Gas and bloating are very common, but the problems they cause vary from patient to patient. The average person passes gas 13 to 20 times a day. When there is excess gas in our bowels or we don’t pass the gas and it stays in our bowels, we develop the signs and symptoms of gas and bloating.
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The most obvious sign of excess gas production is abdominal distention. Some people have a significant change in the size of their abdomens from day to day or even hour to hour. When we have excess gas production in our bowels it causes them to distend, and that pushes out on our abdominal wall. Our pants that fit fine in the morning may feel too tight by the end of the day due to this distention.
Some patients’ abdomens get so big they look pregnant. I have them measure the girth (distance around) of their abdomen when they feel normal and when they feel bloated and see how big the change is. This also helps us differentiate true gas and bloating from visceral hypersensitivity. In visceral hypersensitivity, patients will find that they feel very gassy and bloated, but their abdominal girth has not changed.
What constitutes the symptoms of gas and bloating varies from patient to patient. When the gas is higher up in the gastrointestinal tract, patients can experience excess belching. They sometimes feel an increase in esophageal reflux or even pressure in their chest. At times, the pressure is enough that it can feel just like heart pain. When the gas builds up in the stomach people tend to feel full, even when they don’t have food in their stomach.
One of the most common symptoms is cramps or sharp pains in the abdomen. When the bowels get distended from gas it causes the muscles in the wall of the bowels to stretch and then spasm. It’s the stretch and spasm that we feel. Sometimes when the gas mixes with the fluids in our bowels we get loud grumbling sounds we call borborygmi. When the bowels get stretched it can also cause nausea. When gas is produced in the colon people experience an excess in flatus (farting). The gas in the colon frequently contains sulfur, which gives it most of its odor. Decreased appetite is common with gas and bloating due to the distention, fullness and nausea.
Warning Signs and Symptoms
Most of the time, the symptoms of gas and bloating are benign. However, sometimes they are warning signs of something worse. Heart disease, problems with the pancreas, gallstones, blockages of the bowels with scar tissue or tumors, appendicitis and even diverticulitis (infected pockets in the colon) can present as gas and bloating symptoms. If you have any of the following along with the gas and bloating it’s important to see your physician:
- prolonged abdominal pain
- blood in your stool or dark black stool
- change in the color, frequency or size of your stool
- unexplained weight loss
- chest pain or shortness of breath
- prolonged nausea or vomiting