What to know about ulcerative colitis and bloating

How common is bloating?

The International Foundation for Gastrointestinal Disorders reports that the frequency of bloating is as follows:

• 23–96% in irritable bowel syndrome (IBS)
• 50% in functional dyspepsia, which is recurring episodes of indigestion that have no obvious cause
• 56% in chronic constipation

Causes of bloating

Bloating happens when gas or air becomes trapped in the gastrointestinal tract. It can make the stomach feel tight or full, and may cause pain.

Various behaviors and gastrointestinal conditions have associations with bloating. According to older research, some causes of bloating include:

• the buildup of gas in the gut
• swallowing too much air when eating
• constipation
• IBS
• celiac disease
• food intolerances
• bacterial overgrowth in the small intestine
• gastroparesis, a condition that causes a delay in food moving from the stomach to the intestines
• obstruction in the intestines or bowel
• certain cancers, such as ovarian cancer

People with an inflammatory bowel disease such as UC may report feeling bloated. UC is a condition where the immune system does not function typically, resulting in inflammation and the formation of ulcers in the large intestine.

Learn more about the causes of abdominal bloating here.

Diagnosing UC

The following provides a basis for diagnosis:

Medical and family history

Doctors ask about a person’s other medical conditions, current medications they are taking, and their lifestyle. They also ask about medical conditions of family members.

A major part of the medical history involves noting signs and symptoms. The primary symptoms of UC include:

• watery diarrhea
• abdominal bloating, discomfort, or pain
• blood, mucus, or pus in the stool

Other symptoms may include feeling a constant or sudden urge to have a bowel movement.

Symptoms of severe UC include:

• tiredness
• nausea
• vomiting
• fever
• weight loss

Physical exam

Doctors conducting an exam may:

• check blood pressure, temperature, and heart rate
• apply pressure to the abdomen to detect masses or tenderness
• listen with a stethoscope to abdominal sounds
• perform a digital rectal exam to detect blood in stool

Medical tests

Tests may include:

• Blood tests: These can show signs of UC and its complications, such as anemia. They may also indicate the presence of an infection or other digestive condition.
• Stool test: This can reveal an infection, inflammation, or signs of other conditions.
• Endoscopy of the large intestine: This involves a look into the large intestine to gauge the presence, severity, and extent of UC. It can also help rule out other digestive conditions.

Learn more about UC diagnosis, including more information about tests and real-life stories, here.

Treatment options

Doctors may suggest OTC medications for temporary bloating, such as charcoal caps or simethicone (Alka-Seltzer Anti-Gas).

An alternative treatment for occasional bloating may include probiotics, which are supplements containing live microbes that are beneficial for the gut. Another option involves herbal products, such as peppermint or chamomile teas and turmeric.

When an underlying condition is the cause of bloating, doctors treat the condition. For instance, if the cause is UC, a doctor may prescribe the following medications:

• Aminosalicylates: These reduce inflammation in the intestine. An example is balsalazide (Colazal).
• Corticosteroids: These also decrease inflammation in the intestine and are an option for people whose bodies do not respond to aminosalicylates. An example is prednisone (Deltasone).
• Immunosuppressants: These limit the immune system response and are an option for people whose bodies do not respond to other drugs. An example is azathioprine (Imuran).
• Biologics: These drugs come from natural sources and act on specific parts of the immune system to reduce inflammation. An example is infliximab (Remicade).

Another treatment option for people with UC is surgery. The most common surgery types are ileoanal reservoir surgery and ileostomy, both of which aim to change how the body stores and passes stool.

Diet and UC

The National Institutes of Health advises that people with UC follow a nutritious, balanced diet. This can help reduce symptoms and replace lost nutrients.

Although foods that a person eats cannot cause UC, someone with the condition might find that certain foods might aggravate their symptoms.

Doctors may recommend keeping a food diary to identify foods that tend to cause more of a problem. Depending on an individual’s symptoms and medications, a doctor may advise dietary changes.

Avoiding certain foods when a person has UC can help alleviate symptoms. These foods may include:

• gas-producing foods, including vegetables such as beans, cauliflower, and broccoli
• whole grains
• high fat foods
• nuts
• seeds
• foods with high fiber content
• refined or sugary foods
• carbonated beverages, such as sodas

Learn more about foods to eat for UC here.

Tips for managing bloating

The following are some tips to reduce bloating:

• Try to get regular exercise.
• Keep a food diary to help identify triggers.
• Eat small, regular meals throughout the day.
• Eat slowly.
• Cook vegetables to aid digestion.
• Talk with a doctor about any concerns.

Here are 18 ways to reduce bloating, including short-term and long-term solutions.

Foods to eat to avoid bloating

Following the low FODMAP diet may be beneficial for some people. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are foods that the small intestine does not absorb well.

This diet involves avoiding:

• fruits, such as apples, avocados, plums, mangoes, pears, and blackberries
• vegetables and legumes, such as onions, garlic, lentils, baked beans, cauliflower, eggplant, asparagus, Brussels sprouts, cabbage, broccoli, and bell pepper
• dairy products, such as milk, ice cream, yogurt, cottage cheese, and cream cheese
• honey
• sweeteners in chewing gum and some candies, such as maltitol, and sorbitol

Summary

There is an association between UC and bloating, and people with UC might report that they feel bloated.

However, there are many causes of bloating other than UC. People who experience bloating may benefit from following a low FODMAP diet. On the other hand, if their bloating stems from UC, doctors might prescribe medication and advise the person to follow a balanced diet wherever possible.