What Is Bloating And When Is It A Sign Of A Bigger Issue?

Bloating can be caused by more than just an overindulgent meal - find out more about the causes of bloating & when it might be time to make an appointment with your physician.

What exactly does bloating mean and what causes a bloated stomach? Abdominal bloating typically refers to a state in which the belly feels swollen and tight, according to Penn State Hershey Medical Center. This means that, often times, if you’re feeling bloated, your stomach may also appear distended and even feel tender to the touch. But it may not. That’s the thing about bloating; everyone experiences it differently! 

Most of the time, your bloating probably stems from something you ate since there is no lack of hard-to-digest foods out there, or a poor digestive habits — such as chewing your food too hastily or overindulging at the dinner table. But, occasionally, bloating can signify a deeper health condition, such as Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD) (which includes both ulcerative colitis and Crohn’s disease), Celiac Disease, or in very rare cases, ovarian cancer. Being able to differentiate these two bloating scenarios is key to figuring out what your next steps should be to rid yourself of bloating.

Although your annual physical is the perfect time to discuss your bloating and discomfort with your doctor, you should make an appointment to have this talk earlier if your symptoms are interfering with your daily life. Most bloating comes down to several issues doctors see time and again. But your primary care physician is the best person to talk to if you feel like your ability to function or perform your job are being compromised by your symptoms.  The biggest sign that bloating could indicate a bigger issue is if your symptoms are significantly interfering with your daily activities. 

Are gas and bloating the same thing?

Short answer: no. Gas and bloating are two separate symptoms that can both cause you discomfort after eating. While intestinal gas can be one cause of bloating, bloating is not synonymous with gassiness. In addition to the buildup of gas in the intestines, bloating may also result from excess liquids or solids (such as urine or stool) in your system, as well as other medical causes — some of which include IBS, IBD, celiac disease and ovarian cancer, as previously discussed. 

Many people also confuse bloating with “water retention.” In reality, the symptoms of bloating reach far beyond the mere retention of fluids. Sometimes, there may not even be a physical cause of bloating — in the sense that you may feel excess pressure in your abdomen, even when nothing is physically present there or overeating isn’t a factor. If you’re still confused about whether what you’re experiencing is bloating or merely gas, we recommend consulting your primary care provider (PCP) for a more thorough evaluation of your symptoms. 

Causes of a bloated stomach

Although most people will describe their bloating differently than the next person, most cases come down to a few key causes. In general, these are lifestyle factors that can be mitigated or resolved with some simple tweaks to your diet and habits. But there’s never any harm with discussing how you’re feeling and what steps you can take to feel better with your doctor if you’re concerned.

Maybe you ate too quickly

Shoveling food in your mouth as you work is, unfortunately, increasingly common in today’s work culture. And while that can blunt hunger and fullness cues (see our next point about overeating), it also means you’re getting an unwelcome tag-along with your food: excess air. It brings a new meaning to inhaling your food, and an uncomfortable pressure to your stomach.

It’s possible you overindulged

Overeating is one of the main causes of a bloated stomach. And even though it sounds obvious, it’s not always clear when we’ve overdone it. If your meal resembles your plate at Thanksgiving dinner, sure, some bloating probably isn’t unexpected. But some chains bill grab-and-go options pack more calories than anticipated as well. So it’s possible you put down more than your body is used to in one sitting, while you’re none the wiser.

You might just be constipated

Constipation — one of the uncomfortable consequences of eating too little fiber — may lead to a hard, bloated stomach. When suffering from constipation, you may hear someone say they’re feeling “backed up.” You may also experience this as a full feeling that can, but doesn’t have to, cause your stomach to push out. Well, as the gut fills with food or stool, your digestive tract suffers from overload, leading the stomach to potentially protrude until something is eliminated.

You could have a food intolerance

While lactose intolerance is the most well-known food intolerance, other common culprits include wheat and even some types of sugar — such as raffinose, which is more difficult for the body to break down. Beans and legumes contain raffinose and can give many people that bloated, gassy feeling — which is where that infamous childhood song comes from.

One type of food intolerance, FODMAP intolerance, may be a key cause of IBS in as many as 50 to 80 percent of patients. The term “FODMAP” is actually an acronym standing for multiple types of carbohydrates, such as oligosaccharides and disaccharides, which may be more difficult for some people to digest than others. If your doctor suspects this is the issue, they may put you on an elimination diet to see if your symptoms go away when you’re not eating these foods.

You might be consuming too many artificial sweeteners

Again, everyone reacts differently to foods — or food additives in this case. Some people can handle seemingly endless artificial sweeteners, but it may cause stomach bloating in others. If you’re addicted to Diet Coke, cutting back in favor of some plain water can be a good place to start to check if this is the cause of your discomfort. Gum chewers, check the package of your favorite flavor. You might find them hiding there, too.

It could be what you’re drinking

You don’t have to be knocking back diet sodas to experience this uncomfortable side effect. Many people turn to seltzer and flavored seltzer as a healthy alternative to their soda or diet soda habit. But even if the seltzer is unsweetened, the carbonation might be inflating your stomach with air. Cut back on the bubbly beverages and see if your bloating calms down.

Maybe you have an underlying issue

Again, we don’t want to cause any alarm. Most causes of a bloated stomach can be addressed with simple lifestyle tweaks. But if your bloating and gas gets in the way of your daily life, talk to your doctor. They’ll know what to test to see if you have an underlying issue, like the ones we mentioned earlier. Functional gut disorders, such as IBS, frequently lead to a bloated stomach: as many as 60% of patients with IBS report bloating as a primary symptom.

Your period might be coming up 

For people with periods, Premenstrual Syndrome (PMS) can also trigger bloating. One-third of people who menstruate experience changes in bowel habits due to their periods — and in patients with IBS, as many as 50% may experience worsened symptoms. 

As hormone levels fluctuate before your period, the body releases hormones called prostaglandins, stimulating the uterus to contract and shed its lining. (It should come as little surprise, then, that prostaglandins are also the hormones responsible for those nasty period cramps!) These hormones may also affect the digestive tract, stimulating your gut to contract, too. Tracking your menstrual cycle might help you determine if your bloating is related to changes in prostaglandin levels. 

So what can you do?

Remember that the causes and consequences of bloating largely vary between different people which is why we encourage you to first and foremost listen to your body’s signals in order to, for example, favor foods that won’t inflate your stomach over those that will. If your symptoms are interfering with your daily life, consult with your primary care physician to determine next steps.

If you feel confident that this isn’t stemming from a bigger issue, you can check out our go-to-action plan to relieve bloating which includes a list of simple evidence-backed, natural tips & tricks that will decrease your discomfort and get you back to feeling your best asap. We also curated Daily Digestive Essentials to tackle bloating & discomfort from a wide range of causes and help you compromise less. Thanks to a diverse blend of ingredients, it also strengthens long-term gut health to protect you from more symptoms in the future.