Abdominal meteorism is an increase in the volume of the abdomen due to the accumulation of intestinal gas. This symptom finds its origin mainly in dysfunctions of the small intestine. What are the causes ? And the consequences? How to treat it? Are there solutions to prevent it?

Abdominal meteorism, also called abdominal bloating, is swelling of the abdomen, either apparent or felt by the person, caused by the presence of excess gas in the intestines, or the inability to evacuate them.

One of the most common functional digestive symptoms is abdominal meteorism. It is suspected of affecting nearly one in two French people. It is characterized by a sensation of abdominal distension, mainly under the umbilical or wider topography, with, in two thirds of patients, a visible increase in waist circumference. 

Abdominal meteorism is said to be of functional origin when it is at least 6 months old and no cause is found. It is often made worse by eating and gradually increases throughout the day. It can sometimes be very annoying on a daily basis.

Benign in the majority of cases, abdominal meteorism can however be the symptom of a more or less serious disease, which may require special treatment.

More rarely, abdominal meteorism can be caused by:

• visceral hypersensitivity causing the patient to unpleasantly experience a normal volume of abdominal gas;
• intestinal obstruction;
• gastrointestinal infection;
• food poisoning;
• celiac disease (gluten intolerance);
• chronic intestinal ischemia;
• an attack of appendicitis;
• ascites, which is an accumulation of fluid in the abdomen;
• chronic inflammatory bowel disease (IBD) such as Crohn’s disease;
• Ogilvie syndrome;
• cancer (colon cancer or ovarian cancer).

Different factors can be at the origin of the subjective sensation of abdominal meteorism:

• too much gas absorption, linked to the consumption of carbonated drinks (sodas, sparkling water, cider), excess air swallowed during the meal (aerophagia), too rapid ingestion of insufficiently chewed food, or even prolonged chewing of chewing gum;
• an overproduction of gas in the intestines, usually caused by the consumption of foods that ferment easily in the digestive system such as crucifers (cauliflower, broccoli, Brussels sprouts), or by a malabsorption of sugars such as fructose and sorbitol;
• abdominal muscle dysfunction and / or diaphragm;
• a disturbance of the transit of gases in the intestine;
• an imbalance of the intestinal flora, in particular following an antibiotic treatment, resulting in an upheaval of the fermentation processes and / or a bacterial proliferation which can promote an abdominal meteorism via an increased production of gas in the small intestine ;
• indigestion;
• a lactase deficiency (lactose intolerance) preventing the correct digestion of the sugar contained in milk and dairy products. 

Abdominal meteorism can also be associated with:

• recent weight gain, due to increased intra-abdominal pressure secondary to the development of abdominal adiposity;
• constipation, slow colonic transit slowing the transit of gas in the small intestine;
• diarrhea;
• hormonal changes during pregnancy, the menstrual period and menopause which can promote the overproduction of intestinal gas;
• stress, which can accentuate aerophagia, and therefore trigger or worsen abdominal meteorism;
• smoking, nicotine modifying gastric acidity;
• overuse of laxatives which irritate the lining of the colon;
• age, as transit tends to slow down as we age, allowing food more time to ferment in the digestive system and cause bloating.

Abdominal meteorism can cause:

• a feeling of diffuse malaise;
• noticeable hydro-aeric noises of a gurgling abdomen;
• nausea which can sometimes lead to vomiting;
• flatulence which is sometimes emitted, sometimes not;
• pain throughout the stomach which can be very intense, depending on the sensitivity of the intestine;
• belching.

Treatments for abdominal meteorism are varied.

Digestive dressings

Digestive dressings, such as Pepsane, Polysilane Upsa and Siligaz, contain kaolin, i.e. clay, or silicone derivatives (simethicone, dimethicone) for an anti-foaming effect. Their objectives are to reduce the formation of gases. When abdominal meteorism is associated with heartburn, drugs combining an antacid drug and a digestive bandage, such as Neutroses or Polysilane Delalande, are particularly indicated.

Activated vegetable charcoal

Charcoal (Acticarbine, Arkocaps vegetable charcoal, Carbactive, Belloc charcoal, Formocarbine, Splenocarbine) has the properties of absorbing intestinal gas. It would thus make it possible to fight against their production. It comes in different forms, the oldest being the granulated form. It is sometimes combined with a digestive dressing (Acticarbine, Carbolevure, Carbosylane, Carbosymag).

Antispasmodic drugs for digestive purposes 

Antispasmodics for digestive purposes fight against pain due to abdominal meteorism. Some are combined with a digestive bandage or charcoal (Acticarbine, Dolospasmyl, Météospasmyl, Météoxane) to limit the production of gas liable to cause pain. 

Homeopathy / Phytotherapy

Homeopathic medicines (Gastrocnesin) or herbal medicine (Arkocaps, lemon balm) can also be used in the symptomatic treatment of digestive disorders such as abdominal meteorism, belching and flatulence.

Belly massage

Gentle clockwise belly massages can relieve abdominal meteorism. An anti-bloating massage oil prepared by diluting a few drops of essential oil of peppermint, oregano and basil in a neutral vegetable oil can be used.

If visceral hypersensitivity is suspected

Treatment with antidepressants (tricyclics or serotonin reuptake inhibitors), at low non-antidepressant doses, for at least 2 months can be started. In case of failure, antiepileptics (gabapentin, pregabalin) at low doses may be an alternative. 

In case of constipation

It is recommended :

• reduce its daily intake of lipids and fibers which slow down gas transit;
• practicing physical exercise: for example, pedaling on an indoor bicycle for 75 minutes with periods of effort of 5 minutes interspersed with periods of rest of 3 minutes makes it possible to reduce by two the volume of the gases retained;
• take antispasmodics (trimebutin, phloroglucinol, etc.).

In case of imbalance of the intestinal flora

The intake of probiotics (living bacterial organisms exerting beneficial effects on the individual who ingest them) such as strains of Lactobacilli or Bifidobacteria, is indicated. 

Medicines do not dispense with dietary measures to prevent the production of intestinal gas. Indeed, it is possible by modifying your diet and adopting a healthy lifestyle to prevent abdominal meteorism.

Hygienic-dietetic advice

You are advised to:

• reduce your consumption of carbonated drinks, milk, crucifers and any food with a high capacity to produce gas (white beans, onions, celery, carrots, raisins, prunes, bananas, apricots, wheat germ);
• avoid very fatty foods and those containing sweeteners such as sugar-free chewing gum which promotes the overproduction of gas;
• promote foods that naturally limit the production of intestinal gas such as cilantro, star anise, cumin and fennel;
• decrease the volume of your meals;
• eat slowly, taking the time to chew each bite;
• avoid swallowing too much air during meals;
• get some exercise after meals;
• do not wear tight clothes that hamper digestion;
• stop smoking ;
• engaging in relaxing activities, such as yoga or meditation, to combat stress.