Young beautiful woman is having stomach ache. Isolated on white.Bloating is a common gastrointestinal disorder that is associated with several similar disorders such as irritable bowel syndrome and patients having organic disorders. Patients that encounter bloating complain of having “too much gas” in the abdomen. The severity of bloating may vary from mild discomfort to a severe discomfort with patients complaining of experiencing pain in their belly. Bloating may also be accompanied by abdominal distension that can be shown by an increase in the stomach’s girth.

Pathophysiology of bloating

The causes of bloating are not well understood. It is thought that the condition may be associated with hypersensitivity of the patient’s gut or the gut microflora. Most patients having primary conditions such as dysplasia and inflammatory bowel syndrome are managed by treating the primary condition. However, in few cases, inflammatory bowel disease tends to occur alone without any associated condition. Studies on the possible causes of bloating patients have found that some patients who have functional bloating experience sugar intolerance.

Studies have also indicated that bloating may be associated with an abnormal gut microbiota. Researchers have shown that stool of individuals having the bloating condition contains an altered colonic flora. The luminal microbiota plays a fundamental role in causing bloating and flatulence. The process occurs by carbohydrate fermentation and gas production. Other studies have suggested that patients with the bloating condition have the small intestinal bacterial overgrowth. The bacterial overgrowth results in increased bacteria fermentation and gas production.

Food intolerance and malabsorption is also another possible cause of bloating in patients. Patients having lactose intolerance are commonly reported to experience bloating due to the accumulation of the lactose in the small intestine. As a result, bacterial enzymes break the lactose into short carbonic acids and gasses resulting in bloating. The development of the GI symptoms is also associated with the supply of fermentable foods such as short-chain carbohydrates and polyols. The poorly absorbed and fermentable foods end up being broken in the stomach resulting in gas production.

Management of bloating

1. Antibiotics
Antibiotics are recommended for conditions associated with the small intestine bacterial overgrowth. Antibiotics used include rifamycin and rifaximin. Rifaximin is mostly used due to its inability of not being absorbed from the gut, hence patients experience minimal side effects.

2. Probiotics
The use of probiotics is also thought to help in managing bloating in patients. The use of these agents is considered to be important in conditions associated with altered colonic bacteria.

3. Dietary interventions
During history taking, the diet of the patient must be put into consideration. Patients should be advised to take a diet that is low in fermentable carbohydrates.

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