When is bloating a sign of something more serious

PHILADELPHIA (WPVI) -- Everyone has the occasional episode of feeling too full, or bloated. But when it happens again and again, it's time for a closer look.

"It's a fullness or pressure, often after eating," said Dr. Neena Mohan, GI at Temple Health.

"Bloating can seem trivial to some, but to me, there's something going on," said Veronica Bersani, a registered dietitian.

Bersani, and gastroenterologist Dr. Mohan of Temple Health, said it often takes a little detective work to find the cause of bloating. One step is checking for medical reasons.

"This includes irritable bowel syndrome, or IBS, and also considering things like celiac disease, lactose intolerance, sometimes even certain medications," said Dr. Mohan.

Acid reflux can also be a factor.

Chewing a lot of gum, or regularly drinking through straws can bring a lot of air into your digestive system.

But most of the time, it's a problem with food or a component of food.

"Beans, cabbage, onions, garlic, apples, cherries, these are all things that can produce more gas, and so can make you feel uncomfortable," said Dr. Mohan.

Bersani said a food feelings diary can help, logging not just meals but how you feel.

"Do you feel any gas or bloating or discomfort afterward?" she said.

If there is, she may put a patient on a diet low in FODMAPS which is short for:

"Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. And these sugars are in foods," she said.

The sugars can sit in the gut, fermenting and producing gas. A long list of FODMAP foods are off-limits at first, then reintroduced gradually when they're eliminated as the culprit.

One study showed more than half the IBS patients on a low-FODMAP diet had major improvements in abdominal pain.

Bersani and Dr. Mohan said a low FODMAP diet should only be done under medical supervision.

Don't try it yourself. But the Temple team said you can try one thing, more exercise. That's also been shown to decrease symptoms.
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