What should you know about persistent abdominal bloating?

Bloating is a sensation of fullness or visible abdominal distension. It can follow swallowed air, fizzy drinks, large meals, constipation, or changes in gut movement. Irritable bowel syndrome may combine bloating with abdominal pain and altered bowel habits. Lactose intolerance or another food intolerance can cause symptoms after particular foods. Coeliac disease, giardiasis, and Helicobacter pylori infection are other possibilities that a clinician may consider from the history and examination.

The timing matters: note whether symptoms follow meals, improve after passing stool or gas, occur with diarrhoea, or wake you at night. Bloating alone does not identify one diagnosis.

Keep a brief diary of meals, drinks, bowel movements, pain, stool changes, and bloating. Eat slowly, chew well, reduce fizzy drinks, and consider smaller meals. Gentle movement and adequate fluid intake may help bowel regularity. Avoid starting a highly restrictive diet without guidance, and do not remove gluten before coeliac testing because that can affect the assessment. A nutrition counsellor can help identify patterns without unnecessary food avoidance.

Arrange a GP review when bloating persists, repeatedly returns, or is accompanied by weight loss, ongoing diarrhoea or constipation, vomiting, reduced appetite, blood in the stool, anaemia, or a new change in bowel habit. Seek urgent help for severe or rapidly increasing pain, a swollen hard abdomen, repeated vomiting, inability to pass stool or gas, fever, fainting, or black stools. These signs need assessment rather than self-treatment.

Ask which causes fit your symptom pattern, whether blood or stool tests are appropriate, and whether medicines, constipation, or diet may be contributing. Mention family history, travel, recent antibiotics, weight change, menstrual pattern, and every supplement or medicine you use.