Bloating Abdominal bloating is a common complaint often blamed on excess gas in the bowel. It usually occurs in people with irritable bowel syndrome, in which the gut is very sensitive to distension, so that normal contents of gas or digestive products cause discomfort; and because the movements are not coordinated, the gut contents do not pass down the gut in an orderly fashion and this causes discomfort as well. Research has shown that when small amounts of gas are infused into the intestine, people with irritable bowel syndrome develop bloating and pain, whereas other people tolerate the same or even larger amounts of gas without any discomfort. How distention of the gut is perceived as bloating is not known. Bloating may also be caused by rich fatty meals which delay stomach emptying.

Bloating is often associated with abdominal distension so that skirts or belts have to be loosened. This is usually due to relaxation of the abdominal muscles in an unconscious attempt to relieve discomfort. The distension usually disappears on lying flat or on contracting the abdominal muscles. Bloating is difficult to treat; some understanding of the problem helps. A high-fiber diet is responsible for bloating in some people but generally the bloating improves with time. On the other hand, a high-fiber diet may relieve bloating in others because fiber absorbs water in the gut and gently distends it, helping to prevent the uncoordinated contractions that are partly responsible for the bloating. An irritable bowel may be caused by stress or anxiety so that stress may be responsible for your bloating.

Some people find that activated charcoal or defoaming agents containing simethicone (Gas-X, Mylanta Gas) are helpful. Avoiding gas-producing foods may also help. If the bloating is severe, your doctor may prescribe drugs that help to co-ordinate the contractions of the gut or prevent spasms. Bloating due to a buildup of gas occurs in intestinal diseases such as Crohn’s disease or bowel tumor. These conditions give rise to other symptoms such as weight loss, severe abdominal pains or diarrhea and require prompt medical investigation.

Rumblings/grumblings or noisy guts (politely called borborygmi) Bowel noises, or borborygmi, are produced when the liquid and gas contents of the intestine are shuffled backward and forward by vigorous contractions of the gut. They may be produced by hunger, or by anxiety, or fright: they are very common in irritable bowel syndrome. Loud borborygmi or rumblings also occur because of vigorous contraction caused by diseases of the intestine such as Crohn’s disease or to overcome obstruction. These conditions are associated with other symptoms such as severe abdominal pain and should be reported to your doctor.