Bloating: causes and treatment options

Bloating (meteorism or tympany) is the term for the feeling of a bloated and stretched abdomen. With severe bloating, the abdomen bulges outwards in a spherical shape. The abdomen’s circumference is significantly enlarged.

Bloating is often associated with digestive problems such as a feeling of being uncomfortably full, abdominal cramps or pain. A hard, bloated abdomen feels taut and is sensitive to pressure. Other symptoms of bloating include flatulence (wind, passing gas), bowel sounds, nausea and. Sometimes bloating occurs without flatulence or any other symptoms.

Bloating is caused by gas accumulating in the gastrointestinal tract. There are many reasons for this, including nutrition or lifestyle. Stress or medication can also sometimes lead to a bloated abdomen. The possible causes at a glance:

• Food that causes bloating: Certain foods such as pulses, cruciferous vegetables (including cabbage), onions and mushrooms produce more gases in the intestine. Some people experience a bloated abdomen after eating. Foods high in fructose, such as apples, pears and honey, can also cause bloating.
• Imbalanced microbiome: Numerous microorganisms live in our intestines, including fungi, viruses and various types of bacteria. Together, they form the intestinal microbiome. This regulates various processes in the body, including digestion. If the microbiome is out of balance, this often leads to bloating and other digestive problems.
• Food intolerances: For people withlactose intolerance, eating dairy products leads to bloating. Coeliac disease (gluten intolerance) or fructose malabsorption are often the cause of bloating, flatulence and other symptoms such as diarrhoea or abdominal pain.
• Hasty eating: People who eat too quickly usually breathe in a lot of air. This can lead to bloating. The same happens with carbonated drinks and chewing gum.
• Lack of exercise: Lack of physical activity slows down digestion and in some people leads to bloating, constipation and other digestive problems. This is because sitting for a long time or a hunched posture can put pressure on your abdomen.
• Stress: Mental tension has a negative effect on digestion. Possible consequences include stress-related bloating, flatulence and a feeling of being uncomfortably full.
• Medication: Some medications such as antibiotics, laxatives and gastric acid blockers can disrupt the intestinal flora and lead to a bloated abdomen.
• Liver disease: Sometimes an illness of the liver can cause bloating. Fatty liver disease occurs when increased fat accumulates in the liver cells. This leads to a feeling of pressure in the upper abdomen. End-stage cirrhosis of the liver is often accompanied by ascites; fluid accumulates in the abdominal cavity and the waistline expands sharply.

Bloating often has multiple causes. This can make it difficult to recognise the triggers and take targeted action to combat them.

Hormones play an important role in controlling digestion. Hormonal changes often lead to bloating – in both men and women. The following hormones often cause a bloated abdomen:

• Thyroid hormones: underactive thyroid gland (hypothyroidism) slows down your metabolism. Digestion is sluggish and the stomach is slow to empty. In some sufferers, this can lead to a bloated abdomen, constipation and flatulence. In these cases, tiredness and weight gain are often accompanying symptoms of bloating.
• Cortisol: If you suffer chronic stress, the body generally releases more cortisol. This increases your production of stomach acid and slows down intestinal movement. Possible consequences include bloating, flatulence and feeling uncomfortably full. Lower abdominal pain is also common.
• Insulin: Elevated insulin levels, which can be caused by diabetes mellitus, insulin resistance and increased release of cortisol, can lead to a bloated abdomen. This is because insulin promotes the absorption of glucose from the intestine and inhibits stomach movement. The stomach empties more slowly and the intestine produces more gas. Insulin also promotes fat retention. This contributes to weight gain – another possible cause of bloating.

Women are particularly affected by hormonal bloating. Cycle-related hormonal fluctuations, maternity and menopause are amongst the most common causes of bloating in women.

Bloating and menstruation

Many women have bloating, flatulence and digestive problems before and during their period. These are among the symptoms of PMS (premenstrual syndrome). PMS is triggered by menstrual cycle hormonal fluctuations; before your period, your body produces more oestrogen. This hormone promotes water retention in your tissue. In addition, the womb lining swells and puts pressure on the intestine. Changes in the microbiome exacerbate the complaints. Some women already notice bloating and flatulence around the point of ovulation.

After ovulation, progesterone levels increase sharply. Progesterone relaxes the smooth muscles in the gastrointestinal tract, which slows down intestinal movement. This can lead to a bloated abdomen and pain in the lower abdomen after ovulation. During menstruation, progesterone levels fall again. This triggers uterine contractions, which are often accompanied by cramp-like lower abdominal pain.

Bloated abdomen during pregnancy

A bloated abdomen is one of the most common symptoms of discomfort during pregnancy. Bloating can often develop even in the early stages of pregnancy. This is due to hormonal changes; the hormone progesterone relaxes the muscles of the gastrointestinal tract and slows down digestion. The complaints often worsen as the pregnancy progresses. Many sufferers report extreme bloating. The reason for this is that the growing uterus puts increasing pressure on the stomach and intestines. This can lead to bloating and flatulence. Constipation and occasional abdominal pain are also common during pregnancy.

Bloating is also a possible sign of being pregnant. In these cases, it often occurs early in the pregnancy. If this applies to you, look out for missed periods, tiredness, sensitive breasts, morning sickness and a more frequent urge to urinate.

Flatulence during menopause

During the menopause, many women suffer from bloating. This is caused by a decrease in their oestrogen levels. This influences the formation of progesterone and leads to increased flatulence. Prostaglandins (tissue hormones) also stimulate the muscles in the digestive tract; bowel movements are faster than usual, resulting in flatulence and diarrhoea. In some women, constant flatulence during the menopause lasts for years.

The menstrual cycle coming to an end can also contribute to bloating of the abdomen during the menopause. During this time, bloating is often accompanied by other symptoms such as tiredness, weight gain and hot flushes.

Many sufferers want to get rid of bloating as fast as possible. But which remedies really help against bloating? There are several things you can do about bloating. Find out what helps you personally. This is the best way to get your flatulence and your bloating under control.

If you have extreme bloating that lasts for a long time or is accompanied by additional symptoms such as pain, diarrhoea or bloody stools, consult a doctor. This will let you rule out serious illnesses and start on individual therapeutic measures.

Home remedies for bloating

There are many home remedies for a bloated abdomen. Try them out and see which ones help alleviate your complaints:

• Tea: In some cases, herbal teas with fennel, aniseed, caraway or camomile can help with bloating and flatulence. They relax and soothe the intestines. Drink several cups a day.
• Heat: A hot water bottle or a warm cherry seed pillow on your abdomen relaxes the intestinal muscles and relieves cramps. A warm bath is also a good home remedy for a bloated abdomen.
• Abdominal massage: Try massages for bloating. Gently massage your abdomen in a clockwise direction using circular movements. This stimulates bowel activity and helps to get rid of flatulence.
• Apple cider vinegar: This stimulates digestion and has a preventative effect on bloating in some people. Dilute one to two tablespoons of apple cider vinegar in a glass of water and drink the mixture before meals.
• Calm: Eat slowly and chew thoroughly. Eating under stress or hectic eating may mean you are swallowing too much air. This leads to flatulence.
• Turmeric: Turmeric contains essential oils that promote digestion and soothe cramps. Turmeric stimulates bile production, improves lipid metabolism and thus helps with bloating. Mix a teaspoon of turmeric powder into a glass of warm milk, plant milk or water and drink this daily. Alternatively, incorporate the spice into your meals.
• Magnesium: During menopause, magnesium often helps with bloating. It supports digestion, facilitating the transportation of food through the intestines.

Medication for bloating

There are various medications that relieve bloating and accompanying complaints. Defoaming agents such as simethicone or dimethicone, for example, cause gas bubbles in the intestine to burst and thus reduce flatulence. These medications are usually available over the counter in pharmacies. Antispasmodic agents with the active ingredient butylscopolamine help with cramp-like pain. Herbal medicines with peppermint oil, caraway oil or liquorice root also promote digestion and relieve cramps.

Exercises for a bloated abdomen

Regular exercise and relaxation help to prevent flatulence and bloating. Targeted exercises to combat bloating often alleviate the complaints and relieve persistent flatulence:

• Exercise: Walks, cycling and swimming stimulate digestion and transport gases away from the intestines. Just 30 minutes of moderate exercise a day can prevent flatulence.
• Abdominal muscle training: Sit-ups, crunches and planks are effective exercises for combating flatulence. They strengthen the abdominal muscles and gently massage the intestines. This stimulates intestinal activity and facilitates the escape of gases.
• Yoga: Gentle stretching exercises and breathing techniques as practiced in yoga and Pilates can help to relieve bloating.
• Reduced stress: Tension and stress impair digestion and can lead to bloating and flatulence. Relaxation techniques such as autogenic training, progressive muscle relaxation and meditation have a balancing effect and promote healthy bowel functioning.

With a combination of balanced nutrition, regular physical activity, targeted exercises and relaxation techniques, you have a good chance of getting flatulence and bloating under control in the long term. Be patient and give your body time to adjust to the changes. Consult a doctor if you have extreme bloating or very severe symptoms.