Feeling like you have a bloated stomach at various points throughout the day is a completely normal and common experience. There’s nothing wrong with experiencing minor bloating after, say, having a meal. Even if it’s uncomfortable, it’s usually temporary. Let’s all just thank evolving fashion technology for elastic waistbands and not make ourselves feel bad about having a bloated stomach.
With that said, persistent bloating can sometimes be an indication that something is going on with your health, which might be worth getting checked out. Below, we’ll go over a few different things that can cause run-of-the-mill bloating vs. potentially serious bloating. But first, it’s important to clarify the difference between bloating and distension.
You might swear that your abdomen has expanded after finishing a meal, but not see the difference when you look at yourself. Other times, you may feel like you’re about to burst, and it’s undeniable that your abdomen has pushed out.
“I think it’s important to differentiate the sensation of bloating from the physical change of what we call distension,” Simon Hong, M.D., a gastroenterologist specializing in inflammatory bowel disorders (IBD) and clinical assistant professor at NYU Grossman School of Medicine, tells SELF. “They often go together, but bloating is that feeling of feeling full, which most people attribute to gas.” Distension, he explains, is a noticeable difference in the size of your abdomen.
Feeling bloated for a few hours can be completely normal for a bunch of reasons, like the aforementioned gas. Experiencing distension alongside that sensation can be normal too. But if your abdomen is physically distended and doesn’t return to where it was before, “that’s something that’s concerning,” Dr. Hong tells SELF.
Here are a few ways to get to the bottom of what’s causing that bloated feeling.
Look for food-related patterns in your bloating.
If you’re trying to understand why you’re feeling bloated, consider the context, Dr. Hong tells SELF. “The kind of bloating that may be less dangerous, so to speak, is the kind that seems to have a regular pattern,” Dr. Hong says. This is especially relevant to your diet. If you’ve noticed that you’re regularly getting unusually bloated—relative to what you’re used to—after eating, consider what was on the menu, especially anything new.
There are a few common dietary culprits that cause bloating in a lot of people. For example, dairy products. Russell Cohen, M.D., professor of medicine and director of the University of Chicago’s Inflammatory Bowel Disease Center, points to dairy intolerance—specifically an inability to digest lactose, the sugars in dairy products—as a common cause of bloating.
The Genetics Home Reference with the National Institutes of Health (NIH) says that approximately 65% of people develop a reduced ability to digest lactose as they get older. And those odds might be higher depending on your background. For example, some degree of lactose intolerance is more common among people of East Asian, West African, Arab, Jewish, Greek, and Italian descent. And because people tend to develop lactose intolerance after childhood, it could explain an increase in bloating and distension after eating dairy as you age.
Lactose is one example from a group of food substances called FODMAPs to look out for when tracking your diet and bloating. Take a deep breath before reading what that stands for: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are carbohydrates that your body struggles to digest and absorb, which can lead to bloating and distension.
As well as in dairy products, FODMAPs are present in certain fruits and vegetables—including onions, cauliflower, apples, and watermelon—as well as legumes, processed meats, wheat, rye, high-fructose corn syrup, and nuts like cashews and pistachios. FODMAPs don’t affect everyone equally, so while certain FODMAPs may make you feel bloated, you may be able to process others just fine. The intention is not to permanently stop eating every kind of FODMAP because you think some may be behind your bloating—it’s best to check with someone like a doctor or registered dietitian before trying any kind of elimination diet for health purposes.
Fiber is another food substance that our bodies just aren’t very good at digesting, with potentially bloating consequences. You mainly break down fiber in your colon, where it produces gases including carbon dioxide, hydrogen, and methane. These cause bloating until you literally “pass gas.” The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that doing this 13 to 21 times a day is considered normal—so let it rip. And keep in mind that fiber is a really important part of your diet, so as with FODMAPs, you shouldn’t just cut it out. As the Mayo Clinic explains, eating adequate amounts of fiber actually helps your digestive system function more smoothly. Here’s more information about how much fiber you should have each day and how to keep its potentially unpleasant effects to a minimum.
Consider if your bloating is lining up with your menstrual cycle.
If you’re someone who has periods, that’s another factor to track when you’re looking for patterns in your bloating, says Dr. Cohen. A 2014 study in BMC Women's Health asked 156 women about their gastrointestinal symptoms before and during their periods. The results showed that bloating was the most common GI-related symptom pre-menstruation and the second most common (behind abdominal pain) during menstruation. Unlike bloating due to digestive issues, bloating related to your period could happen because of fluid retention rather than gas.
Bloating that’s connected to your menstrual cycle is pretty normal. But that doesn’t make it much fun. If you’ve also noticed that certain foods make you feel bloated, consider limiting them in the days leading up to your period (within reason—as we mentioned, the idea is not to just cut out every food group you think could be behind your bloating). To help reduce water retention, the Mayo Clinic recommends steps like curbing your salt intake if you think sodium may be a factor.
Talk to a doctor if you think a gastrointestinal disorder is causing your bloating and distension.
If your bloating doesn’t follow a neat pattern, you can’t pinpoint a factor behind it like hormonal changes or lactose intolerance, and you experience additional bothersome symptoms, you could have a gastrointestinal condition like ulcerative colitis or Crohn’s disease. These both fall under the umbrella of inflammatory bowel disease (IBD), which describes conditions that cause inflammation of various parts of the bowel. The Centers for Disease Control and Prevention explains that ulcerative colitis affects consistent stretches of the large intestine and rectum, while Crohn’s disease can affect any part of the digestive system, with inflammation usually occurring in patches.
In addition to bloating, here are symptoms that may indicate IBD:
- Abdominal pain
- Diarrhea
- Blood and/or pus in your stools
- Fever
- Unexplained weight loss
- Fatigue
People with Crohn’s or ulcerative colitis can go for long periods of time with no symptoms. But these are serious, chronic conditions that require treatment. Left untreated, ulcerative colitis can lead to rectal bleeding, joint inflammation, and inflammation in deep tissue layers of the large intestine, the NIDDK says, while Crohn’s can lead to ulcers, intestinal obstructions, fissures, and abscesses.
Other medical conditions can cause persistent, painful bloating, including irritable bowel syndrome (also known as IBS, this describes a wide range of symptoms with no observable physical cause) and celiac disease (a chronic disease in which the immune system attacks the small intestine when it detects the presence of gluten).
If you’re regularly experiencing any uncomfortable symptoms in addition to your bloating, including pain and/or diarrhea, talk to your doctor. They may recommend investigating with blood tests such as a C-reactive protein (CRP) test, which can show whether you have inflammation that may indicate a health condition, and a fecal calprotectin (CALPR) test, which specifically tests for active GI inflammation, Dr. Hong says. They can also offer guidance on other diagnostic tests you may need, like an endoscopy, in which a doctor uses a flexible tube to examine your digestive system. Based on the issue in question, treatment follows from there.
Most of the time, bloating indicates nothing more than your digestive system doing its job. And now that you know how to determine if it’s potentially serious, you can tell the difference between when you may need to see a doctor—and when it’s time to change out of your uncomfortable jeans and into your favorite leggings.
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