Bloating

[Mhc53]

Can anyone help me. I am new to this and I am having trouble with bloating. I am constantly bloated it never actually goes away just gets worse. For 12 months now I haven't been able to get into my normal clothes. I have followed the FODMAP diet but this doesn't help with the bloating. I am obviously doing something wrong but can't seem to establish what. My question is on IBS do you normally get bloat free days. Also what can I do to assist with the bloating.

[b1b1b1]

Have you been diagnosed with IBS? If not, that would be the first step. Also, check if you are lactose intolerant as that can cause bloating, and a lot of gas.

[Jadiegirl in reply to b1b1b1]

how did the doctor diagnose with ibs? i have not been diagnosed but am 99% positive that I have it as far as I can tell, there isn't an actual test to diagnose ibs ???

[b1b1b1 in reply to Jadiegirl]

Mostly it is a diagnosis by elimination, as well as some tests depending on what your specific symptoms are, to rule out more serious issues.

[Jadiegirl in reply to b1b1b1]

thanks so much-that's what I thought- I have pretty much figured out on my own the have IBS- I have combination with constipation and diarrhea which just complicates even more as far as diet but I have had a good bit of success trying things on my own to a point where it's pretty much under control-Doc put me on generic zoloft 7 wks ago as I as supper anxious after I quit smoking and that was also when the ibs issues started before Thanksgiving- plus I woke up all night and couldnt shut down my brains which meant laying awake at night -the meds have improved both of these issues took about 5 weeks for it to really kick in but it definitely works anyway, thanks for your reply -i appreciate it

[BabblingBrooks in reply to b1b1b1]

Even after a negative sigmoidoscopy it was never actually confirmed.

It’s a weird one really because it’s based on reported symptoms rather than any significant test.

[Risita]

take xtra gasx

[xjrs]

Assuming that you have been diagnosed with IBS, I am an IBS sufferer currently working on a website containing my research into IBS - here is my Gas & Bloating page:

Gas & Bloating

In studies, when healthy individuals are continuously fed gas into the intestines, they normally evacuate all gas without discomfort, passing more easily when a person is standing than laying down. They can tolerate 1.8 litres per hour and distension is related to the amount of gas within the gut. There is a better tolerance to gas when the gut is relaxed and if it is in the large bowel rather than the small bowel. (3)

Daily evacuation of gas in healthy people is around twenty times, depending on diet. Some foods are fermented in the large intestine producing gases, since they are not completely absorbed in the small intestine. This includes some dietary fibres, starches, complex carbohydrates such as beans and sorbitol and fructose sugars. Beans contain a compound that blocks the intestinal enzyme that helps to digest starches in the small intestine meaning more enters the large intestine thus increasing gas production through fermentation. (3)

Many IBS sufferers complain of excessive gas production, but studies have shown that the volume of gas produced by IBS sufferers is normal (1) (3) (7).

However, gas related pain and bloating in IBS sufferers may be connected to impaired transit of gas (3), resulting in gas retention and distension. However, a study using sophisticated measuring techniques didn’t find excessive retention of gas in IBS subjects (3). In contrast, the transit of solids and liquids didn’t experience significant abnormalities (3). IBS patients demonstrate symptoms such as intestinal gas retention, abdominal distension, and/or abdominal symptoms from an intolerance to intestinal gas loads that would normally be well tolerated by healthy subjects (1) (2) (3) (5) (6). Studies that involved the infusion of gas into the intestines of IBS patients showed impaired gas clearance due to abnormal gut reflexes which lead to delayed gas transit and retention (3).

It is often thought that gas is retained in the large intestine. However, a study of those complaining of bloating had the movement of infused gas tracked through different areas of the intestines using radioactive isotope. It was found that the small intestine was responsible for the impaired gas transit. Other studies found that gas infused into the first part of the small intestine, stayed there, since it was not propelled into further parts of the intestine. However when infused into more distant parts of the intestine, it cleared normally. This means that in IBS patients, the total volume of gas is not increased, but it tends to pool in specific areas resulting in a perception of distension and bloating due to IBS patients being hypersensitive (responsive to stimulation) to the presence of excess gas in these areas. Bloating relates to a feeling that can result from fullness after eating, constipation, functional dyspepsia or IBS (8). Whereas, distension relates to the increase in abdominal girth. Often this perception of distension evolves during the day and resolves overnight. Measuring techniques have found that this distension, that is a wider girth, is real and not just perceived. (3)

In healthy subjects, electromyography, which highlights electrical impulses in the muscles, has shown that there is abdominal muscle contraction in reaction to the volume of infused gas in specific areas, that is, the body adapts to the handling of the excess gas. However, in those complaining of bloating, this reflex contraction does not happen which leads to abdominal protrusion, even though there isn’t a true increase in the overall volume of gas. Subsequently, it is the abnormal control of abdominal muscles that causes the bloating and not necessarily gas in itself. (3)

The Rome Foundation explains the mechanics of bloating and distension (8):

Meals stretch the stomach or intestines causing the bloating sensation.

A brain reflex response to the sensation is to move the diaphragm down into the abdomen and relax the abdominal wall muscles.

Due to the increase in pressure, the abdominal cavity pushes out through the abdominal wall leading to distension (abdomino-phrenic dyssynergia).

Bloating and distension are independent. Some experience bloating and no distension and others have distension without a bloating sensation. The Rome Foundation may treat this with rebreathing techniques, central neuromodulators (drugs to reduce hypersensitivity improving brain regulation of the sensation to raise thresholds for bloating and pain), and less commonly biofeedback with esophageal probes. By treating the brain/gut communication bloating sensation may be reduced thus decreasing the possibility of distension occurring as a reflex to the bloating. (8)

10%-30% of healthy individuals experience bloating often, frequently or greater than 25% of the time meaning that bloating is not just limited to IBS sufferers. Some people who have gained weight might complain of bloating perhaps due to a reduction in volume into which abdominal contents can expand due to abdominal fat stores. As mentioned, weakness in abdominal muscles may also play a part. A third of patients complaining of bloating are unable to do one sit up. In addition to abdominal exercises, physical activity generally may help bloaters. (16) Theoretically, if part of the issue is connected with abnormalities in the gut/brain connection, gut directed hypnotherapy apps such as Nerva may help.

Probiotics & Gas

Many probiotics contain Lactobacillus spp. or Bifidobacteria spp.. These bacterial strains not only inhibit Clostridia spp. which produce gas, but they also tend not to produce gas on fermenting carbohydrate themselves. (4)

A study of women aged 18 to 65 who suffered from IBS with abdominal pain, bloating, straining and incomplete evacuation where daily given one of 1 × 106 colony forming units (cfu); 1 × 108cfu; 1 × 1010cfu i.e. differing amounts of Bifidobacteria infantis. 1 × 108 cfu, improved abdominal pain and discomfort, bloating, passage of gas, straining, bowel satisfaction, and feelings of incomplete evacuation significantly more than placebo although the other two doses were not better than placebo. No dose significantly improved stool frequency. (5)

Medications For Gas

Products such as Rennie Deflatine and Wind-eze contain Simeticone which can help with trapped wind and bloating by bringing together the small gas bubbles in the gut to form bigger bubbles, allowing trapped air to pass through the body more easily. (9)

Tips For Controlling Gas

There are tips for controlling or relieving gas here: (10) (11) (12) (13) (14). Note that the last reference contains a recommendation for clove oil. However, there is a suggestion that clove oil is potentially toxic (15).

There is a further section on Treatments Options – here (3), which some may find useful, though it is clear that more research is needed.

[xjrs in reply to xjrs]

Here are the references:

(1) Serra J, Azpiroz F, Malagelada JImpaired transit and tolerance of intestinal gas in the irritable bowel syndrome Gut 2001;48:14-19.

gut.bmj.com/content/48/1/14

(2) Hermann Harder, Jordi Serra, Fernando Azpiroz, and Juan-R. Malagelada: Reflex control of intestinal gas dynamics and tolerance in humans, American Journal of Physiology-Gastrointestinal and Liver Physiology 2004 286:1, G89-G94

journals.physiology.org/doi...

(3) Fernando Azpiroz, MD, PhD Hospital General Vall d’Hebron, Barcelona, Spain: Understanding Intestinal Gas, International Foundation for Gastrointestinal Disorders

iffgd.org/research/research...

(4) SPILLER, R. (2008), Review article: probiotics and prebiotics in irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 28: 385-396. doi.org/10.1111/j.1365-2036...

onlinelibrary.wiley.com/act...

(5) Lacy BE, Weiser K, De Lee R. The treatment of irritable bowel syndrome. Therap Adv Gastroenterol. 2009 Jul;2(4):221-38. doi: 10.1177/1756283X09104794. PMID: 21180545; PMCID: PMC3002524.

ncbi.nlm.nih.gov/pmc/articl...

(6) NHS: Beat the bloat, 28 August 2019

nhs.uk/live-well/eat-well/r...

(7) IFFGD ABOUT IBS: Bloating

aboutibs.org/bloating-in-ib...

(8) Dr. Drossman: Bloating and Distension: What’s the Difference?, The Rome Foundation

theromefoundation.org/bloat...

(9) NHS: Simeticone

nhs.uk/medicines/simeticone/

(10) International Foundation for Gastrointestinal Disorders: Tips on Controlling Gas

iffgd.org/gi-disorders/symp...

(11) International Foundation for Gastrointestinal Disorders: Treatment of Gas

iffgd.org/gi-disorders/symp...

(12) Amber J. Tresca, Medically reviewed by Priyanka Chugh, MD: Moves to Relieve Gas, verywellhealth.com, updated on April 27, 2020

verywellhealth.com/tips-for...

(13) Dr. Victor Marchione: Yoga and sleeping positions to relieve gas and bloating, belmarrahealth.com, March 30, 2017

belmarrahealth.com/yoga-sle...

(14) Jayne Leonard, Medically reviewed by Saurabh Sethi, M.D., MPH: How to get rid of trapped gas, medicalnewstoday.com, January 25, 2020

medicalnewstoday.com/articl...

(15) Owen Pearson: The Toxicity of Clove Oil, leaf.tv

leaf.tv/5036639/why-consumi...

(16) Stephen Norman Sullivan, Functional Abdominal Bloating with Distention, International Scholarly Research Network, ISRN Gastroenterology, Volume 2012, Article ID 721820, 5 pages, doi:10.5402/2012/721820

downloads.hindawi.com/archi...

[Jackie1612]

Sorry to hear this Mhc53. I do get bloating every day but it’s usually every evening. I do not think that you are doing anything wrong, bloating is one of the symptoms of IBS, and it is a pain. Perhaps your doctor would be able to help?

[SingC]

Hello! For me, avoiding lactose and gluten does the trick. Other things that can be helpful are peppermint oil capsules, increasing your exercise even just a little bit - maybe more walking, or house cleaning is actually really good because of the additional bending and stretching. Also, ensuring you’re drinking enough water/fruit tea. Lastly, if you can reduce your stress levels, that does wonders for the gut! So, find activities that are calming for you. That could be going for a walk or singing or having a long bath or listening to some favourite music or hanging out with a good friend or bird watching - whatever works for you! Or identifying your stress trigger(s) and dealing with or avoiding them.

I hope things improve for you!

[grumpyold]

I used to get so bloated, I looked 7 months pregnant, despite my low FODMAP diet. I began taking Alflorex, a probiotic you can take at any time of day, it doesn't have to be first thing on an empty stomach. I get the chewable banana and strawberry ones.

Also, I have found Atrantil to be a godsend. After just a few days of taking 6 a day, my stomach went down and I have been much more comfortable ever since.

Everyone's different I know, but they may be worth a try? Good luck.

[grahamrupertrules in reply to grumpyold]

buscapa n paracetamol for bloating pain.also eat

and plenty of water.avoid foods with artifcl sugars.

walk or do a little ypga can help.

Windeze sometimes helps me.

Last resort for pain ginger wine or tramadol.

not both at the same time.

Heat pad helps me.

[Deerpark1966]

I have the same problem which has been the case for months and months now. I'm currently waiting to see a Dietitian. I take Mebeverine which helps a little with the bloating. It affects you in so many ways.Clothes can be very difficult to find.I hope you get this resolved very soon.