness such as gastroenteritis, which is irritation (inflammation) of your digestive system, you may get bloating alongside other symptoms, which should get better after a few days
• indigestion – often caused by eating or drinking something that doesn’t agree with you, the main symptom is pain or discomfort in the upper part of your tummy, but other symptoms can include bloating and heartburn. It’s usually short-lived and goes away on its own or with self-care measures
• IBS – this long-term (chronic) bowel condition can cause tummy cramps, loose poos (diarrhoea) and constipation, as well as bloating (especially in the evenings). It’s thought to be caused by food passing through your gut either too quickly or too slowly, and can be made worse by stress. It can last for days, weeks or months at a time, and often comes and goes
• constipation – bloating can also be a symptom of constipation, when you don’t poo regularly or find it hard to push a poo out. It’s thought that the longer poo stays in your bowels, the longer bacteria sit there, which can cause gas to build up. Along with hard poo that’s not moving through, this can lead to that uncomfortable bloated feeling. These symptoms may last until you do manage to go for a poo

Less common causes of bloating include:

• food intolerances – if you have a food intolerance, such as lactose intolerance, sensitivity to gluten or coeliac disease, you may get a bloated tummy if you eat ‘trigger’ foods. This should improve once you reduce or remove these foods from your diet
• inflammatory bowel disease (IBD) – chronic gut-related conditions such as Crohn’s disease and ulcerative colitis can cause pain and swelling in the tummy, which may come and go
• other tummy infections – giardiasis and other digestive system infections caused by parasites are usually caught by consuming contaminated food or water, and can cause bloating and other symptoms. These should get better within a week, if treated with antibiotics. Urinary tract infections (UTIs) can also affect your tummy and cause bloating, which can be treated in a few days with antibiotics
• medication – you may notice bloating as a side effect of certain medicines, including opioid painkillers (such as codeine), iron supplements, antacids and medication used to treat constipation. Speak to your doctor or pharmacist before you stop or change any medication you’re taking
• physical changes in your body – bloating or a swollen tummy can happen when your tummy is growing during pregnancy, or sometimes it can be a symptom of non-cancerous growths in your womb called fibroids. If you’re worried about any changes in your body, speak to your doctor
• other health conditions – bloating can also be a symptom of some more serious medical conditions that need treatment from a doctor, including a prolapse, liver disease, fluid in the abdomen (ascites), kidney failure, heart failure and ovarian, womb, bowel and pancreatic cancers

How a pharmacist can help with bloating

A pharmacist may be able to offer you relief for some causes of bloating, with treatments including:

• trapped wind tablets – these often contain simethicone alongside an antacids, and work by breaking up the gas bubbles in your tummy and neutralising stomach acid. However, more research is needed into how effective they are at relieving symptoms
• activated charcoal – products containing charcoal are thought to be able to absorb excess gas in your tummy, and may help relieve bloating
• peppermint oil capsules – these are ‘antispasmodics’, which work by relaxing the muscles in the wall of your bowel. This can help with bloating, tummy cramps and farting, especially if you have IBS
• laxatives – if your bloating is thought to be caused by constipation, a pharmacist may offer you laxatives to help you poo more regularly
• probiotics – studies suggest these may help with bloating and constipation if you have IBS, although more research is needed

When to see a doctor

If you’re worried about your symptoms, you can use our Smart Symptom Checker to get more information and help you work out what to do next.

You should see a doctor if your bloating doesn’t go away or if self-care measures don’t help. They can look into what might be causing your bloating and, if necessary, do tests to rule out any serious health conditions.

You should see a doctor as soon as you can if you’re bloated and:

• it’s getting worse
• it’s lasted longer than a week or it keeps coming back
• you have a high temperature (fever), diarrhoea for 7 days or you’re being sick (vomiting) for 3 days
• your tummy is really painful
• you notice blood in your poo or pee
• you feel full quickly after not eating very much, and you’ve lost your appetite
• you’re needing to go for a wee more often than usual
• you’ve noticed weight loss, or have quickly gained a lot of weight
• you’re feeling tired or short of breath
• you’ve noticed swelling anywhere else in your body
• you’ve noticed long-lasting changes to your poo, or how often you go for a poo

You should call an ambulance or go to hospital if you feel bloated and:

• you have really bad tummy pain and a fever
• you’re being sick and it looks like blood, coffee grounds or it’s bright green, or you can’t keep any fluids down
• you suddenly can’t pee or you haven’t peed all day
• you haven’t had a poo or farted all day
• you have a lot of blood in your poo or pee
• your poo looks like tar and is dark black

How is bloating diagnosed?

First, your doctor will ask about your symptoms. It’s a good idea to keep a diary to record how often you feel bloated, and when it happens – do you feel bloated after eating certain foods, for example? They may also ask about your medical history, diet and lifestyle.

After this, you may be given a physical exam, when your doctor will feel around your tummy. Depending on your symptoms, they might also suggest tests to rule out any underlying health conditions.

Your doctor may recommend tests such as:

• poo (stool) analysis – a stool sample can be checked for signs of an infection or a problem with your digestive system
• blood tests – to check for markers of inflammation, coeliac disease or ovarian cancer
• ultrasound scan – to look at the organs in your tummy, such as your liver or pancreas, or to check for fibroids, ovarian cysts or ovarian cancer. This may be done with a scanning device over your tummy area (abdominal scan), or a small scanning device inserted into your vagina (transvaginal scan)

In somes cases, you might be referred to a specialist called a gastroenterologist. They may do tests such as:

• CT scan or MRI scan – these scans can be used to see the inside of your tummy, if conditions such as ascites or Crohn’s disease are suspected
• endoscopy or colonoscopy – these procedures can look inside your tummy or bowel to check for conditions such as IBD or bowel cancer
• hydrogen breath test – this specialist test may be used to find out if a digestive disorder such as lactose intolerance or small intestinal bacterial overgrowth (SIBO) is causing your bloating

Medical treatments from a doctor

There are lots of different treatments that may help with bloating, and how your doctor treats your symptoms will depend on what’s causing them.

If a medical condition is to blame, they’ll be able to offer you specific medication or treatment, such as:

• an elimination diet – if a food intolerance or allergy is causing your bloating you may be referred to a dietician, who can guide you through an elimination diet. This means eating only a small number of foods for a short time, then slowly introducing certain foods to test how your body reacts. The low-FODMAP diet is 1 example, which involves avoiding some types of fruit and vegetables, milk and wheat products
• hormone therapy – this may be used to relieve bloating caused by hormones. You may be offered the birth control pill, or hormone replacement therapy (HRT) if you’re going through the menopause
• antibiotics – if an infection such as giardiasis or a UTI is causing your bloating, your doctor may prescribe antibiotics
• proton pump inhibitors (PPIs) – if indigestion is making you bloated, you may be prescribed a type of medicine called a proton pump inhibitor (PPI) to reduce tummy acid, such as omeprazole (read more about indigestion treatment)
• IBS medication – depending on your symptoms, your doctor may prescribe an antispasmodic called mebeverine to ease painful tummy cramps, a low dose of certain antidepressants to relieve pain, or linaclotide to treat constipation (read more about IBS treatment and relief)

Your health questions answered

Am I bloated or fat?

Answered by: Healthily’s medical team

“If your tummy feels a bit bigger than usual, you might not know if this is caused by bloating or excess fat. But there are some key differences. While bloating usually only affects your tummy, fat collects across your body, so you’re likely to notice it elsewhere, such as on your legs, arms and back. And tummy fat feels soft, while a bloated tummy can feel tight and uncomfortable. Another difference is how long your symptoms last for. Bloating usually comes and goes, especially after eating. But to get rid of excess fat, you need to eat a healthy, balanced diet and do regular exercise. Read more about how to lose weight safely.”