Bloating otherwise called functional abdominal bloating and distension (FABD) by the scientists is a common gastrointestinal complaint. We all get a bit of bloating but sometimes it can become a serious problem and go beyond a bit of discomfort, cause pain and even a be a serious health risk. Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen.

Bloating and distension have been reported by 30% of the adult general population and are almost universal among patients with IBS (Irritable Bowel Syndrome) and other gut conditions like SIBO (Small Intestinal Bacteria Overgrowth) and constipation. However, only about half of the patients with bloating also report abdominal distension and bloating is more common among patients with IBS, and distension is more common in patients with chronic constipation. Some studies have also shown that women have double the likelihood to report bloating than men (19% vs 10.5%) and are also more likely to have severe symptoms (24% vs 13%).

Bloating and distension also often present in association with other manifestations of gut illness including:

    • Celiac disease
    • Non celiac gluten sensitivity
    • SIBO – Small Intestinal Bacteria (or Fungi) Overgrowth
    • Lactose, fructose, and other carbohydrates intolerances
    • Reflux
    • IBS (Irritable Bowel Syndrome)
    • IBD (Inflammatory Bowel Disease)
    • Gastroparesis (problems with stomach emptying)
    • Pancreatic conditions and insufficiency
    • Gallbladder conditions

As well as:

    • Diabetes mellitus
    • Hypothyroidism
    • Scleroderma

Understanding if you have any of these conditions can go a long way to helping you fix the underlying problem. In addition a better understanding of the problem can be gathered through a detailed dietary and symptom history, including severity and other symptoms (eg nausea) and by assessing bowel movement frequency and stool consistency. The more information you can gather the more you can target you anti bloating strategy.

In most cases the bloating is thought to be caused by a build-up of gas, water, and fecal material. Gas may build-up within the gut through the overproduction of fermentation gases by the small or large intestine microbiome (often bacteria or fungi) which cannot escape. If it is produced in the Small intestine with SIBO it is difficult for it to escape upwards through the sphincter and stomach to produce burping etc and it is a bit far up to go through the whole length of the bowel (7- 8 meters long) especially if something is blocking it. Or maybe the normal bowel movement process (known as the MMC) is not working so nothing is pushed along so it just pushes out?

Other underlying mechanisms include visceral hypersensitivity or food related sensitivities linked to dysfunction with the immune and or nervous system.

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