Bloating as a symptom of heartburn and indigestion

What is bloating?

And does it have to do with heartburn and indigestion?

Bloating is a common and bothersome symptom.¹ It is a sensation of belly fullness,² discomfort or feeling excessively full after you’ve eaten. ^4,5

• Sometimes your belly looks bigger (distension), but not always. ^1,2
• People with bloating do not necessarily have too much gas in their stomach, but they are often much more sensitive to stomach symptoms. ^2,3

Indigestion is a feeling of pain or discomfort in the chest or stomach that sometimes happens after eating or drinking. ^4,5

• Sometimes this feeling is accompanied by a bloated feeling (as well as burping or passing of wind – together with the sensation of trapped wind.) ⁴
• Indigestion is a common problem that affects many people, but in most cases it's mild and only occurs occasionally. ^4,5
• In most cases indigestion is related to eating, although it can be triggered by other factors such as smoking, drinking, alcohol, pregnancy, stress or taking certain medications. ^4,5

Heartburn is a burning sensation in the chest 6,7,8 that usually occurs after you’ve eaten certain types of food. ⁹

• It’s fairly common to experience heartburn and indigestion together.

What causes bloating?

Most people have had bloating, sometimes alongside gas or belching. ²

• Belching (or burping) is usually caused by swallowing too much air, eating or drinking too fast, drinking carbonated or caffeinated drinks, smoking, or a nervous habit. ^2,3
• Gas or passing wind (flatulence) is the release of excess gas in the colon. It is usually related to your diet. Sometimes these symptoms can cause problems or pain. ^2,3

If these symptoms are experienced more than occasionally, one or more of these disorders— irritable bowel syndrome, functional dyspepsia (indigestion), or functional constipation— are usually the cause. ^1,2,3

Bloating is one of the principal symptoms of postprandial distress syndrome, one of the two subgroups of functional dyspepsia, where it is often located in the upper abdomen and precipitated by meals. ¹

Is bloating dangerous?

Bloating is not typical of dangerous conditions, but you should let your doctor know if you are losing weight, having fevers, or bleeding. These symptoms can be more serious. Although anxiety, depression, and stressful life events do not cause these conditions, they may make the symptoms worse and harder to treat. ²

How can you treat these symptoms?

Even severe symptoms usually improve over time with diet and lifestyle changes. ²

Try modifying your diet ²

• Eat and drink more slowly to swallow less air.
• Limit fatty and spicy foods.
• Avoid caffeine, carbonated drinks, and artificial sweeteners.
• Avoid common gas-causing foods, such as beans, peas, lentils, cabbage, onions, broccoli, cauliflower, and whole grains.
• Try removing one food at a time from your diet to see if your gas improves.
• Eat fibre and probiotics.

Exercise ²

• Regular daily exercise often reduces symptoms.

If lifestyle changes aren’t working, talk to your doctor or pharmacist. They can help you decide which treatments are best for you. ²

Please note: All information presented is not meant to diagnose or prescribe. Always read the label before taking any medication. If symptoms are severe or prolonged, you should consult a doctor or pharmacist.

REFERENCES:

1. Iovino P et al. Bloating and functional gastro-intestinal disorders: where are we and where are we going? World J Gastroenterol, 2014; 20(39): 14407–14419.
2. AAFP (American Academy of Family Physicians). Information from Your Family Doctor: Gas, Bloating, and Belching. 2019: 1-2.
3. Wilkinson J et al. Gas, Bloating, and Belching: Approach to Evaluation and Management. American Family Physician, 2019; 99(5): 301–309.
4. NHS Inform website: “Indigestion.” Updated 14 February, 2020. URL: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/indigestion
5. NICE (National Institute for Health and Care Excellence) Guideline: Indigestion, heartburn and reflux in adults – Information for the public, 2014.
6. Kahrilas PJ et al. Regurgitation is less responsive to acid suppression than heartburn in patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol, 2012a; 10: 612–9.
7. Vakil N et al. The Montreal Definition and Classification of Gastroesophageal Reflux Disease: A Global Evidence-Based Consensus. Am J Gastroenterol, 2006; 101:1900–1920.
8. Meteerattanapipat P & Phupong V. Efficacy of alginate-based reflux suppressant and magnesium-aluminium antacid gel for treatment of heartburn in pregnancy: a randomized double-blind controlled trial. Scientific Reports, 2017; 7 (44830): 1–6.
9. Mandel KG et al. Review article: alginate-raft formulations in the treatment of heartburn and acid reflux. Aliment Pharmacol Ther, 2000; 14: 669–690.