Hazel Marie Galon Veloso, M.D.

If you’ve ever experienced waves of sharp pain in your belly along with the feeling that your waistline is inflating like a balloon, you might be experiencing bloating and cramps due to intestinal gas.

Everyone gets gas on occasion. It’s a natural byproduct of the bacteria in your intestines doing their job and breaking down the fibers, sugars and starches in the food you eat. Though gas pain is usually nothing serious, the discomfort can be intense.

Intestinal gas and its discomfort are likely to resolve on their own. Burping or passing gas through the rectum (flatulence) is usually enough to ease your physical discomfort.

Johns Hopkins gastroenterologist Hazel Marie Galon Veloso provides some perspective on bloating and gas cramps, including when to see a doctor.

Does constipation cause gas?
Yes, Veloso says. Anything that slows down the digestive process, such as a low-fiber diet, use of opioid medications or an anticholinergic drug can put the brakes on timely bowel function.

Veloso says eating a diet rich in fiber, staying hydrated and exercising is a good long-term approach for beating bouts of gas and cramping. “If these measures don’t improve constipation and gas, a polyethylene glycol laxative can help,” she notes.

Steps to Avoid Gas Pain
“Since constipation causes gas and cramping, you should try to exercise regularly, stay hydrated and eat a healthy diet with plenty of fiber,” Veloso says.
Here are some other tips:

Don’t drink with a straw.
Choose noncarbonated beverages.
Avoid chewing gum.
If your symptoms persist, see your doctor to rule out food sensitivities, and other conditions.

Gas Pain: When to See a Doctor
Veloso says to be on the lookout for abdominal pain and bloating that persists even after constipation improves.

“You may have celiac disease or small intestinal bacterial overgrowth (SIBO), which can cause these symptoms and can occur with either constipation or diarrhea. You may also have irritable bowel syndrome or another problem,” she notes.

The SIBO Connection
“We see SIBO in patients who have had abdominal surgeries such as roux-en-Y gastric bypass or conditions such as diverticulosis of the small bowel. It’s more common in people with systemic diseases such as long-standing or poorly controlled diabetes, scleroderma, lupus, Crohn’s disease, celiac disease, and those with a lowered immune system.

“Long-term intake of narcotics or acid-suppressive medications such as omeprazole, pantoprazole, lansoprazole and esomeprazole can also cause SIBO. Advanced age can be another risk factor,” Veloso adds.

The condition can be treated with antibiotics, antimicrobial herbs or a low FODMAP diet. FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols.”

Food Intolerance
When it comes to recurring bouts of intestinal gas, food sensitivities such as lactose intolerance are another common culprit. Veloso says some food sensitivities are present at birth (primary); others can develop later on (secondary).

“If you get repeated episodes of gas and cramping, try to notice foods that tend to set it off,” Veloso advises.

Once you identify the food(s) that cause problems, check in with your doctor, who can help determine if you’re reacting to lactose, fructose, gluten or another ingredient. Modifying your diet, taking enzyme pills or other treatments may bring relief.

For women, if your doctor rules out a digestive problem, a visit to the gynecologist may be in order. Bloating and abdominal pain can mean something going on with your uterus, ovaries or fallopian tubes.

There are many causes of bloating and gas pain, and most have treatments that can help you get relief. Any abdominal pain that’s severe or interferes with your life is a good reason to go with your gut and see a doctor.