'I would look pregnant': When is bloating the sign of something more serious? An expert weighs in

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We all know the feeling: you're on your period or you've eaten a big meal and your stomach feels painfully bloated. But sometimes, a distended abdomen can be more than just a passing discomfort—it could be a sign that something’s off in our bodies.

From inflammation in our stomach to hormonal changes, or even the early signs of cancer, Yahoo Canada spoke to women and an expert about when bloating is a bigger issue—and when you should seek treatment.

Kate Hickmott, a 38-year-old living in Mitchell, Ont., experienced “very painful” bloating for as long as she could remember. When she initially sought help, she was diagnosed with gastritis, an inflammation in the stomach lining; however, the bloating didn't improve with medication, and her condition worsened years later.

“I would look pregnant…and it just didn’t feel right–the amount of pain the bloating caused and how rock solid my stomach felt,” Hickmott said.

When she had a colonoscopy, she was told she had irritable bowel syndrome (IBS), a common and chronic gastrointestinal disorder.

“I told myself I’m sure everyone bloats like this and I guess I’ll just live with it,” Hickmott said.

Over time her symptoms multiplied and worsened. She would be bedridden from migraines, unable to open her eyes. She developed “extreme lower back and tailbone pain,” and she ended up in the emergency room when they discovered a cyst on her left ovary. “I was scared,” said Hickmott. “And I wasn’t able to manage the bloating whenever it would flare up. Nothing helped, not drinking more water, lying down, or taking a walk. Nothing made it less painful.”

When Hickmott was diagnosed with endometriosis, she cried from relief at finally having an answer as to what was causing her pain. The disorder causes tissue lining the uterus to grow in places it doesn't belong, like the bladder and stomach. The build-up of tissue can become painfully inflamed and can cause Endometriosis bloat, or “endo belly,” is an uncomfortable bloating that can last for hours, days or weeks.

Hickmott had excision surgery to remove excess endometrial tissue, which she said alleviated her lower back pain. “I felt amazing. The bloating stopped.”

Dr. Ruth Vilayil, a clinical assistant professor at the University of British Columbia and an OBGYN, said abdominal bloating, which is quite common, can have many potential causes and it can be tricky to nail down the source.

“Typical abdominal bloating should be off and on, or cyclic,” she told Yahoo Canada, adding that for women who are still menstruating, bloating might be more prominent the week before their period. “So worrisome and concerning bloating could be something that’s a bit more steady, or a daily bloating that’s come up or new for a person.”

According to the Mayo Clinic, nearly 40 per cent of the general population report having issues with chronic abdominal bloating and distention. The causes can range from anything like food intolerance to gut-brain interaction disorders, like IBS, or an abnormal viscerosomatic reflex, which controls gas clearance.

When a patient comes to Vilayil for their bloating issues, she considers things like pregnancy, polycystic ovarian syndrome, premenstrual syndrome (PMS), a cyst in the ovaries or something more serious, like cancer in the ovaries. “That can give the sensation of increased gas or increased abdominal circumference," she explained.

Alvina Nadeem is a 37-year-old living in Montreal, who was also diagnosed with gastritis when she went to the doctor for bloating issues. “I would feel really swollen and there was a pain,” said Nadeem, adding that her medication wasn’t helping and her pain got worse. Nadeem thought she might be going through perimenopause. “The bloating was constant and…it felt like really intense menstrual cramps.” After an ultrasound and MRI, Nadeem was diagnosed with ovarian cancer.

“Luckily, Stage 1…which means everything was contained and there was only one location,” said Nadeem. “I’m just really grateful I listened to myself and got it checked out.” Nadeem added if she could give advice, it would be to go to the doctor if you’re feeling something is off, rather than sitting on it. “And it might be nothing, but that one day wasted in a waiting room is worth your life.”

Vilayil said certain things that would raise an alarm for bloating include if it’s new onset, the severity, if it’s associated with unintentional weight loss or a decreased appetite, vomiting, diarrhea, blood in the stool or belly pain. “Especially if it wakes you up at night,” she added.

Still, Vilayil said there’s so much individual variation when it comes to bloating, so if you’re hoping to manage what might be a normal bloating issue, she recommends starting with a dietary check. If the issue is PMS-related or related to hormone fluctuations, she recommends exercise.

“Cardiovascular exercise, in particular, can help manage some of these symptoms," she said. Still, Vilayil urges people to get checked out if something is off regardless, rather than minimizing or “explaining away” their symptoms.

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