“The term bloating designates abdominal distention which generally occurs after meals, more or less painful and sometimes accompanied by transit disorders. recalls Dr Pierre Nys, endocrinologist-nutritionist, former attaché at the Paris Hospitals. (1) This bloating is due to gas production. Bloating is one of the most common functional digestive symptoms (without organ abnormalities).
Recurrent bloating: symptoms of irritable bowel syndrome
THE irritable bowel syndrome (IBS), previously called functional colopathy, is a functional intestinal disorder. This chronic disease is very common. It affects around 8% of the population, most often women and people under 50. One of the key symptoms is abdominal pain frequently associated with bloating. But to make the diagnosis of irritable bowel syndrome, other criteria must be present. The Rome-IV criteria must be applied which are used to make the diagnosis of this functional disorder. Abdominal pain must have been present for at least 6 months and at least one day per week for the last 3 months. At least 2 of the following 3 criteria must be associated with this pain: pain relieved or aggravated by passing stools, change in the frequency of stools or in the form of stools (diarrhea, constipation or alternation of diarrhea and constipation). “All these signs appear gradually and then become more pronounced. They are increased by stress,” specifies Dr Pierre Nys.
Recurrent bloating: other causes
“There are three main differential diagnoses: food intolerances and food allergies, including what is known as celiac disease, SIBObacterial proliferation in the small intestine and SIFO, fungal proliferation in the small intestine”, informs Dr Pierre Nys. Signs of food allergies and intolerances are bloating and intestinal pain, diarrhea or constipation. SIBO for small (bowel) intestinal bacterial overgrowth manifests itself by symptoms that can be found in functional or organic digestive diseases, namely nausea, bloating, abdominal distension, gas, abdominal pain or cramps, diarrhea or even constipation or transit irregular. SIFO for Small Intestinal Fungal Overgrowth also causes gastrointestinal symptoms such as bloating, abdominal pain, nausea, and transit disorders. As you can see, recurring bloating can be a sign of different disorders.
Recurring bloating: do I have irritable bowel syndrome?
On the other hand, bloating in the context of irritable bowel syndrome is never associated with notable weight loss, deterioration in general condition, pain that wakes you up at night, or the presence of blood in the stools. , acute pain of sudden onset. Such symptoms require medical consultation. “If there is the slightest doubt, a colonoscopy is carried out to see if there is colon cancer,” points out the doctor interviewed. If you think you have irritable bowel syndrome (your bloating is present as part of other signs described above without alarming signs), Dr. Pierre Nys advises you to try it a very strict diet without FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), which include several families of substances that ferment in the intestines.
A diet low in FODMAPs often helps improve irritable bowel symptoms. “A significant improvement in the disorders after 6 weeks of eliminating FODMAPs is in favor of irritable bowel syndrome. On the other hand, if you do not notice any improvement in 3 to 4 weeks, you must look for another cause to this bloating”, explains Dr. Nys. However, this underlines the interest of a medical consultation. “The person will be able to benefit from a clinical examination of the abdomen”, he explains. In case of IBS, the clinical examination is normal.
(1) Author of The FODMAP diet in 50 keys, Editions Leduc, October 31, 2023