Patients with lactose intolerance are deficient in lactase, an enzyme necessary in the digestion of lactose (a disaccharide found in milk, yogurt, and ice cream). Lactose is a fermentable, gas-producing substance in the stomach that, if left undigested in the intestines, is fermented by naturally occurring bacteria (the normal flora of the gastrointestinal tract) that produces gas and subsequent abdominal bloating.
This is a condition where the body is unable to break down gluten, a protein found in foods made with wheat, barley, rye, and triticale. The immune system reacts to gluten, creating toxins that destroy the villi in the small intestines, causing poor absorption of nutrients.
H. pylori bacterial infection
This predisposes patients to hyperacidity, ulcer formation, and gastroesophageal reflux, which as mentioned earlier, causes gas increased gas production.
This is a condition seen most commonly in the elderly population, where there is an outpouching of the intestinal walls where stool can pile up. This may lead to intestinal obstruction and inflammation, which may also manifest as abdominal bloating.
Specifically, giardiasis, hookworm infection, and amoebiasis are gastrointestinal parasites that can cause bloating.
Short Bowel Syndrome
This is a condition seen in patients who have gone gastrointestinal resection, have birth defects/hereditary conditions (intestinal atresia), Crohn’s disease, or any condition causing a portion of the large or small intestine to not function properly, leading to poor absorption of nutrients.
When to seek consultation
Abdominal bloating alone may not be a cause for serious concern, if patients are constipated, increased intake of fiber and hydration may resolve their bloating.
However, when abdominal bloating is accompanied by other symptoms such as uncontrolled/excessive vomiting, haematemesis (blood in the vomit), hematochezia/melena (blood in the stool), nausea, a loss of consciousness, uncontrolled diarrhea, or no bowel movement for three days, then patients should seek consultation immediately.