Most women rank bloating highly on their list of health concerns, but it's a topic that is not well understood and has prompted a new book which explains why some people can't do up their jeans at night.
In a new book "Understanding Gas and Bloating - Why can't I do up my jeans at night?" prominent Australian gastroenterologist Professor Terry Bolin provides information and management tips to help deal with bloating.
Professor Bolin's book "Understanding Bloating and Gas - Why I can't do my jeans up at night?" sets out the facts around bloating in a simple straightforward manner and provides an easy to understand explanation of how our bodies digest food, how bloating can occur and most importantly what treatment and management programs are available.
The term bloating refers to swelling or distention of the abdomen. Some people can have symptoms and no visible signs. Constipation is a symptom, and diet can play a crucial role in providing relief", Prof Bolin said.
The book explains a number of important facts about bloating, including:
The bloating cycle
The process of digestion
The controversial brain-gut axis
Examining the link between gas and bloating
Who is most susceptible?
How bloating relates to other conditions
Professor Terry Bolin
Understanding Gas and Bloating: Why can't I do up my jeans at night?
Author: Professor Terry Bolin
Question: What is bloating?
Professor Terry Bolin: Bloating is a sensation of discomfort that can be severe and affects up to two thirds of women. A quarter of those will have such severe symptoms that they feel it interferes with their work and social activity. The bloating may be accompanied by obvious distention of the abdomen, though frequently not. This has led to it being largely ignored by the medical profession who when they cannot see evidence of a symptom think it largely imagined. The bloating may occur high up in the abdomen and be present in the morning or immediately after meals; it may be in the middle of the abdomen or in the low abdomen and often worse towards the end of the day. This accounts for the description 'I can't do my jeans up at night' or 'I look six months pregnant'.
Question: Can bloating be a symptom for health issues?
Professor Terry Bolin: It is unusual for bloating to be a symptom of other health issues although it is a key part of the syndrome of irritable bowel and coeliac disease often needs to be excluded. This is particularly so because many young women believe that they are intolerant to gluten and therefore exclude it from their diet even though they aren't truly coeliac. The intolerance to gluten relates to their sensitivity to distention by gas and is frequently accompanied by other symptoms that we relate to the unconscious or autonomic nervous system which controls the circulation. As a consequence of this many such women complain of cold hands or feet and often have other more severe symptoms such as chilblains and even discolouration of their fingers which may go blue.
Question: Why did you decide to write Understanding Gas and Bloating: Why can't I do up my jeans at night?
Professor Terry Bolin: The decision to write a book on bloating relates to the fact it is such an extraordinarily common complaint usually ignored by professionals including doctors, nutritionists and naturopaths. It often relates to the fact that the symptoms may be severe but there is little to see and the book may help women in particular to take control either by modifying their diet, being aware of intolerances particularly to fat and caffeine, obtaining medications either on prescription or over-the-counter, that can be beneficial.
Question: Who is most susceptible of bloating issues?
Professor Terry Bolin: Women are the most susceptible to bloating which often begins during teenage years and through into adult life. There is a link with the reproductive system in the sense that symptoms are often worse before or during periods. There is another link with stress because that will exaggerate the symptoms they experience. This we call the brain-gut axis.
Question: Can you talk about the link between gas and bloating?
Professor Terry Bolin: An additional form of bloating occurs in older people. Again women more than men, who experience pain and bloating high up in the stomach under the ribs on eating. As a consequence they can only eat small meals and frequently experience other symptoms such as difficulty swallowing particularly solids and this is often felt high up in the pharynx so there is a symptom of pharyngeal choking and coughing.
We used to believe that bloating was due to gas that forms in the colon. Over a period of 24 hours we may generate almost 25 litres of gas which needs to be disposed of either by reabsorption from the bowel used by the 2kg of bacteria in the colon expiration on the breath or by passage of flatus. This colonic gas may account for the low abdominal bloating and distention that occurs later in the day.
Recent research shows that the small intestine is now a major contributor to bloating and pain. Up to three litres of carbon dioxide gas are generated in the small intestine which together with one litre of nitrogen produced by swallowing air amounts to two large party balloons full of gas. Normally this travels down the two metres of small intestine and is slowly absorbed so that none is present by the time it reaches the colon. If there is a disturbance of the muscular contractions in the small intestine, then gas is trapped, bloating is experienced and distention may be evident. The treatment is directed at trying to minimise gas production, improve the muscular activity, treat the discomfort and pain and perhaps most of all overcome the constipation which is a frequent accompaniment of bloating.