Have you ever looked at your belly and wondered how you suddenly look six months pregnant when just a few hours ago you didn’t?
Bloating, even in a form as dramatic as this, affects most of us from time to time. And, in most cases, it’s just an unfortunate side effect of overindulging.
If swelling is persistent or very regular, see a doctor, says Dr Philippa Kay
But it can also be a sign that something is wrong.
Last month, researchers suggested that routine blood tests on patients who visit their doctor complaining of bloating and stomach pain could help detect more “hidden” cancer cases.
Pancreatic, stomach, ovarian, and colorectal cancer are associated with bloating and abdominal discomfort.
It can also be a symptom of a variety of digestive tract diseases, including ulcerative colitis, Crohn’s disease, and irritable bowel syndrome (IBS).
So if you suffer from bloating regularly, when should you worry?
Well, to start, it’s important to remember that bloating is common.
And I don’t say this to downplay the impact it can have.
Bloating is uncomfortable and can make you feel unwell and can even affect your mood or cause body image issues.
And that is why doctors, like me, never dismiss—or should not dismiss—a symptom when a patient comes to us complaining about it.
Bloating, even in a form as dramatic as this, affects most of us from time to time. And in most cases, it’s just an unfortunate side effect of overindulging. But bloating can also be a sign that something isn’t quite right.
Pancreatic, stomach, ovarian, and colorectal cancer are associated with bloating and abdominal discomfort. It can also be a symptom of a variety of digestive tract diseases, including ulcerative colitis, Crohn’s disease, and irritable bowel syndrome (IBS).
When we were in medical school, we were taught the five Fs of “bloating,” when the abdomen appears swollen.
These causes are: fetus – a pregnancy; fat – obesity; fluid – again, a build-up, medically known as ascites; stool – a build-up, caused by constipation and, most relevant here, flatus or gas, probably the most common cause of bloating.
We all have gas in our gastrointestinal tract. We swallow air when we eat, drink or even talk, which causes gas in the stomach, which can be expelled in the form of burping.
The abundant microbiome of bacteria in the large intestine produces gas as they ferment and break down fiber and food.
All of this leads to bloating, where the abdomen feels larger, fuller and tighter than usual, which can be uncomfortable and painful.
As a general rule, if you feel bloated mainly after eating, it’s probably related to that.
You may also notice that your bowels are noisier or gurgling than usual along with more burping and the need to pass gas.
Keeping a simple food diary can be helpful, as you may notice that you become more bloated after eating certain trigger foods.
One trigger is suddenly eating large amounts of fiber: Suddenly eating large amounts of fibrous vegetables like cauliflower, broccoli and sprouts, or beans and onions, can trigger bloating.
The way to avoid this effect is to introduce small amounts over a few weeks, rather than loading up the entire plate on the first day.
On the contrary, not eating enough fiber or drinking enough water can lead to constipation, which often results in uncomfortable bloating.
Other dietary factors may also play a role, for example, bloating may be caused or worsened by drinking carbonated drinks or chewing gum.
Eating too quickly and drinking too much alcohol can also cause bloating, as can a food intolerance.
But if you notice that you are persistently bloated, for three weeks or more, or if you notice that you feel bloated very regularly, more than 12 times in a month, see your doctor.
Likewise, if you feel that swelling is affecting your life, make an appointment. That’s what doctors are for.
Hormonal factors may play a role: the hormone progesterone relaxes the muscles in the gut, which slows down mobility within the gut, meaning constipation and bloating are more likely to occur.
This is why women may notice that during the second half of the menstrual cycle, when progesterone levels are naturally higher, they become bloated.
Bloating may also be related to hormones found in some hormonal contraceptives, such as the progestin-only pill, implant, or injection, or the combined oral contraceptive pill.
Bloating can also be caused by a variety of conditions, including Crohn’s disease, celiac disease, and ulcerative colitis.
While there are important differences in terms of how these diseases manifest, they are all characterized by parts of the intestine that become swollen, inflamed and ulcerated.
In addition to bloating, they cause other uncomfortable digestive symptoms, such as cramps, diarrhea or constipation, and blood in the stool.
Fatigue, loss of appetite and weight loss are other common symptoms of these conditions, collectively known as inflammatory bowel disease or IBD.
Among the famous people suffering from bowel conditions is Made in Chelsea star Louise Thompson, 34, who revealed in April that she suffers from ulcerative colitis and had undergone surgery to have a stoma fitted.
Not all patients with IBD need a stoma (when part of the small intestine can be diverted through an opening in the abdomen) and many cases can be managed with medications and lifestyle changes.
Among the famous victims is Made in Chelsea star Louise Thompson, 34, who revealed in April that she suffers from ulcerative colitis and had undergone surgery to fit a stoma.
Meanwhile, The Only Way is Essex veteran Sam Faiers, 33, went public with her Crohn’s disease diagnosis in 2014.
Not all patients with IBD need a stoma (when part of the small intestine can be diverted through an opening in the abdomen) and many cases can be managed with medications and lifestyle changes.
However, if surgery is needed, although serious, it can be incredibly relaxing and people like Louise prove that there is nothing to be ashamed of.
Persistent bloating with other symptoms such as decreased appetite, pain or tenderness in the abdomen or pelvis, feeling full very quickly after eating, along with urinary symptoms or unexplained weight loss and fatigue, may be due to ovarian cancer.
Similarly, a change in bowel habits (i.e. going more or less frequently than usual), changes in stools such as diarrhoea or constipation or both, blood in the stool, bleeding from the bottom and stomach pain as well as bloating could be a sign of bowel cancer.
While this is more common in people over 50, it is seen more in younger people: Dame Deborah James, who died in 2022, aged 40, after living six years with bowel cancer, is a clear example.
Therefore, if you experience any of these symptoms, consult your GP without delay.
If you go to the doctor with any of these problems, you will be asked many questions to try to figure out what is happening.
You may be examined and have blood tests or other investigations to try to determine the cause of the swelling.
If there is a worrying reason for your swelling, it is likely to be helpful to get it diagnosed and investigated as soon as possible.
I say this for many conditions when people ask me, “How do I know if my symptoms are severe enough to bother my doctor?”
While bowel cancer is most common in people aged over 50, it is seen more in younger people: Dame Deborah James, who died in 2022, aged 40, after living for six years with bowel cancer, is a clear example.
My answer here, regarding swelling, is the same as for many other conditions.
First, you are not ‘bugging’ your doctor, that is our job, and second, if it is bad enough to bug you, it is bad enough to bug me.
However, when it comes to swelling, whether it is persistent or very regular, it is time to make an appointment.
And forget about tight clothing. Wearing tight clothing, such as skinny jeans, can make swelling worse.
