Generally speaking, gas and bloating is what I call a symptom-driven disease. What that means is it rarely causes any long-term problems and we just treat the symptoms to make people feel better. However, depending on what is causing your gas and bloating, sometimes there are possible long-term complications we need to watch for. I will go over eight of the most common things that need to be considered as a possible cause when dealing with gas and bloating.
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When we don’t digest foods well and they are not broken down by our bowels like they are supposed to be, our bodies have a difficult time absorbing them. This can manifest as bloating. When this happens we can develop a nutritional deficiency. Becoming deficient in certain vitamins or nutrients can lead to a whole host of health problems. Celiac disease, cystic fibrosis and food allergies are just a few of the things that can lead to malabsorption. There are many lab tests that exist that can help rule out malabsorption as a cause of your gas and bloating.
Parasites, yeast and bacteria can all get introduced into our bowels by a variety of means. Many people have intestinal infections and are completely asymptomatic. Most people develop the typical symptoms of fatigue, nausea, diarrhea, abdominal pain, gas and bloating. Many intestinal infections will go away on their own if just given time. Some infections become chronic and can cause all kinds of problems, including malnutrition. Through blood and stool studies we can diagnose and treat most of these infections.
Our gallbladder is a storage sack for bile and digestive enzymes that are made by the liver and pancreas. In some people it can contain small or large stones. The presence of stones is many times asymptomatic, but at times can cause the same symptoms of gas, bloating and pain. The problem with gallstones is that if one of the small stones get pushed out of the gallbladder into the small drainage tube (bile duct) leading to the small intestine it can get stuck and cause cholecystitis (inflammation of the gallbladder) or biliary pancreatitis (inflammation of the pancreas). Both of these conditions are dangerous and may require surgery.
Inflammatory Bowel Disease
Inflammatory bowel disease is a spectrum of conditions in which the body’s immune system causes inflammation in the bowels. Ulcerative colitis and Crohn’s are the common examples. Most people with inflammatory bowel disease develop pain, diarrhea and blood or mucus in their stool. Early on in the development of the disease some people just get worsening gas and bloating. When gas and bloating is accompanied with a change in the bowels, inflammatory bowel disease needs to be considered in the workup. The potential complications are ulcers, malnutrition, dehydration, cancer and need for surgery. These can be diagnosed with blood work, X-rays and endoscopic studies.
A blockage in the bowels is one of the most dangerous causes of increased gas and bloating. If the normal amounts of gas cannot pass through the bowels because they are blocked or compressed, you will feel more bloated that normal. Blockage can develop due to things inside the lumen of the bowel (like a tumor) or things compressing the bowel from the outside (like a hernia). Typically, a bowel obstruction requires surgery.
There is conflicting views on if the little bacteria called Helicobacter pylori, which can live in the stomach, causes symptoms or not. We do know it can increase the risk of ulcers and a certain type of stomach cancer, but it may play a role in gas and bloating as well. It is easily diagnosed and treatable, so it should be ruled out if you’re having problems.
A hiatal hernia occurs when the top part of the stomach pushes up into the chest where it doesn’t belong. When this happens, the normal sphincter, or valve, at the bottom of the esophagus stays open and allows free reflux of fluid and gas upward. This can present as increased belching and the feeling of pressure in the chest. It can lead to long-term acid damage in our esophagus, which can cause things like esophagitis (inflammation), strictures or even Barrett’s esophagus (a precancerous change to the lining of the esophagus).
Due to long-term alcohol use, certain medication and even autoimmune diseases, your pancreas can slowly lose some of its function. We call this chronic interstitial pancreatitis. If present, besides the gas and bloating patients typically feel, it can lead to malnutrition and increased risk of pancreatic cancer. Luckily, it can be diagnosed as well with blood work, radiographic studies and endoscopic procedures.