What should you know about really bad bloating?

Bloating can result from swallowed air, constipation, changes in gut movement or fermentation of certain carbohydrates. Irritable bowel syndrome may combine bloating with abdominal discomfort and altered bowel habits. Lactose intolerance and other food intolerance can produce symptoms after particular foods. Coeliac disease, Helicobacter pylori infection or giardiasis are other possible explanations in the right clinical setting. The timing of symptoms, stool changes, travel, medicines and meals helps a clinician narrow the possibilities.

Eat slowly, chew well, stay hydrated and take gentle movement breaks. Notice whether constipation, fizzy drinks, large meals or a specific food precedes symptoms. Keep a diary of meals, pain, bowel movements and bloating rather than removing many foods at once. Avoid starting a strict exclusion diet without guidance, because it can make nutrition harder and may affect testing for coeliac disease. Nutrition counselling can provide a structured way to explore triggers.

Seek urgent help for severe or rapidly worsening pain, a swollen rigid abdomen, repeated vomiting, inability to pass stool or gas, blood in the stool, faintness or breathing difficulty. Arrange medical review for persistent or recurrent bloating, unintentional weight loss, fever, ongoing diarrhoea, anaemia symptoms or a new change in bowel habit. Bring your symptom diary to the appointment.

Could constipation, food intolerance, IBS or infection explain this pattern? Do I need blood, stool or other tests? How can I change my diet without losing key nutrients?