How to Fight Abdominal Bloating and Indigestion: Causes, Treatments, and Tips

Most of us have experienced bloating and indigestion at one time or another. But for some people, abdominal bloating is a daily occurrence. Bloating can be uncomfortable and even downright painful. If you notice that your stomach frequently feels bloated or that you don’t seem to be digesting your meals well, here are some tips.

What are the symptoms of bloating and indigestion?

Bloating is the sensation that your abdomen is uncomfortably full. It can happen in the upper abdominal area (which contains the stomach, gallbladder, liver, and upper parts of the large and small intestine) or the lower abdominal area (the majority of the large and small intestines). Bloating symptoms can include:

• A feeling that gas is trapped inside your belly

• Stomach churning

• Excessive flatulence

• Nausea

• Getting full too soon after you start eating

• Discomfort in specific areas of your abdomen

There is a lot of overlap between bloating and indigestion. Their symptoms are similar, but indigestion may also include acid reflux or heartburn.

What causes bloating?

Bloating is usually caused by too much gas building up in the digestive system. Some reasons for this gas buildup can include: 

• Eating too quickly

• Swallowing too much air

• Being intolerant to foods

• Having an imbalance of “good” and “bad” bacteria in the gut

• Not having enough digestive enzymes to break down specific foods

• Suddenly adding a large amount of fiber into your diet

But gas buildup is not the only cause of bloating. It can also be caused by fluid retention, slowed digestion, and constipation. 

Serious (but rare) causes of bloating

People with certain conditions may have more permanent and severe bloating. This bloating is often accompanied by serious problems like unintentional weight loss, unexplained anemia, fevers, or blood in the stool. 

Conditions that can cause severe bloating include:

• Cancer

• Liver failure

• Problems with the pancreas

• Heart failure

• Bowel blockages 

What are the causes of lower vs. upper abdominal bloating?

Where you experience bloating can sometimes give you clues about the cause. Though it’s not an exhaustive list, upper abdominal bloating might be caused by the following:

• Gastroparesis: This is a condition in which the stomach does not empty fast enough.People with diabetes can have nerve damage that prevents the stomach from working properly. This causes food to build up in the stomach, leading to a sensation of upper abdominal bloating. 

• Swallowing too much air: This can happen from chewing too much gum, drinking carbonated beverages, or even smoking. 

• Acid reflux: When stomach acid creeps up into the esophagus, it can cause pain and a full sensation in the upper abdomen.

• Gastritis: This is a medical term that just means “inflammation in the stomach.” The inflammation could be caused by an H. pylori infection or damage to the stomach wall lining. Stress, alcohol, medications, and smoking are common culprits. 

Lower abdominal bloating, on the other hand, is felt in the area around and below your belly button. Lower abdominal bloating is more common in the following scenarios:

• IBS (irritable bowel syndrome) or functional dyspepsia: It’s thought that IBS and functional dyspepsia might be the same thing, or at least very similar conditions. Functional dyspepsia just means that the cause of the digestive symptoms is unclear. Both conditions are characterized by pain, cramping, or abdominal discomfort. In IBS, symptoms often worsen after eating certain foods or beverages. You might have diarrhea, constipation, or a combination of both. A bowel movement can make IBS symptoms temporarily better or worse. 

• Food intolerance: The most common food intolerance is lactose intolerance. This is when the sugar in dairy products causes gas, bloating, belching, upset stomach, and/or bowel movements. Food intolerances happen when you don’t have enough digestive enzymes in your body to break down certain types of foods. It is common to have food intolerances to wheat, dairy, or soy, among other foods.

• Hormone fluctuations: More common in women, hormone fluctuations can cause you to retain more fluid and have slower digestion. Both of these problems can lead to bloating in the lower abdomen.

• Imbalance of “good” and “bad” bacteria: If your gut microbiome isn’t healthy, you might experience bloating in the lower or upper abdomen. SIBO (small intestinal bacterial overgrowth) is a common cause of bloating. It’s when too much bacteria builds up in the small intestine. The bacteria feed on the food in the digestive tract, and they emit gas. The gas causes painful bloating and indigestion. Some people with IBS also have SIBO.

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How do I treat painful bloating?

It really depends on the cause of your symptoms. As you can tell, there are many possible causes of bloating. It is important to get a full medical evaluation if you have any concerns, so that you can treat your symptoms confidently. However, if you are interested in trying some home treatment options before seeing a healthcare provider, the tips below can get you started. 

Lifestyle changes and home remedies

Before we get into diet, reducing stress and chewing your food thoroughly can both help with bloating (your mother was right).

But most people can start with dietary changes. Generally, here are some things you can try:

• Eat a diet low in FODMAPS foods. If you think you might have IBS, consider following a low-FODMAPS diet until your symptoms have stabilized for a while. Then you can gradually reintroduce foods that you can tolerate.

• Cut down on foods that frequently cause bloating. This includes sugar, caffeine, and carbonated beverages. 

• Increase your fiber intake gradually. Fiber is great for all sorts of things, but you’ll want to ramp it up slowly to avoid unpleasant digestive symptoms. 

• Experiment with removing dairy or wheat from your diet. If you have a food intolerance, you might feel better a few days after cutting out wheat and dairy. But it may take up to a few weeks to see full improvement. You can do the same with any other food you suspect might be causing bloating. 

Supplements

Some people prefer to try supplements before medications to treat their bloating. While there is not enough evidence to know for sure how well these help, they are generally safe when taken in recommended doses. You can try:

• Digestive enzymes: These are most helpful if you have lactose intolerance. But some people have reported improvement after taking over-the-counter digestive enzymes prior to a meal. A simpler solution might be to chew your food extra thoroughly, as digestive enzymes are released into saliva as you chew. 

• Probiotics: Depending on the cause, these may or may not help your symptoms. A review of 15 studies found that certain strains of probiotics (“good” bacteria) may help lower abdominal bloating and pain caused by IBS. 

• Fiber supplements: Wait, didn’t we just say fiber can cause bloating? Long-term, fiber actually helps prevent bloating. It moves food through the digestive tract more quickly, keeping things “cleaned out,” so to speak. Be sure to drink plenty of water along with the fiber, since fiber absorbs water. 

• Ginger supplements: Aside from its other health benefits, ginger has been shown to decrease flatulence, abdominal bloating, and indigestion. 

• Peppermint oil: Oral supplements may improve symptoms of IBS and functional dyspepsia. But be careful if you also have heartburn, because peppermint can worsen acid reflux. This is because peppermint relaxes the lower part of the esophagus, allowing stomach acid to come back up. 

Medications

Medications are only recommended for certain conditions that cause bloating and indigestion. Here are some common medications that might be prescribed:

• Proton-pump inhibitor (PPI) medications: If you have an ulcer or severe heartburn, your healthcare provider might recommend a medication. If you have not responded to other medications, they might suggest a PPI such as lansoprazole, pantoprazole, omeprazole or esomeprazole. 

• Clarithromycin and amoxicillin: For people who are diagnosed with H. pylori — a bacterial infection that can cause ulcers and stomach pain — antibiotics are recommended. These usually include clarithromycin and amoxicillin. Symptoms of dyspepsia often resolve once the H. pylori is gone.

• Neomycin or rifaximin: These antibiotics are commonly used to help people with IBS or SIBO (often, they have both conditions). Rifaximin, in particular, is considered a first-line treatment for SIBO. Since it is not absorbed systemically, it can kill harmful bacteria in the gut without causing as many side effects.

• Prokinetic agents: A medication to speed up the passage of food from the stomach can be helpful for people with gastroparesis or delayed gastric emptying. The most commonly used include metoclopramide (Reglan), erythromycin, and domperidone. All of these medications require careful monitoring and a prescription. 

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Written by:

Nicole Rowe, MD

Dr. Nicole Rowe, MD, is a telehealth family practice physician. She received her medical degree from the University of North Carolina School of Medicine and completed her residency in family medicine at University of Colorado’s Swedish Medical Center.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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