Bloating and Gas

Bloating and gas cause abdominal discomfort and pain (belly ache or stomach ache).  It is a common symptom.  Everybody experiences some level of abdominal pain, bloating, and gas at various times in life.  Often the pain is self-limited and resolves on its own within hours or a few days.  Abdominal bloating and gas can be brought on by indigestion, intolerance to a particular food in the diet, infection, constipation, stress, or weather changes.    Often the gas is related to food ingestion.   The discomfort related to bloating and gas can be short-lived (acute) or can last several weeks or longer (chronic).   While most patients with abdominal pain and gas have self-limited conditions, the symptoms can be related to diseases that require medical and/or surgical treatment.

What causes abdominal bloating, gas, and pain?

Abdominal gas pain has many potential causes, some more serious than others.  The location, duration, pattern of abdominal pain can provide important information to make a diagnosis.   The list of conditions that can cause abdominal gas pain is long.  The following categories are listed to provide you with some basic information and are not intended for self-diagnosis.  Furthermore, the following is not a substitute for a formal medical evaluation:

• Bacterial overgrowth
• Cancer and tumors of the stomach, small bowel, or colon
• Celiac disease and/or gluten allergy
• Constipation
• Dietary (excessive intake of gas producing foods)
• Diverticulitis
• Food allergies
• Fructose, glucose, or lactose intolerance
• Gut motility issues
• Inflammatory bowel disease such as Crohn’s disease
• Irritable bowel syndrome
• Intestinal blockage
• Intestinal infections
• Helicobacter pylori bacterial infection of the stomach
• Slow emptying of the stomach (gastroparesis)
• Thyroid or hormonal issues

 

When should you be concerned about the pain and bloating?

Abdominal gas and bloating can cause minor discomfort in some patients, yet in some it can be the source of significant pain.  While most patients who experience gas and bloating do not have a serious condition, it is important to seek care for proper diagnosis and symptoms treatment.  Patients with bloating and gas pains who have any of the following associated symptoms should seek immediate medical care:

• Bloody stools, especially if loose stools
• Darkening of the urine
• Distended, bloated abdomen that is sensitive to the touch
• Fever
• Inability to pass gas
• Pain that is worse with coughing or moving around
• Persistent nausea with vomiting and inability to keep food down
• Severe pain, especially if it is associated with cramping
• Sudden onset of severe abdominal pain
• Yellow skin or change in the color of the white of the eyes

In addition, patients who have chronic gas pain (pain for days, weeks, or months) with any of the following symptoms should seek medical care:

• Bloating and gas regardless of what you eat
• Blood in the stool with or without defecation (bowel motion)
• Change in bowel habits (constipation, diarrhea, loose stools)
• Fatigue
• Pain that does not go away and is present on most days
• Weight loss

What tests are needed to evaluate abdominal pain?

 

When you visit the clinic of Dr. Maher Abbas, he will take a complete history and perform a physical examination to determine the tests that are needed.  Often the history and physical examination are sufficient to formulate a diagnosis and treat you.  It is important that you bring with you the reports of any previous tests and a list of medications you have used.  Depending on the location, duration, type of abdominal pain, and associated symptoms, one or more tests may be needed.  Dr. Maher Abbas will customize your tests in order to provide you with the highest quality of care.  Tests that are useful to assess abdominal pain, bloating, and gas include but are not limited to the following:

• Blood tests: CBC (complete blood count to assess for anemia or infection), liver function test, renal (kidney) function test, CRP (C reactive protein) and/or ESR (erythrocyte sedimentation rate) to check for inflammation, thyroid test, calcium level, celiac disease serology, helicobacter pylori bacteria serology, pregnancy test in women of reproductive age
• Breath tests: urea breath test for helicobacter pylori bacteria, lactose intolerance test, fructose and lactose intolerance test
• Endoscopic procedures: Colonoscopy and Gastroscopy to check inside the colon and stomach
• Radiologic examinations: CT scan (computed tomography), MRI (magnetic resonance imaging scan), or ultrasound of the abdomen
• Stool tests: useful tests include ova and parasites, Calprotectin level (to check for inflammation), guaiac or the FIT test (fecal immunochemical test) to check for blood in the stool, helicobacter pylori bacteria toxin for bacterial infection, stool cultures, Gastrointestinal Multiplex panel (to test for various infection), clostridium
• difficile toxin
• Other tests: in rare cases, other types of tests are available to evaluate your condition

Treatment

Treatment of bloating and gas is directed towards symptoms relief and to treat any underlying cause.  Once a diagnosis is reached, Dr. Maher Abbas will offer you proper treatment recommendations.