DR. PHILIPPA KAYE: We’ve all suffered from bloating at some point… but here’s how to tell if it’s a hidden sign of cancer or something more sinister

Have you ever wondered how it is possible that you suddenly look six months pregnant when you didn’t just a few hours ago?

Bloating, even as dramatic as this, affects most of us from time to time. And in most cases, it is simply an unfortunate side effect of overeating.

But it can also be a sign that something is wrong.

Just a month ago, researchers suggested that patients who visit their doctors complaining of bloating and abdominal pain should have regular blood tests, which could help detect more “hidden” cases of cancer.

Pancreatic, stomach, ovarian, and colorectal cancers are all associated with bloating and abdominal discomfort.

It can also be a symptom of a number of digestive tract diseases, including ulcerative colitis, Crohn’s disease, and irritable bowel syndrome (IBS).

If you regularly suffer from bloating, when should you be concerned?

To start, it’s important to remember that bloating is a common occurrence.

And I don’t say that to downplay the impact it can have.

Bloating feels uncomfortable and can make you feel unwell. It can even affect your mood or cause problems with your body image.

And that is why doctors, like me, never ignore the symptom – or should ignore it – when a patient comes to us with a complaint about it.

In medical school we learned about the five F’s of ‘abdominal distension’: the abdomen appears swollen.

These causes include: fetus – a pregnancy; fat – obesity; fluid – again a build-up, medically known as ascites; feces – a build-up, caused by constipation and, most relevant here, flatulence – or gas, probably the most common cause of bloating.

We all have gas in our gastrointestinal tract. We swallow air when we eat, drink or even talk, which results in gas in the stomach, which you can release as a burp.

The teeming microbiome of bacteria in your colon produces gas as they ferment and break down fiber and food.

All of this leads to bloating, where your belly feels larger, fuller and tighter than normal, which can be uncomfortable and painful.

In general, if you feel bloated especially after eating, it is probably food-related.

You may also notice that your bowels are rumbling or gurgling more than normal, that you burp more, and that you pass gas.

Keeping a simple food diary can be helpful, as you may find that you feel bloated after certain trigger foods.

One trigger is suddenly eating large amounts of fiber. Suddenly eating large amounts of high-fiber vegetables such as cauliflower, broccoli, and Brussels sprouts, or beans and onions can cause bloating.

To avoid this effect, it’s best to eat small amounts spread out over a few weeks, rather than loading up your plate from day one.

Conversely, eating too little fiber and drinking too little water can lead to constipation, which often leads to bloating.

Other dietary factors may also play a role. For example, drinking soda or chewing gum can cause or worsen bloating.

Eating too quickly and drinking too much alcohol can also cause bloating, as can food intolerances.

However, if you notice that you have persistent bloating for three weeks or longer, or if you notice that you feel bloated very regularly, more than 12 times a month, see your doctor.

And if you feel like bloating is really affecting your life, please make an appointment. That’s what we doctors are for.

Hormonal factors may play a role: the hormone progesterone relaxes the muscles of the intestines, reducing intestinal mobility and increasing the likelihood of constipation and bloating.

Women may notice bloating during the second half of the menstrual cycle, when progesterone levels are naturally higher.

Bloating may also be related to the hormones in certain hormonal contraceptives, such as the progesterone-only pill, implant or injection, or the combined oral contraceptive pill.

Bloating can also be caused by various conditions, such as Crohn’s disease, celiac disease and ulcerative colitis.

Although there are important differences in the way these diseases manifest, they are all characterized by swelling, inflammation, and ulceration of parts of the intestines.

In addition to bloating, they also cause other unpleasant digestive complaints, such as cramps, diarrhea or constipation and blood in the stool.

Fatigue, loss of appetite, and weight loss are other common symptoms of these conditions, which are collectively known as inflammatory bowel disease (IBD).

High-profile victims include Made in Chelsea star Louise Thompson, 34, who revealed in April that she suffers from ulcerative colitis and had undergone a stoma operation.

Meanwhile, The Only Way is Essex veteran Sam Faiers, 33, revealed in 2014 that she had been diagnosed with Crohn’s disease.

Not all IBD patients require a stoma (when part of the small intestine can be diverted through an opening in the abdomen) and many cases can be treated with medications and lifestyle changes.

If surgery is needed, no matter how serious it is, it can be a huge relief. People like Louise show that you don’t have to be ashamed of it.

Persistent bloating with other symptoms, such as loss of appetite, pain or tenderness in the abdomen or pelvis, feeling full quickly after eating, combined with urinary complaints or unexplained weight loss and fatigue, may be due to ovarian cancer.

Changes in bowel movements (for example, going to the toilet more or less often than normal), changes in stool, such as diarrhea or constipation or both, blood in the stool, bleeding from the buttocks, and stomach pain in addition to a bloated feeling, can also be a sign of colon cancer.

Although this is most common in people over 50, it is increasingly seen in younger people. Dame Deborah James, who died in 2022 at the age of 40 after living with bowel cancer for six years, is a case in point.

If you experience any of these symptoms, contact your doctor as soon as possible.

If you go to the doctor with any of these problems, he or she will ask you all kinds of questions to find out what is going on.

You may be examined and have blood tests or other tests performed to determine the cause of the bloating.

If there is a reason for your bloating, it may be helpful to get a diagnosis and tests done as soon as possible.

I say this with many conditions when people ask me, “How do I know if my symptoms are serious enough to see my doctor?”

My answer to this, regarding bloating, is the same as for many other conditions.

First, you don’t ‘bother’ your doctor with it, that’s our job, and second, if it’s serious enough to bother you, then it’s serious enough to bother me.

However, if it is just bloating and it is persistent or very regular, then it is time to make an appointment.

And ditch the tight clothing. Wearing tight clothing, like skinny jeans, can actually make bloating worse.