DR PHILIPPA KAYE: We ALL get bloated from time to time… but here’s how to tell if it’s a hidden sign of cancer or something else sinister

Have you ever looked down at your belly and wondered how you suddenly look six months pregnant when a few hours earlier you didn’t?

Bloating, even as dramatically as this, affects most of us from time to time. And in most cases, it’s just an unfortunate side effect of over-indulging.

If bloating is persistent or very regular, get medical advice, says Dr Philippa Kay

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

Just last month, researchers suggested giving routine blood tests to patients who visit their doctor complaining of bloating and stomach pain could help flag up more ‘hidden’ cancer cases. 

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

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

So, if you’re suffering bloating regularly, when should you worry?

Well, for a start, it’s important to remember that bloating is common. 

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

Bloating feels uncomfortable and can make you feel unwell and can even affect people’s mood, or cause issues with body image. 

And that’s why doctors, like me, don’t — or shouldn’t — ever dismiss the symptom, if a patient comes to us complaining of it. 

Bloating, even as dramatically as this, affects most of us from time to time. And in most cases, it’s just an unfortunate side effect of over-indulging. But bloating can also be a sign that something is wrong

Pancreatic, stomach, ovarian and colorectal cancer are all associated with bloating and abdominal discomfort. It can also be a symptom of a range of diseases of the digestive tract, including ulcerative colitis, Crohn’s and irritable bowel syndrome (IBS)

Back in medical school, we were taught about the five Fs of abdominal ‘distension’ — when the tummy appears swollen.

These causes are: foetus – a pregnancy; fat – obesity; fluid – again, a build-up, known medically as ascites; faeces – a build up, caused by constipation and, most relevant here, flatus – 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 leading to gas in the stomach, which you might release as a burp. 

The teeming microbiome of bacteria in your large intestines produce gas as they ferment and breakdown fibre and food. 

All this leads to bloating, where your tummy feels bigger, fuller and tighter than usual, which can be uncomfortable and painful. 

As a general rule of thumb, if you mainly feel bloated after eating, it’s probably related to that.  

You might also be aware that your guts are more rumbly or gurgly than usual along with more burping and the need to pass wind.

Keeping a simple food diary can be helpful as you may notice that you get more bloated after particular trigger foods. 

One trigger is suddenly eating loads of fibre — suddenly eating loads of fibrous veg such as cauliflower, broccoli and sprouts, or beans and onions can trigger bloating.

The way to avoid this effect is introducing small amounts, over a few weeks rather than loading up your plate on day one. 

Conversely, eating not enough fibre and not drinking enough water can lead to constipation, which often leads to uncomfortable bloating. 

Other dietary factors can also be involved, for example, bloating can be caused, or worsened by drinking fizzy drinks or chewing gum. 

Eating your food too quickly and drinking too much alcohol can also cause bloating, as can a food intolerance. 

But if you find that you are persistently bloated, for three weeks or more, or if you find that you feel bloated very regularly, over 12 times in a month, please see your doctor.

Likewise, if you feel bloating is really affecting your life, please make that appointment. It’s what we doctors here for.  

Hormonal factors can play a role: the hormone progesterone relaxes the muscles of the intestine, slowing down mobility within the gut, meaning that constipation and bloating are more likely. 

So women may notice that during the second half of the menstrual cycle, when progesterone levels are naturally higher, that you become bloated.

Bloating can also be related to the hormones found in some hormonal contraception such as the progesterone only pill, implant or injection, or the combined oral contraceptive pill.

Bloating can also be due to various conditions, for example Crohn’s disease, coeliac disease and ulcerative colitis. 

While there are important differences in terms of how these disease manifest they are all characterised by parts of the gut becoming swollen, inflamed, and ulcerated.

Alongside bloating, they cause other distressing digestive symptoms, such as cramps, diarrhoea or constipation and blood in the stool.

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

Famous bowel disease sufferers include Made in Chelsea star Louise Thompson, 34, who revealed in April that she suffers from ulcerative colitis and had undergone surgery to have a stoma fitted

Not all IBD patients need a stoma — when part of the small intestine can be diverted out of an opening in the abdomen — and many cases can be managed with medication and lifestyle changes

Famous sufferers include Made in Chelsea star Louise Thompson, 34, who revealed in April that she suffers from ulcerative colitis and had undergone surgery to have a stoma fitted.

Meanwhile, The Only Way is Essex veteran Sam Faiers, 33, went public with her Crohn’s disease diagnoses in in 2014. 

Not all IBD patients need a stoma — when part of the small intestine can be diverted out of an opening in the abdomen — and many cases can be managed with medication and lifestyle changes. 

However if surgery is needed, while serious it can be incredibly relieving and people like Louise show it’s nothing to be ashamed of.

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

Likewise, a change a bowel habits — so, going more or less often than usual — changes to your stools, such as diarrhoea or constipation or both, blood in your stool, bleeding from your bottom, and stomach pain in addition to bloating could be a sign of bowel cancer.

While this is most common in over 50s it is being seen more in young people — Dame Deborah James, who died in 2022, aged 40, after living for six years with bowel cancer, is a case in point. 

So if you experience any of these symptoms, please see your GP without delay.

If you do go to the doctor with any of these issues, they’ll ask you lots of questions to try and work out what is going on. 

You might be examined and there could be blood tests or other investigations to try and work out the cause of the bloating. 

If there is a concerning reason for your bloating then being diagnosed and investigated sooner rather than later is likely to be helpful.

I say it for many conditions when people ask me: ‘How do I know if my symptoms are serious enough to bother my doctor?’

While bowel cancer is most common in over 50s it is being seen more in young people — Dame Deborah James, who died in 2022, aged 40, after living for six years with bowel cancer, is a case in point

My answer here, with regards to bloating, is the same as for many other conditions.

Firstly, you aren’t ‘bothering’ your doctor, it is our job, and secondly, if it is serious enough to bother you, it is serious enough for you to bother me. 

When it comes to bloating though, if it is persistent or very regular, time to make that appointment.

And ditch the tight clothes. Wearing clothes which are tight, like your tight fitting skinny jeans, can actually make bloating worse.