Feeling bloated? You're not alone. Abdominal bloating and gas are among the most common digestive complaints that doctors hear from patients. And now there are new bloating culprits: COVID-19 and long COVID. Show (Getty Images) Belly bloating bothers some people largely because of how it looks. They may think a protruding tummy makes them look "pregnant." Others are frustrated when that swollen stomach sticks around even after weight loss. But for some people, it's less about looks and more about discomfort. Not everyone experiences tummy bloating in the same way and symptoms can vary. Often, patients also describe belching or abdominal distension, as well as symptoms of acid reflux, says Dr. Charlotte Smith, an urgent care physician at Penn Medicine in Philadelphia. If you're ready to get rid of abdominal bloating, here's what you should know. What Is Stomach Bloating?The terms bloating and abdominal distension are often used interchangeably. Technically, bloating is a temporary feeling of fullness, usually due to intestinal gas, while abdominal distension refers to a visible, measurable increase in the stomach's size. Passing gas, belching or having a bowel movement may or may not provide relief. Many people also experience heartburn, constipation or abdominal pain. Stomach bloating may persist hours after a meal. Food allergies, lactose intolerance and other digestive disorders could be bloating culprits. Quite simply, you know it when you have stomach bloating. However to find out why, you and your doctor or dietitian need to do some detective work. What Causes Tummy-Bloating Symptoms?Dr. Hardeep Singh, a gastroenterologist with St. Joseph Hospital in Orange, California, says bloating can develop from several causes. Dietary problems are the most common, Singh says, with intolerance of certain food products leading the way. A food intolerance, or food sensitivity, means your digestive system can't break down specific foods, which leads to excess gas and bloating. "Typical intolerances include dairy or gluten, but people can be intolerant to almost anything," he says. Beyond specific food triggers, swallowing air from eating too fast, chewing gum or using a straw is among the most common nutrition-related causes of bloating, says Cassie Vanderwall, a registered dietitian in the department of clinical nutrition at UW Health in Wisconsin. Stomach bloating actually exacerbates a normal function of the stomach – expansion. Your stomach muscle is about the size of a fist at rest, but its muscular walls are designed to expand quite a bit to accommodate large amounts of food. Until the stomach completes its work of churning and breaking down food with digestive enzymes, it's natural to feel temporarily full after a substantial lunch or supper. Therefore, one of the first steps in relieving bloating is to consume smaller portions that don't force the stomach to expand so much all at once. Farting and belching are also closely related to bloating. Belching or burping is caused by swallowed air that collects in the stomach. Passing rectal gas, or flatulence, is usually a combination of swallowed air and gas caused by bacteria in your colon forming around undigested carbohydrates. Constipation can also cause bloating. If you're bothered by a rock-solid stomach with abdominal pain that worsens through the day – and it's relieved by pooping – constipation is the likely cause. With constipation, normal intestinal gas gets trapped behind a slow-moving poop and builds up. Of course, a belly that isn't perfectly flat can be perfectly normal. Sometimes, patients embarking on weight-management programs who don't develop the six-pack abs they've been striving for may complain of bloating, when that's not really an issue, Vanderwall notes, but more just stomach size overall. Singh says other more serious potential causes of belly bloating include:
Latest Bloating Contributor: COVID-19COVID-19 infection can cause digestive problems. “With active COVID, we have seen patients with some GI symptoms: nausea, vomiting, bloating and those kinds of things,” says Dr. Greg Vanichkachorn, director of Mayo Clinic's COVID Activity Rehabilitation Program. That can happen with almost any viral illness, he notes, like the flu, “which can cause substantial stomach and digestive issues.” Medications to treat active COVID-19 may contribute. “Some of the medicines we use can definitely affect the gut,” Vanichkachorn says. “Some antibiotics used early on for complicated infections can destroy the gut bacteria.” Steroids and other drugs can affect the GI system as well as the rest of the body, causing abdominal pain, bloating, constipation and food sensitivity. Now, long COVID is creating persistent gastrointestinal woes. “What has been more surprising is that as we have gotten more into evaluating long COVID, we have seen that there are a fair number of patients who have been reporting ongoing GI problems,” Vanichkachorn says. “In some studies, 16% of patients report having new GI symptoms even 100 days or more after their infection, things like abdominal pain, constipation, vomiting and diarrhea. We’ve also heard about problems with excessive gas and the bloating sensation.” Some patients with long COVID continue to experience GI symptoms for eight months and more on follow-up, according to an evidence review published in August 2022. Which Foods Affect Bloating?
Which Digestive Conditions Cause Bloating?
Long COVID and Digestive WoesNew food sensitivities may arise in patients after COVID-19. “So they didn’t have any problems consuming, say, dairy products or, or have troubles with sugar,” “Vanichkachorn says. But afterward, they find themselves having a very limited diet that they can tolerate. We have some patients who are just eating Cheerios and yogurt and that’s all they can really stomach.” Ongoing problems with taste and smell can also throw off patients’ appetites, he notes. “If we’re not careful, it can really get into a situation where they’re not eating enough and developing malnutrition, with electrolyte problems.” Patients with long COVID describe a constellation of GI symptoms. “It can have a lot of functional impacts,” Vanichkachorn says. “I have some patients who, for example, have really severe, bloody stool, diarrhea and incontinence issues that keep them from leaving home and going to work.” Figuring out how to treat COVID-related GI symptoms is an issue. “Most of the time we’ll start with things like a bland diet, probiotics and adequate hydration,” Vanichkachorn says. Probiotics may help promote the regrowth of healthy gut bacteria, he says, although patients’ results have been mixed. “But it’s worth a shot now.” Such patients undergo a gastroenterology evaluation. “They go through testing like colonoscopies to see if there’s anything else going on, or testing to see if there are problems with how the gut moves because we’ve seen that occur in neuropathy issues, which we’ve also seen quite a bit with long COVID, too.” Whether and when GI symptoms like bloating resolve are uncertain. “Some get resolution, but the patients I have right now who have these significant GI issues really seem to be not resolving with time,” Vanichkachorn says. “So I’m not comfortable telling people: OK, this is going to go away with time. I think we need to have more research on the GI illness for those with long COVID and hopefully develop some treatments.” How Do Body Type and Weight Relate to Bloating?Extra belly fat can contribute to bloating, even in an otherwise thin person. Possible culprits for excess abdominal fat include cigarette smoking and chronic alcohol consumption. Smoking affects where fat is deposited in the body, tending to favor the stomach. Heavy drinking has a similar effect, particularly in men. A so-called "beer gut" can really occur with any type of alcohol used in excess. In women, having an apple-shaped body type means fat is more concentrated around the midsection, as opposed to pear-shaped body types. Obesity can be reduced with a healthy weight-loss plan. You'll lose body fat all over, however, rather than just in your seemingly bloated midsection. How Can You Get Rid of Bloating?You don't have to live with bloating, and there's plenty you can do to alleviate bothersome or persistent symptoms.
It's possible that serious medical conditions may be the underlying cause of bloating, so the bottom line is: If issues persist, see a gastroenterologist, he says. "People need to realize that this is not normal,” Vanichkachorn emphasizes. “So if patients are worried about any symptom, whether it may be related to COVID or not, they should go ahead and try to find care.” |