Gaseous abdominal bloating as a long term symptom.

The sensation of abdominal bloating can come from intestinal distension  and/or heightened sensitivity to this.

Excessive flatulence and belching can also suggest increased formation or reduced absorption/utilization of gas. Loud gurgling or rumbling noises in one's tummy (borborygmi) may mean the same.

A swollen belly without increase in one's body weight, suggests the same.

People with irritable bowel syndrome may complain of abdominal bloating worsening as the day goes on, especially after meals. This may be due to bacterial fermentation of carbohydrates, food intolerance reactions or possibly swallowing too much air (aerophagy.)

Considerable small intestinal malabsorption of carbohydrates can occur, even to the extent that bacterial populations in the intestine are altered towards species which thrive on this.
Eating easily digested food is often recommended, so nutrients can be absorbed closer to the start of the intestine, away from bacteria.

I generally get people to try digestive enzyme supplements instead of the above.

If one is intolerant to particular foods, the more rapidly they are fully digested the less the probability of a bad reaction2.
It is undigested or partly digested food material which provoke reactions. They gain access to the tissues of the intestinal wall when our mucosal defences1 have been damaged.

Pancreatin is digestive enzymes extracted from pig pancreas
Acid or pancreatin supplements may speed up slow digestion, starving out the germs in our small intestine and avoiding food intolerance reactions.

An ounce of prevention

From Dr. Herbert Shelton's Hygenic Review 1978...
"Our Golden Rule is this: If not comfortable in both mind and body from one meal to the next, miss the next meal. If you are worried, apprehensive, grieved, angry, jealous, depressed, irritable, grouchy, petulant, fearful, or otherwise mentally distressed, wait upon the recovery of poise before eating. This is as important as not eating when in pain or when there is fever. It is as important as not eating when fatigued. Good digestion depends upon emotional poise."

Very recent onset of distended abdomen

This needs to be sorted out urgently.

It will help the doctor if you know whether or not your weight has changed at the same time. Ascitic fluid can accumulate around the bowel, in which case one will have put on weight. "A pint of water weighs a pound and a quarter" - at least I seem to remember it did when I was at school.


And if it's gas, here's the future.

Only in pigs so far, but this will be one way to measure our gas production in small and large intestines. A small capsule will do the meaurements.



Fermentable, Oligo-saccharides, Di-saccharides, Mono-saccharides, and Polyols.

Sue Shepheard3 coined the acromym FODMAPS for them (less of a mouthful.)

In randomized controlled trials4, people with IBS eating less FODMAPs reported abdominal pain and abdominal bloating as the symptoms with the greatest improvement.

Notes and references

1. Our intestinal lining is covered with a layer of mucus and has secretory IgA antibodies against our food on its surface. These and the tight junctions between cells, keep most food away from the tissues of the intestinal wall until it is fully broken down into sugars, fats and amino acids.

Bacterial lipopolysaccharide endotoxins and gluten are capable of damaging the tight junctions between the cells. Bacterial biofilm can replace the mucous layer against the cells.

See "Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease."

2. The role of protein digestibility and antacids on food allergy outcomes.

3. shepherdworks.com.au

4. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis.




From abdominal bloating back to abdominal pain diagnosis


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