Bloated stomach - The 5 F's of bloating

Bloating of the stomach (tummy or abdomen) is often due to wind or flatulence, but may arise as a result of other causes.

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Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
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An introduction to bloated stomachs

The word ‘stomach’ is used in a number of ways. People commonly use it to identify the part of our body lying below the rib cage and above the hip bones, otherwise known as the ‘tummy’. This area is known medically as the abdomen. In addition, anatomically, the stomach is an organ of digestion.

Similarly, the words ‘bloating’ or ‘bloated’ are also used in a variety of ways. Most commonly, it describes a feeling of being full or swollen as a result of wind or flatulence.

Hence, when people speak of a bloated stomach, they usually mean that their abdomen (or tummy) feels ‘full’ or ‘swollen’ as a result of wind in the digestive tract.

Doctors refer to this as abdominal distension or abdominal swelling. Wind (or flatulence) is the most common cause of abdominal swelling, and these are situations which do not normally cause any major concerns. However, before a doctor comes to this diagnosis, he or she will eliminate other causes of stomach bloating or abdominal distension.

Causes of abdominal distension

Doctors remember the main causes of abdominal distension by using the five Fs:

  • Flatus (wind or flatulence)
  • Faeces (constipation)
  • Fat (being overweight)
  • Foetus (being pregnant)
  • Fluid (in the abdominal cavity)

The 5Fs provide a quick and easy way of going through possible reasons and causes of stomach bloating, but are not exhaustive.

Flatus causing a bloated stomach

The word flatus is derived from Latin and refers to gas in the intestinal tract.

Most often, it means gas which is passed from the bottom end of the digestive tract (wind), but flatus can also be released when we burp.

Flatus is produced naturally by the action of bacteria on the food we eat. It is estimated that the normal digestive tract produces more than 5 litres of gas a day – visualise this quantity by lining up 5 one litre bottles of water in your house!

Flatus or wind is perhaps one of the most common causes of people complaining of a bloated tummy. From time to time, all of us find that too much gas is produced. Often, the cause is put down to foods we have just eaten (eg. certain types of beans, onions or a curry).

However, some people find that they produce a lot of gas on a regular basis, complaining that their stomach is constantly bloated. There are many reasons for this but the key factors are usually a combination of food intolerances and a disturbance of bacterial flora in the gut.

Although uncomfortable, stomach bloating resulting from excessive wind is unlikely to be a serious health problem and a change in diet, lifestyle and some healthcare advice can help reduce or eliminate symptoms.

Occasionally, stomach bloating can be an indication of more serious problems within the digestive tract. The causes are too numerous and complex to mention in this short article, but these problems are almost always associated with increasing, sudden or severe pain in the abdominal, stomach or tummy area. If you are experiencing any symptom that worries you, seek the advice of a doctor.

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Constipation is a common problem, and it is said that this can be put down to the increased use of pre-prepared and refined foods, and a tendency for people to exercise less. Other aspects of our modern lifestyle, including work pressure and stress can also make one prone to constipation.

The naturopath Jan de Vries often says that what one imports (eats) today should be exported tomorrow. Some people find it difficult to achieve this, only opening their bowels 2 or 3 times a week. Women, for some reason, are more likely to be constipated than men.

Being constipated increases the amount of gas in the digestive tract (as the bacteria are allowed to work longer) which in turn causes a bloated stomach. However, when severe, the accumulation of faeces in the lower gut can, in itself, lead to abdominal or stomach distension.

Pregnancy and being overweight

These are self-explanatory. Swelling or bloating of the stomach occurs gradually over a period of weeks or months and the causes of these forms of abdominal distension are usually quite clear.

Many of us carry a bit extra weight ‘around the middle’. For some unknown reason, excess calories seem to make a bee-line straight for our tummies and this tendency increases as one becomes older, giving rise to the so-called ‘middle-age spread’.

Apart from use of weighing scales, the state of our ‘bloated stomach’ is one of the easiest ways to assess which way our weight is going each day as you work out how easy it is to fasten your trousers, skirt or belt.

It is rare for a woman noticing the gradual swelling of her tummy, having missed her menstrual periods, not to at least consider the possibility that she could be pregnant. True, from time to time, one reads that the cause of a bloated stomach was thought simply to be a bit of extra pudding rather than a baby, but this is not really that common.


A bloated stomach resulting from fluid in the abdomen (medically known as ascites) is rare. However, when it does happen, it almost always indicates a serious health condition. Causes include:

  • Heart problems
  • Liver problems
  • Kidney problems
  • Tumours
  • Certain types of infections (eg. Tuberculosis).

It goes without saying that if you suspect that your stomach bloating is due to any of the above conditions, you should seek medical advice urgently.

What to look out for

This article is only intended to provide a brief guide to the general causes of stomach bloating (abdominal distension) and does not replace any advice from your doctor. If you are concerned about any aspect of your health, it is important that you seek help to obtain a diagnosis and treatment.

In addition, if you are experiencing a distended, swollen or bloated stomach which is unexplained, seek the help of a medically qualified person, especially if you experience the following:

  • Abdominal, stomach or tummy pain
  • A worsening of symptoms
  • Blood in your stools / dark stools
  • Loss of appetite or loss of weight, or both
  • Nausea or vomiting
  • A change in colour of your urine

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