“I feel pregnant,” or even “I look pregnant,” are frequent complaints by patients suffering from abdominal distention or bloating. Bloating is a common symptom in irritable bowel syndrome (IBS), particularly in women, although mostly it is a nuisance rather than the most severe aspect of the disease. However, bloating may be the only symptom for some people.
The description of bloating given by the sufferers is surprisingly consistent. Patients report that their abdomen is relatively flat in the mornings but becomes progressively more distended over the day. By the evening, tight clothes such as jeans have to be replaced by loose fitting clothing. Some say their stomach enlarges before their eyes, and certainly a rapid onset over only a few minutes is not unusual. The distention tends to reduce after lying down, or overnight.
Eating appears to provoke the symptoms and patients may want to avoid food during the day if a flat stomach is desired in the evening, to attend a social function, for example. Many women report more bloating in the week prior to their period.
Patients and doctors alike have assumed that excess gas within the gut causes bloating. However, several techniques for measuring intra-abdominal gas volume have failed to confirm this view. Nevertheless, dietary bulking agents such as fiber which cause gas will often worsen the symptom. For the present, the cause must remain unknown.
Treatment or Management
No therapy has been proven to be of definitive benefit and therefore the advice given to the patient must be a physician’s individual opinion. Dietary and life-style factors are perhaps the most likely to help bloating in the long term. Try the following:
Take small regular meals. Don't avoid eating during the day, followed by a large evening meal. Avoid rushed eating, but rather set aside 30 minutes to eat in order to “digest” your meal. Reduce fat consumption. A varied diet low in saturated fats may help.
Reduce fiber consumption. Unless constipated (see below) do not add excess bran, fruit or fiber to your diet as these products can induce bloating. A sensible dietary fiber intake is suggested.
Avoid constipation. Bloating is often worse in severe constipation, and a regular bowel habit can help reduce it. There is clearly a problem in avoiding constipation while reducing consumption of bran and bulking agents. Nevertheless, with some experimentation a happy medium can usually be found.
Take regular exercise. Exercise improves bowel function and is recommended. As well as formal exercise sessions, movement during work time may be important. Many jobs involve sitting for much if not all of a day. Long periods in this position may worsen bloating regular breaks to “stretch the legs," and perhaps therefore the abdomen, may help.
Dietary and life-style measures may help to reduce bloating, although a complete cure for the symptom is perhaps asking too much. These tips, combined with your personal physician’s advice and medications he may prescribe, might at least make the bloating more bearable and thus less of an interference with other activities.
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