Bloating is an extremely common symptom that adult women of all ages present to me about for assessment. While often it is a fairly innocent but annoying symptom, bloating may be associated with a variety of underlying gynaecological disorders.
Why do I sometimes feel bloated?
Bloating can be due to a few physiological changes within the abdomen and pelvis. Most commonly transient disturbance and slowing of gut motility leading to distended loops of bowel occur. Bloating can be caused by fluid retention and enlargement of pelvic veins and the uterus late in the menstrual cycle prior to the period. Less often but more concerning bloating may on occasion be due to a growth or tumour in the pelvis.
What kind of conditions might be causing bloating?
Cyclic premenstrual bloating is due in part to fluid retention, increased blood flow into the pelvis and slow gut motility. This is commonly part of PMS/PMT. These symptoms tend to resolve with the arrival of your period. Sometimes the prime disorder lies with a problem with the gastrointestinal tract, particularly if there is a change of bowel habit or the symptoms are not cyclic in nature. Food intolerance may be at the heart of the issue.
Tumours such as ovarian cysts and uterine fibroids as they enlarge may cause little more than a feeling of bloatedness. Least commonly but most seriously ovarian cancer presents with increasing bloating and abdominal distension, often, though not exclusively in postmenopausal women.
What should I do if I am experiencing bloating?
You should see your usual doctor first. If they have concerns, you can obtain a referral to see me for an appointment and assessment. During your appointment we will discuss your medical history, examination and an ultrasound will be performed in my rooms to formulate a diagnosis. Once this is determined, a management plan can be put into action.
What kinds of things can be tried?
Sometimes it is simple dietary changes and addressing issues such as constipation. If your bloating is more related to your menstrual cycle then the introduction of, or changing the formulation of an oral contraceptive pill may be beneficial. Sometimes surgery is required if masses are found in the pelvis.