Why do you feel Bloated?

Dr. John Hsiang

Dr. John Hsiang

Livingstone Digestive & Liver Clinic

Dr. John Hsiang is a gastroenterologist and hepatologist with more than 15 years of clinical experience. His clinical interests include managing fatty liver disease, viral hepatitis, Helicobacter pylori infection, and effects of the gut microbiome on irritable bowel syndrome and has extensive experience in gastrointestinal cancer screening.

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You’ve probably experienced it at one point or another after biting off more than you could chew at the dinner table. That growing tightness in your stomach; the urge to undo the top button of your pants and just lie down, motionless, until the discomfort fades away. We refer to this unpleasant sensation as bloating. 

Bloating is largely a short-term condition of the gastrointestinal (GI) tract, characterised by a feeling of pressure or fullness in either the upper or lower abdomen, which may be accompanied by a visible enlargement of the waist, or abdominal distension.

Here are some reasons why you might be feeling bloated.

It boils down to what you eat – too much food or the wrong types of food.

When you open your mouth to welcome that bite of chicken rice or that sip of milk tea, you swallow a small amount of air in the process, which gradually accumulates the more, or the faster you eat. The volume of air taken in can also be artificially increased if you choose to use a carbonated beverage to wash down your meal. The air swallowed contributes to bloating of the upper abdomen, which is often accompanied by belching and symptoms of reflux, or heartburn.

Consuming greasy foods such as fried chicken can similarly bring about upper abdomen bloating. The fat taken in results in a longer time required for the contents of your stomach to empty into the small intestine. Meanwhile, your meal continues to churn around in the stomach, giving rise to the sensation of bloating.

What about lower abdomen bloating? Consider that not everything you eat can be digested and absorbed into the bloodstream. The body does not synthesise the enzymes required to break down the insoluble fibre found in whole grains and leafy vegetables for example. Amongst Singaporeans in particular, there exists also a ubiquitous compound that our digestive systems simply cannot process – lactose, the sugar that occurs naturally in milk, cheese and other dairy products. Indeed, according to the National University Hospital, an approximate 90% of the population is lactose intolerant to some degree.

These indigestible substances make their way to the large intestine, where they are feasted upon by gut bacteria in a process known as fermentation. The result – the production of intestinal gas, which brings about lower abdomen bloating, excessive flatulence and sometimes constipation.

You might be suffering from gastroparesis.

Normally, food is propelled through the GI tract from one organ to the next through the action of strong muscular contractions. In gastroparesis cases however, the spontaneous movement of the stomach’s muscular walls is inhibited, thereby slowing the rate at which food is emptied from the stomach into the small intestine. Consequently, a smaller quantity of food is required to trigger the sensation of bloatedness.

The Solutions

Temporary bloating can be addressed by adopting simple lifestyle changes. It would be wise to cut down on foods that trigger bloating, such as beans, fatty or spicy foods. Talking, eating rapidly and drinking soda during mealtimes can be avoided, to reduce the volume of air taken into the GI tract. Sometimes the bloating symptom is associated with other digestive problems, endoscopy is recommended to exclude conditions like Helicobacter pylori infection, and other causes of constipation. Improving sleep to reduce gut hypersensitivity will also help with the bloating sensation

If however the bloating is persistent, and comes with other concerning symptoms such as fever, fatigue and vomiting, do pay a visit to your family doctor for a consultation, or seek advice from a gastroenterologist. Indeed, Livingstone Health’s Digestive and Liver Clinics are ready and willing to provide professional and personalised guidance should the need ever arise.

Article reviewed by Dr John Hsiang, Senior Consultant Gastroenterlogist at Livingstone Digestive & Liver Clinic


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