Bloating

Bloating
ICD-10	R14.r
ICD-9	787.3

For patient information click here Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Bloating is any abnormal general swelling, or increase in diameter of the abdominal area. As a symptom, the patient feels a full and tight abdomen, which may cause abdominal pain sometimes accompanied by borborygmus.

Causes

Bloating may have several causes, the most common being accumulation of liquids and intestinal gas. Ascites is the proper medical term for abdominal bloating caused by excessive accumulation of liquid inside the cavity.

Common causes for abdominal bloating are:

• Overeating (gastric distension)
• Lactose intolerance, fructose intolerance and other food intolerances
• Food allergy
• Aerophagia (air swallowing, a nervous habit)
• Irritable bowel syndrome
• Partial bowel obstruction
• Gastric dumping syndrome or rapid gastric emptying
• Gas-producing foods
• Constipation
• Visceral fat
• Splenic-flexure syndrome
• Menstruation, dysmenorrhea and premenstrual stress syndrome
• Polycystic ovary syndrome and ovarian cysts
• Alvarez' syndrome, hysterical or neurotic abdominal bloating without excess of gas in the digestive tract
• Massive infestation with intestinal parasites, such as worms (e.g, Ascaris lumbricoides)
• Diverticulosis

Important but uncommon causes of abdominal bloating include large intra-abdominal tumors, such as those arising from ovarian, liver, uterus and stomach cancer; and megacolon, an abnormal dilation of the colon, due to some diseases, such as Chagas disease, a parasitic infection. Gaseous bloating may be a consequence of cardiopulmonary resuscitation procedures, due to the artificial mouth-to-mouth insufflation of air. In some animals, like cats, dogs and cattle, gastric dilatation-volvulus, or bloat also occurs when gas is trapped inside the stomach and a gastric torsion or volvulus prevents it from escaping.

Bloating from irritable bowel syndrome (IBS) is of unknown origin but often results from an insult to the gut, and as such can overlap with infective diarrhea, celiac, and inflammatory bowel diseases. IBS is a brain-gut dysfunction that causes visceral hypersensitivity and results in bloating in association with recurrent diarrhea (or constipation) and abdominal pain.

While there is no direct treatment for the underlying pathology of IBS, the symptom of bloating can be well managed through dietary changes that prevent the over-reaction of the gastrocolic reflex. Having soluble fiber foods and supplements, substituting dairy with soy or rice products, being careful with fresh fruits and vegetables that are high in insoluble fiber, and eating regular small amounts can all help to lessen the symptoms of IBS (Van Vorous 2000).

Foods and beverages to be avoided or minimized include red meat, oily, fatty and fried products, dairy (even when there is no lactose intolerance), solid chocolate, coffee (regular and decaffeinated), alcohol, carbonated beverages, especially those also containing sorbitol, and artificial sweeteners (Van Vorous 2000).

Postmortem bloating occurs in cadavers, due to the formation of gases by bacterial action and putrefaction of the internal tissues of the abdomen and the inside of the intestines.

Drug Side Effect

• Lactulose
• Norgestrel and Ethinyl estradiol
• Polyethylene glycol-electrolyte solution (PEG-ES)

See also

• Abdominal distension

Source

• Partly based on Abdominal bloating. MedlinePlus (US public domain Medical Encyclopedia). Update Date: 10 November 2004. Updated by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

• Van Vorous, Heather. Eating for IBS. 2000. ISBN 1-56924-600-9. Excerpted with author's permission at Help for Irritable Bowel Syndrome (see IBS Diet Section)

References

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