Among healthy people, the prevalence of bloating is around 20-30%, whereas in irritable bowel syndrome (IBS) bloating occurs in 80-90% of cases, mainly in women. The symptom is more of a nuisance than the most serious symptom of IBS. In some cases of IBS, bloating may be the only symptom.
In people with IBS, the abdomen is usually not bloated in the morning, and patients feel that their tummy is flat. During the day, however, bloating gradually develops, and patients feel their abdomen becoming increasingly tight, distended and tense. By the evening, they swap tight clothing (e.g. jeans) for light, loose clothes. Some people with IBS say that their abdomen sometimes swells up before their very eyes.
After going to bed and during the night, the bloating disappears.
Eating provokes bloating, so people with IBS eat little or nothing during the day, because the resulting symptoms interfere with their daily lives. They prefer to eat in the evening, at home. In women with IBS, bloating gets worse in the days before menstruation.
Interestingly, in IBS bloating and abdominal distension are not necessarily caused by increased gas production. In people with IBS, increased sensitivity of the internal organs (so-called visceral hypersensitivity), motility disorders of the digestive tract (dysmotility) and inadequate adaptation of the abdominal wall to increased abdominal pressure all contribute to the symptoms. Of course, eating foods that cause bloating can make existing symptoms worse.
Bloating has a negative impact on the quality of life of people with IBS. The abdominal tension and pain that accompany bloating are the most troublesome symptoms. In IBS, bloating is the hardest symptom to control, which also interferes with daily life.
In most cases, bloating is only a nuisance, but in some cases patients' physical activity and energy levels also decrease, which can be made worse by reduced or skipped meals during the day.
