stomach bloating

[Stomach2024]

I have pain starting from stomach then it seems to travel down to lower abdomen. I am very bloated, only burping or passing wind, my pain can be released a bit. The bloating is so bad, I couldn’t even breathe. I am wondering if anyone who have similar symptoms and how to relief such painful bloating.

[711debbie]

Just wrote this to Gizmo above - in case you don't see it: since you're in the UK, go talk to the good folks at Boots and Superdrug. They have Windsettlers and Windeze for trapped gas as well as Deflatine. There's also Colpermin and other peppermint oil capsules (make sure they are coated, i.e., enteric. Also, there's fennel seeds to chew on and fennel tea to drink. There are yoga poses for wind on the internet. You can use a water bottle or heating pad on your stomach. It won't go away forever but there is plenty to do to make it less annoying. (when I go to the UK, I load up on all the above products - life is much more bearable!). For you, Stomach2024, I'd definitely try the hot water bottle/heating pad route.

[Stomach2024 in reply to 711debbie]

Tx so much for your advice. I am very confused by the pain in stomach. It is a bit like hunger pain. I took some anti acid. But it didn’t help. Only burping can relieve the pain. I am wondering what is IBS like?

[711debbie in reply to Stomach2024]

DON'T take antacids if you think you have IBS!!!!! Do your own research - I educated myself on IBS. Or get a referral to a gastroenterologist and do some tests. You can learn a lot from this website but you can also get confused. See a doctor first.

[Stomach2024 in reply to 711debbie]

Tx. I had both colonoscopy and endoscopy and found nothing. But I still have pain and bloating.

[CaseyU in reply to 711debbie]

I take charcoal.

[xjrs]

Rennie Deflatine can help with gas. Here is the research I did into gas and bloating - split into 2 posts:

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.

Latterly it has been suggested by scientists that gut microbiota hydrogen and carbohydrate metabolism may be altered in patients with IBS, which contributes to gas formation and abdominal pain (19).

[xjrs]

Gas & Bloating continued ..

Gas & Irregular Heartbeats

The oesophagus (or food pipe) which links the stomach with the throat is in close proximity to the heart. The vagus nerve also serves sensory functions for both the digestive system and the heart. Build up of gas in the gastrointestinal system, bloating or a full stomach can lead to elevation of the diaphragm and subsequently displacement of the heart. This affects the ability of the heart to fill with blood and increases the force with which the heart pumps in order to maintain an equilibrium. Hiatal hernia (a small part of the stomach that gets pulled up through the diaphragm) can press on the heart which can cause chest pains and palpitations. The vagus nerve can be compressed by a bloated stomach, making the heart rate go down; the autonomous nervous system can react by increasing blood pressure and heart rate resulting in abnormal heart beats.

The combination of gastric and abnormal heart beat issues is known as Gastric Cardia or Roemheld Syndrome (RS). Symptoms can be heart palpitations, arrhythmia (irregular heartbeats), nausea, tachycardia (a rapid heartbeat), dizziness, shortness of breath or a tight chest in the presence of indigestion, acid reflux or bloating. It can be misdiagnosed as anxiety, panic attacks or depression. Symptoms can be worse when lying on the right hand side rather than the left due to the compression of the part of the body nearest to the vagus nerve.

If you are concerned about related symptoms, it is best to speak with a medical professional so they can rule out any heart issues and for management if the symptoms are bothersome and related to gastric cardia.

(17) (18)

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.

Further Reading and References

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

(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

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

(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...

(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.

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

(7) IFFGD ABOUT IBS: Bloating

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

(9) NHS: Simeticone

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

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

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

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

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

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

(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

(17) Dr Sanjay Gupta: Roemheld Syndrome guide – is this the reason for your heart palpitations?, drsanjayguptacardiologist.com

(18) Wikipedia: Roemheld syndrome

(19) Dr. James Versalovic: Clues provided by the microbiota-gut-brain connection may help improve IBS diagnosis and management, Gut Microbiota For Health, January 2nd, 2023

[Stomach2024 in reply to xjrs]

Tx so much for the advice. I have brought some windsettler and peppermint oil tablets.

[711debbie]

Read this website thoroughly: helpforibs.com/

It's American and is very useful if you want to educate yourself about IBS. I don't agree with Heather on everything but it's a good start. I'm bloated right now but I've got too much to do to worry about , but I did make a big cup of Heather's fennel tea. The bloating will come and go - that's just the way IBS works. But don't take antacids!!!!!!!!

[Stomach2024 in reply to 711debbie]

Tx a lot!!

[Shoosh_kw in reply to 711debbie]

Thanks loads for the informations youb posted,, really helpful as I am bloated and in pain right now because of a meal that had garlic.. I had fennel tea 2 hours ago but still in pain. let's see how it subsides.

[Stomach2024 in reply to Shoosh_kw]

What your pain feels like and where you feel the pain? I thought most people have IBS, the pain is at lower abdomen. But my pain is upper abdomen where stomach is. Is it normal?

[Shoosh_kw in reply to Stomach2024]

Pain differs from one another, so sometimes I do have the same pain as yours but today it is lower abodminal pain. Do some exercises and try to walk for a while, also hot water bottle is very helpful.

Hope you feel better soon dear .

[CaseyU]

Try charcoal

[winfong]

Simethicone does the trick for me