Intestinal Gas (Belching, Bloating, Flatulence) (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Intestinal gas facts
- What causes belching?
- What causes bloating?
- What causes flatulence (gas)?
- What are the causes of intermittent abdominal bloating/distention?
- How is belching, bloating/distention, and flatulence evaluated?
- How is excessive intestinal gas treated?
What causes bloating?
It is important to distinguish between bloating and distention.
- Bloating is the subjective sensation (feeling) that the abdomen is larger than normal. Thus, bloating is a symptom akin to the symptom of discomfort.
- In contrast, distention is the objective determination (physical finding) that the abdomen is larger than normal. Distention can be determined by such observations as the inability to fit into clothes or looking down at the stomach and noting that it is clearly larger than normal.
In some instances, bloating may represent a mild form of distention since the abdomen does not become physically (visibly or measurably) enlarged until its volume increases by one quart. Nevertheless, bloating should never be assumed to be the same as distention. Bloating and even mild cases of distention may be caused by relaxation of the muscles of the abdominal wall.
There are three ways in which abdominal distention can arise. The causes are an increase in air, fluid, or tissue within the abdomen. The diseases or conditions that cause an increase of any of these three factors are very different from one anther. Therefore, it is important to determine which of them is distending the abdomen.
There are two types of distention; continuous and intermittent.
- Continuous distention may be caused by the enlargement of an intra-abdominal (within the abdomen) organ, an intra-abdominal tumor, a collection of fluid around the intra-abdominal organs (ascites), or just plain obesity.
- Intermittent distention is usually due to the occasional accumulation of gas and/or fluid within the stomach, small intestine, or colon.
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