What’s behind that bloated belly?

Here are five common causes of a bloated belly. The reasons could be trivial but it's better to get a check-up.

You're not pregnant and you haven't gained weight, but your jeans are straining at the waist. What's going on?

Irritable bowel syndrome

Could be the cause if: You've been bloated on and off for a long time and have also experienced symptoms including pain, constipation and/or bouts of diarrhoea.

A common bowel condition, IBS is a functional disorder which means there's nothing wrong with the structure of the bowel itself, but the way the gut works is abnormal. Peter Whorwell, professor of medicine and gastroenterology at the University of Manchester, says, "We think the gut is over-sensitive in IBS sufferers so it's normal processes which cause the symptoms."

Bloating is one of the most disruptive side-effects of IBS. Some women go up a couple of dress sizes and even need different clothes depending on whether or not they are bloated. For many, it tends to worsen towards the evening, so it can disrupt your social life. There's no cure for IBS, but you can manage the symptoms. "Cutting out cereal fibre eases symptoms by between 30% and 40% in the majority of sufferers," says Professor Whorwell.

This means avoiding wholemeal bread, oats, muesli, digestive biscuits, cereal bars and all breakfast cereals other than rice krispies. But white bread, cakes, cream crackers and most biscuits are fine. Try doing this for three months to see if it helps. Probiotics may also ease symptoms. Try yoghurts, as the probiotic strain they contain has been shown to help IBS. Doctors can prescribe medication such as anti-spasmodics, laxatives and anti-diarrhoeals. "There's no problem taking laxatives and anti-diarrhoeals in the long term if you have IBS," adds Professor Whorwell.

Flatulence

Could be the cause if: You are passing a lot of wind, but don't notice any other symptoms. We all experience flatulence from time to time — it's perfectly normal to do so up to 15 times a day — and sometimes you may not even notice that you are doing it. While there's no medical definition of excessive flatulence, if it's bothering you and makes life awkward or feels uncomfortable, there are steps you can take to reduce it.

Try cutting down on foods that are high in non-absorbable carbs. Common culprits include beans and pulses, broccoli, cabbage, prunes and apples, and foods containing the sugar substitute sorbitol. These tend to be digested very slowly and can release small amounts of sulphur gas while they pass through the gut.

Nutrition consultant Ian Marber says, "Eat food slowly and remember to chew. Without chewing, food is more likely to pass into the gut partially broken down and there's a higher chance it will ferment and produce gas." Be aware that occasionally, an underlying health condition — including those that are listed here — could also be causing flatulence.

Coeliac disease

Could be the cause if: You often feel tired; you've lost weight for no apparent reason; you are suffering from abdominal pain. Coeliac disease is an adverse reaction to gluten, which is found in wheat, barley, rye and all foods containing them — everything from pasta and bread to pies and some gravies and sauces. It is an auto-immune condition where the body mistakes substances in the gluten for a threat and attacks them, leading to damage to the surface of the small bowel, which then affects your ability to absorb nutrients from food.

It used to be mainly diagnosed in children, but it's now known that people can go undiagnosed into middle age. If you have these symptoms, see your doctor and ask to have a blood test for coeliac disease. National Institute for Health and Clinical Excellence guidelines state that anyone with bloating and other IBS-type symptoms should be tested for it. If you're diagnosed, you'll feel better once you start avoiding all foods containing gluten.

Ovarian cancer

Could be the cause if: Bloating is persistent and you have other symptoms such as a perpetual feeling of fullness and abdominal pain. The symptoms of ovarian cancer tend to be quite vague, which is often why it's diagnosed late when it's harder to treat. So it's important to be aware of potential signs. Cancer expert Annwen Jones says, "Key symptoms are bloating that is persistent rather than coming and going and increased abdominal size. Look out for persistent and frequent abdominal pain, difficulty eating and urinary symptoms."

"It's unlikely your symptoms are caused by a serious problem, but it's important to get a check-up."

Hormonal fluctuations

Could be the cause if: You are premenstrual or in the early stages of pregnancy. During pregnancy, and just before your period, levels of the hormone progesterone are raised. This can slow down gut mobility or movement, which means food passes more slowly through the body, leading to bloating and possibly constipation. But you can beat the bloat. Exercise can help improve gut mobility and walking for 30 minutes a day could be enough to make the difference. Also, drink plenty of fluids and eat lots of fruit, vegetables and whole grains to avoid constipation.

Times of India

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