We all know the feeling of being bloated. Whether you've simply bolted down a meal too fast, or have hormonal changes to blame, the uncomfortable sensations in the abdomen are often accompanied by a sense of being lethargic and run-down.
"Bloating is often described as a stretched, puffy and uncomfortable feeling in the stomach," says Dr Ayesha Akbar, consultant gastroenterologist from The London Digestive Centre at The Princess Grace Hospital, part of HCA UK. "In some cases, the stomach can feel rock-hard and look swollen in appearance. Most people will experience bouts of bloating fairly regularly, and there can be a number of factors and triggers that cause this."
Although it's hard to assess the exact prevalence of bloating, the condition is certainly commonplace. Many people experience bloating after a big weekend of eating, such as over the festive period, and the gassiness will eventually dissipate by itself. In these cases, there is little to worry about, beyond being temporarily unable to zip up your favourite jeans.
However, if your bloating is more than an occasional inconvenience, it may be worth exploring further. As Akbar explains, regular or consistent bloating can be extremely debilitating.
"It doesn't just impact a person's health but can also have an effect on body confidence and general well-being," she says. "If bloating symptoms persist, are continuously affecting daily life, or are accompanied by other symptoms, such as a change in bowel movements, then my advice would be to book in to see a GP or specialist gastroenterologist as soon as possible. They will be able to help pinpoint the cause of the bloating through a variety of tests."
For those who deal with persistent bloating, the most likely culprit is diet. If you've ruled out the obvious (having eaten too much in one sitting, or eaten too quickly), it's possible you have a food intolerance or allergy and have consumed something that doesn't 'agree' with you.
Although everybody is different, the two food groups most liable to lead to bloating are dairy products and foods containing gluten. In these cases, your bowel might not be emptying properly, or too much gas might be being produced in reaction to the food.
"Even people who are not officially diagnosed as being intolerant to dairy or have an autoimmune condition which causes their body to react to gluten (coeliac disease) can often experience sensitivity to these foods, and experience bloating after eating them," says Akbar. "The best thing to do when trying to identify a bloating trigger is to keep a food diary for a couple of weeks, and note down when bloating symptoms arise."
She adds that several other food types can be a bloating trigger - most notably, the kinds that are notorious for causing wind. (For instance, if you're feeling bloated after Christmas dinner, you might be able to blame the Brussels sprouts along with the overindulgence.)
"I always recommend to my patients that they should reduce the amount of foods they are eating which are known to cause excess gas. These foods include beans, onions, broccoli, cabbage, sprouts and cauliflower," she says.
An imbalance in the gut bacteria which help you digest food can also lead to bloating. Several trials have shown that some probiotics and prebiotics can help improve bloating.
Another common cause of bloating is constipation, which can lead to a hard feeling in the stomach. If that's you, make sure to eat a fibre-rich diet, drink lots of water and take regular exercise.
Bloating can be exacerbated by lack of sleep, and by stress and dehydration, and is a hallmark of premenstrual syndrome (PMS). It can also come about when you've taken in too much air, in which case cutting down on chewing gum and fizzy drinks ought to help. Akbar recommends sitting down to eat, and avoiding talking while eating.
Possible medical reasons
Less commonly, bloating may point to a number of medical conditions. Aside from food intolerances, these can include coeliac disease, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).
These are distinct digestive conditions with different causes: coeliac disease occurs when the intestines react to gluten, causing inflammation; IBD is a chronic inflammatory disorder of the gut; and IBS is related to a loss of coordination in the digestive nervous system. Since the symptoms can overlap, it's important not to self-diagnose - see a doctor!
Very rarely, bloating - along with a persistent feeling of fullness, and needing to urinate more - can be a symptom of ovarian cancer. This disease is most likely to develop in women over 55, and sadly is often diagnosed late, due to low awareness of the symptoms.
According to the charity Target Ovarian Cancer, only a third of women would book a doctor's appointment when faced with persistent bloating. However, NHS England recommends seeing your GP if you've been feeling bloated most days for the past three weeks. In the unlikely event that there was something wrong, early detection would make it much easier to treat.
Pinpointing the cause
More often than not, though, the cause will be something much less serious. As Akbar explains, if a medical professional is looking to identify the root cause of bloating, they will ask you a few key questions.
"They are likely to ask questions around how often bloating is experienced, how long the bloating typically lasts for, and if there are any lifestyle changes, dietary changes or medication that help to improve the condition," she says. "They may also ask if you are experiencing any unusual symptoms or changes in your bowel movements, which could help to identify what's causing the bloat to occur."
Once the cause of your bloating is nailed down, it should be much easier to find ways to alleviate it. Bloating is certainly uncomfortable, but most of the time it can be redressed through lifestyle changes and it poses no real cause for concern.