Bloating

WHEN TO SEE YOUR DOCTOR

* You have persistent, unexplained bloating for more than three days.

* You also have abdominal pain.

What Your Symptom Is Telling You

A single scoop of cherry vanilla ice cream; several sips of a frothy, strawberry shake; a few bites of a cream cheese omelet--as much as you love dairy foods, they don't seem to love you. Eating even modest portions makes your stomach balloon up, and you feel uncomfortably stuffed.

Doctors call the gassiness, bloating and discomfort that occurs after eating dairy foods lactose intolerance. It means your stomach is unable to digest the lactose--or milk sugar--in dairy foods.

Unfortunately, most adults have this problem to some degree, according to Jay A. Perman, M.D., associate professor and director of the Division of Gastroenterology and Nutrition in the Department of Pediatrics at Johns Hopkins University School of Medicine in Baltimore. As people age, he says, they produce less lactase--the enzyme needed to digest lactose. Without lactase, the undigested milk sugar ferments and gases form. The trapped gas makes your stomach bloat.

Other hard-to-digest foods--such as beans, nuts, seeds, fruits, brussels sprouts, oats, barley, honey and yeast--can also cause gas and an inflated stomach.

Food allergies can cause your stomach to puff out, too. But this is a reaction of the immune system involving the whole body, and usually hives and runny nose are the more prominent symptoms.

If your digestive system is the least bit sensitive--and you have what's called irritable bowel--then, milk, beans and other common problem foods may be even more intolerable. With an irritable bowel, the nerves in your intestines may overreact to irritating food and drink. This triggers spasms in the muscle wall of the large intestine. The contents can't move along, so you become constipated. This distends the bowel. As the contents ferment, gases are produced, making you bloat even more.

If you eat your food too quickly, you'll swallow air, which also stretches out the bowel.

Persistent bloating with pain could indicate a number of digestive diseases. These include obstructions in the bowel or kidney, diverticulitis, appendicitis, gallstones, ulcers or a tumor.

Symptom Relief

Here's what to do if you're feeling bloated.

Take a post-meal stroll. Besides nudging bowel contents along, exercise may release hormones that encourage bowel activity, according to Ralph Bernstein, M.D., clinical professor of medicine at the University of California and chief of gastroenterology at Highland Hospital in Oakland.

Get rid of gas. To deflate that full feeling, try Phazyme 95. This over-the-counter medication contains simethicone, which quickly breaks up gas bubbles, says Ronald Hoffman, M.D., director of the Hoffman Center for Holistic Medicine in New York City.

Try herb tea. For on-the-spot relief, try a cup of peppermint, chamomile or fennel tea, says Dr. Hoffman. These herbs help relieve gas.

Get more fiber. Fiber softens the bowel contents and seems to help if bloating is caused by intestinal spasms. You can add fiber to your diet by eating vegetables and whole grains, says Roger Gebhard, M.D., gastroenterologist at the Veterans Administration Medical Center and professor of medicine at the Univeristy of Minnesota in Minneapolis. But wheat starch may cause bloating, he adds, so try switching to rice and potatoes, which contain starch that is more easily tolerated. Or try a tablespoon of Metamucil mixed into juice once a day. "In some people, Metamucil may cause gas, although generally this seems to be a more tolerable form of roughage," says Dr. Gebhard.

Skip the stimulants. Coffee, tea and chocolate can all overexcite the digestive tract, says Dr. Gebhard. Fat is another food that's often hard to digest and may stimulate spasms--and consequently bloating--in the bowel, he adds.

Approach milk with respect. Just because milk and dairy products cause bloating doesn't mean you have to give them up. You can drink lactose-free milk, which tastes sweeter, or add liquid lactase to your dairy products, says Dr. Perman. Both the more easily tolerated milk and the digestive enzyme are available at many supermarkets and health food stores. Nonfrozen yogurt and aged cheeses such as Romano have only small amounts of lactose in them, so you may be able to eat them without a problem, says Dr. Perman.

Avoid too-hot or too-cold foods. You may be unconsciously drawing in air when tasting foods that are extreme in temperature, says Dr. Gebhard. Bubbly beverages and chewing gum can also make you swallow air, so it's a good idea to avoid them as well.

Slow down; chew carefully. When you eat too fast, you can easily trap a pint or more of air in your gut. With slow, careful chewing, you'll take in less air and you'll drench your food with saliva, says Dr. Hoffman. Saliva contains enzymes that begin to break down food before it even reaches your gut.

Take a PMS supplement. "Prior to menstruation, the female abdomen often becomes the repository of all fluids, much like camels' humps," says Michele Harrison, M.D., professor of psychiatry at the University of Pittsburgh and author of Self-Help for Premenstrual Syndrome. Women who take supplements containing the B-complex vitamins and also magnesium and calcium seem to have fewer complaints about bloating, she says.

Keep a bloat diary. People have different reactions to specific foods, according to Dr. Hoffman. A diary will help you identify your own troublemakers so you can reduce portions or eliminate them.

Get a diagnosis. Bloating can signal any of several serious digestive diseases, says Dr. Gebhard. If none of these self-help remedies provides help, see your doctor for a thorough exam.

See also Constipation; Gas; Water Retention