What should you know about painful bloating?

The abdomen may feel tight, swollen, crampy, or tender. Irritable bowel syndrome can link bloating with abdominal pain and changes in bowel movements. Lactose intolerance, another food intolerance, or coeliac disease may cause symptoms after particular foods. Giardiasis and Helicobacter pylori infection are other possible digestive causes. The pattern matters: note meals, bowel movements, stool changes, vomiting, weight change, and whether discomfort improves after passing gas or opening the bowels.

Eat slowly, chew thoroughly, and choose smaller meals for a short period. Drink fluids, move gently, and address constipation with gradual dietary changes rather than sudden large amounts of fibre. Keep a simple food and symptom diary, but avoid removing many foods without professional guidance. Nutrition counselling can help identify a balanced approach when food triggers are suspected. Do not begin a gluten-free diet before discussing testing for coeliac disease, because this can affect the results.

Seek urgent care for severe or rapidly worsening pain, a hard swollen abdomen, repeated vomiting, blood in the stool, black stool, fever, fainting, or inability to pass stool or gas. Arrange a clinical review when bloating is persistent, recurrent, unexplained, or accompanied by unintentional weight loss, ongoing diarrhoea, constipation, or reduced appetite. Assessment can distinguish a food-related pattern from conditions needing specific treatment.

Ask which causes fit your symptom pattern, whether stool or blood tests are appropriate, and how to manage constipation or suspected intolerance safely. Bring your food and bowel diary.