Risk for Abdominal Bloating Increased Among Women, Gastrointestinal Comorbidities

Women and patients with gastrointestinal comorbidities, including irritable bowel syndrome (IBS), chronic constipation, and ulcerative colitis, are at increased risk of experiencing abdominal bloating, according to study findings published in Clinical Gastroenterology and Hepatology.

Researchers conducted a national survey to examine healthcare-seeking behaviors related to bloating and the prevalence of gastrointestinal symptom within the past 7 days. Documented gastrointestinal symptoms include bloating, abdominal pain, dysphagia, nausea or vomiting, fecal incontinence, heartburn, regurgitation, diarrhea, and constipation. Participants completed the Rome IV questionnaires to characterize IBS, functional constipation, and opioid-induced constipation. 

The primary outcome was the prevalence of abdominal bloating in the past 7 days. Participants with bloating answered the National Institute of Health Patient-Reported Outcomes Information System (NIH PROMIS) scale questionnaire to assess the impact on daily living and bloating severity. To assess healthcare utilization, researchers asked participants if they saw a healthcare professional within the last year to resolve their symptoms. 

A total of 264,058 participants were invited to participate in the survey and 88,795 participants were included in the study. In the study population, 13.9% of participants experienced bloating within the last 7 days, with women having an increased probability of bloating (odds ratio [OR], 2.56; 95% CI, 2.43-2.69). Hispanic Black participants and participants older than 60 years of age had decreased odds of bloating. 

Of the patients with bloating in the past 7 days, a diagnosis of irritable bowel syndrome (OR, 2.09; 95% CI, 1.95-2.25), chronic constipation (OR, 2.20; 95% CI, 2.08-2.33) or functional constipation (OR, 1.38; 95% CI, 1.27-1.50), or ulcerative colitis (OR, 1.39; 1.18-1.64) increased the odds of bloating. Other comorbidities with significantly increased odds of bloating included diabetes (P =.02), diverticulitis (P <.001), fibromyalgia (P =.001), gastroenteritis (P <.001), gastroparesis (P <.001), and peptic ulcer disease (P =.02).

Participants with concomitant gastrointestinal symptoms such as abdominal pain, excess gas, and constipation experienced increased odds of bloating (all P <.001), while concomitant diarrhea displayed a lower bloating severity (P <.001). 

Among patients who were symptomatic in the last 7 days, women and Hispanic participants had a higher risk of increased bloating severity. Bloating severity increased with participant ages until 59 years (PROMIS percentile score, 50.3), then decreased in those who were older than 60 years of age (PROMIS percentile score, 45.9). 

Non-Hispanic Black patients were more likely to seek medical care for bloating compared with non-Hispanic White patients. Other factors associated with increased likelihood of seeking a medical professional among patients who were symptomatic in the past 7 days include celiac disease (OR, 2.73; 95% CI, 2.11-3.54), Crohn disease (OR, 2.50; 95% CI, 1.94-3.24), and ulcerative colitis (OR, 2.60; 95% CI, 2.02-3.36). 

Of the participants reporting symptoms within the past 7 days, 7211 (58.5%) never sought medical attention for bloating. Reasons for not seeing medical care include self-resolving symptoms (32.5%), symptoms that were not bothersome (29.9%), and self-management of symptoms using over-the-counter medications (20.8%). In post hoc analysis, researchers excluded 4064 patients reporting self-resolving symptoms and not bothersome symptoms. 

Study limitations include the lack of weighted population estimates in analyses and the exclusion of participants without internet access. 

“The hesitancy in seeking healthcare or discussing bloating in patients may be attributed to lack of routine screening for bloating, lack of focus on bloating complaints by providers, or patients’ dissatisfaction with management of bloating symptoms,” study authors wrote.

This article originally appeared on Gastroenterology Advisor