Abdominal Distension & Bloating in People with IBS and SIBO
Abdominal bloating and distension are possibly the two most common causes of why people consult a gastroenterologist. As a matter of fact, everybody has suffered from bloating and distension at some point or another.
At times, these symptoms occur as a result of digestion caused by the intake of high-fiber food items (beans, broccoli, onions, etc.), which are normally associated with the production of gas. However, some people experience this bloating and gas most of the time
Table of Contents
- 1 What is Bloating and Abdominal Distension
- 2 What are the Causes of Abdominal Distension
- 3 SIBO/IBS and Abdominal Distension
- 4 What are the Treatment Options to Relieve Abdominal Distension
- 5 Treatment for SIBO
- 6 Diet to Prevent or Treat SIBO
- 7 Conclusion
If your abdominal distension and bloating are accompanied by other symptoms like nausea, diarrhea, fatigue, and abdominal discomfort, then you could have irritable bowel syndrome (IBS), ulcerative colitis, lactose intolerance, Crohn’s disease, stomach ulcer, or small intestinal bacterial overgrowth (SIBO) as the possible cause 1.
What is Bloating and Abdominal Distension
Abdominal distension occurs when your GI tract is full of gas or air, which accumulates and causes your abdomen to expand. It is not a disease or illness, but a symptom of an underlying dysfunction or disease.
Most people suffering from abdominal distension describe it as feeling tight, full, swollen, or bloated in their abdomen. The abdomen may also get hard, painful, and swollen. Some of the other signs and symptoms that you may experience along with distension include:
- Excessive gas (flatulence)
- Frequent burping
- Abdominal gurgles or rumbling
Abdominal distension can occur in both children and adults. It can interfere with their ability to work and to take part in recreational or social activities.
What are the Causes of Abdominal Distension
Air and Gas
It is one of the most common reasons why you feel bloated, particularly after eating. Gas accumulates in your digestive tract when you swallow air, or the food that is undigested gets broken down.
While everyone can swallow air when drinking or eating, some people swallow it more than others, particularly if they are smoking, chewing gum, drinking or eating too fast, or wearing loose dentures.
Flatulence and burping are the two ways by which swallowed air leaves your body. When this emptying of the stomach gets delayed, and air accumulates, abdominal distension and bloating occurs.
Some of the other medical causes of abdominal distension and bloating include:
- Weight gain
- Food intolerance
- Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis
- Irritable bowel syndrome (IBS)
- Giardiasis (parasitic infection of the intestine)
- Functional gastrointestinal disorders (FGIDs)
- Hormonal flux (mostly in women)
- Mental health factors like depression, stress, anxiety, and more
- Eating disorders, such as bulimia nervosa or anorexia nervosa
- Some medications
Some of the risk factors for bloating and distension associated with the conditions mentioned above include:
- Altered gut motility
- Overgrowth of bacteria within your gastrointestinal tract
- Abnormal abdominal reflexes
- Impaired gas transit
- Accumulation of gas
- Malabsorption of carbohydrate and other nutrients
- Feeling of abdominal distension or bloating in normal body changes (visceral hypersensitivity)
SIBO/IBS and Abdominal Distension
Irritable bowel syndrome is possibly one of the most common gastrointestinal disorders encountered today. IBS is characterized by abdominal pain, distension, discomfort, and irregular formation and passage of stool.
People with bacterial overgrowth in their small intestine or SIBO also experience abdominal discomfort, distension, bloating, loose motion, and flatulence 2.
What are the Treatment Options to Relieve Abdominal Distension
1. Lifestyle Changes
In most cases, the symptoms associated with bloating and distension can be reduced or prevented by incorporating a few lifestyle changes in your routine, like losing weight if you are obese. To lessen swallowing of too much air, make sure to
- Limit your consumption of carbonated drinks
- Eat slowly and do not drink using a straw
- Avoid chewing gum since it can make you swallow extra air, which can cause bloating
- If you are intolerant to lactose, make sure to use dairy products that are free from lactose
- Avoid food items that can cause gas, including lentils, dried beans, and vegetables belonging to the cabbage family
While probiotics are believed to help in repopulating your intestine with healthy bacteria, there is mixed research on the efficacy of probiotics. Scientific evidence shows that probiotics are moderately effective against bloating. Probiotics like Greek yogurt and kefir can give you some relief from bloating and abdominal distension.
2. Abdominal Massage
Abdominal massages are also useful for reducing abdominal bloating and distension. Research showed that 15-minute abdominal massages two times a day for three days could improve the symptoms of abdominal distension and bloating, including anxiety and depression 3.
Consult your doctor if dietary interventions and lifestyle changes do not improve the symptoms of abdominal distension.
If there is an underlying medical condition for your abdominal bloating, then your doctor may recommend medications. He may prescribe antidepressants, antispasmodics, or antibiotics, depending on your condition.
Treatment for SIBO
If you have SIBO or IBS, then it is highly possible that your abdominal distension is related to those conditions. You should consult your doctor about the treatment of bacterial overgrowth in your small intestine.
Normally, the treatment for small intestinal bacterial overgrowth involves taking antibiotics that aim towards reducing the bacterial population in your small intestine. There are plenty of antibiotic regimens that may work, some of which include rifaximin, metronidazole, doxycycline, neomycin, ciprofloxacin, and amoxicillin-clavulanic acid.
Diet to Prevent or Treat SIBO
Some dietary manipulations may help treat the bacterial overgrowth that is already present or reduce the risks of recurrence of SIBO. It is currently believed that treatment for SIBO involves taking a diet that lessens the consumption of fermentable foods.
Avoid eating artificial sweeteners like sucralose (Splenda), have a moderately low-fiber diet, and avoid sugar alcohols like isomalt, xylitol, sorbitol, and others. Make sure to lessen the consumption of foods that are rich in prebiotic inulin, such as asparagus, beets, garlic, onions, and leeks.
These tips may look familiar to you because they are also recommended in a low FODMAP diet that is commonly used for treating irritable bowel syndrome (IBS). If you want to follow this manipulated dietary plan seriously, you should first talk to a licensed dietitian to find out what foods can be included in this low FODMAP diet since it can be somewhat restrictive.
Moreover, most of the fermentable and high-fiber foods are overall healthy. Therefore, it is not feasible to continuously follow a low-fiber diet for a long time.
If the reason for developing SIBO is poor diet, after treating SIBO by eliminating high-fiber fermentable foods, artificial sweeteners, and processed foods, it is worth gradually reintroducing the sources of plant fiber into your diet. Make sure to talk to your dietitian before doing this.
Small intestinal bacterial overgrowth has several non-specific symptoms, which can be related to numerous mental and physical ailments.
Not all abdominal distension and bloating are associated with SIBO. Talk to your medical practitioner if abdominal bloating and distension occur with any of the other signs, including diarrhea, high fevers, severe abdominal pain, vomiting, dark, tarry stools, unexplained weight loss, and worsening heartburn.