Dr Ian Berkowitz


Bloating and Gas

Bouts of excess bloating, belching and gas often resolve on their own. Consult your doctor if your symptoms don't improve with changes in eating habits or you notice:


Persistent or severe abdominal pain

Bloody stools

Changes in the color or frequency of stools

Unintended weight loss

Chest pain

These symptoms could signal an underlying digestive condition. Intestinal symptoms can be embarrassing — but don't let embarrassment keep you from seeking help. Treatments are available.

Bloating, burping and passing gas are natural and are usually caused by swallowed air or the breakdown of food through digestion. You may experience gas and gas pains only occasionally or repeatedly in a single day.

When gas and gas pains interfere with your daily activities, there may be something wrong. Find out how to reduce or avoid gas and gas pains, and when you may need to see your doctor.

Bloating: Gas buildup in your stomach and intestines

When gas doesn't pass through belching or flatulence, it can build up in the stomach and intestines and lead to bloating. With bloating, you may also have abdominal pain that can vary from mild and dull to sharp and intense. Passing gas or having a bowel movement may relieve the pain.

Bloating may be related to:

Eating fatty foods, which can delay stomach emptying and make you feel uncomfortably full

Drinking carbonated beverages or eating gassy foods

Eating too quickly, drinking through a straw, chewing gum or sucking on candies, resulting in swallowing air

Stress or anxiety


A gastrointestinal infection, blockage or disease

Irritable bowel syndrome, a condition characterized by abdominal pain or cramping and changes in bowel function

Conditions such as celiac disease or lactose intolerance in which the intestines aren't able to digest and absorb certain components of food

To reduce bloating, it may help to avoid or reduce the amount of gas-producing foods you eat. Many carbohydrates cause gas, and the following items are common culprits:



Brussels sprouts


Carbonated drinks


Chewing gum

Fruits, such as apples, peaches and pears

Hard candy


Milk and milk products


Sugar alcohols found in sugar-free foods (sorbitol, mannitol and xylitol)

Whole-grain foods

Belching: Getting rid of excess air

Belching or burping is your body's way of expelling excess air from your stomach. It's a normal reflex caused by swallowing air. You may swallow excess air if you eat or drink too fast, talk while you eat, chew gum or suck on hard candies, drink carbonated beverages, or smoke.

Acid reflux or gastroesophageal reflux disease (GERD) can have the same effect. If stomach acid backs up into your esophagus, you may swallow repeatedly to clear the material. This can lead to swallowing more air and further belching.

Some people swallow air as a nervous habit — even when they're not eating or drinking. In other cases, chronic belching may be related to inflammation of the stomach lining (gastritis) or to an infection with Helicobacter pylori, the bacteria responsible for some stomach ulcers.

You can reduce belching if you:

Eat and drink slowly. Taking your time can help you swallow less air.

Avoid carbonated drinks and beer. They release carbon dioxide gas.

Skip the gum and hard candy. When you chew gum or suck on hard candy, you swallow more often than normal. Part of what you're swallowing is air.

Don't smoke. When you inhale smoke, you also inhale and swallow air.

Check your dentures. Poorly fitting dentures can cause you to swallow excess air when you eat and drink.

Treat heartburn. For occasional, mild heartburn, over-the-counter antacids or other remedies may be helpful. GERD may require prescription-strength medication or other treatments.

Flatulence: Gas buildup in the colon

Intestinal gas is typically caused by the fermentation of undigested food, such as plant fiber, in the colon. Gas can also form when your digestive system doesn't completely break down certain components in foods, such as gluten or the sugar in dairy products and fruit.

Other sources of intestinal gas may include:

Food residue in your colon

Changes in intestinal bacteria due to antibiotics or other medications

Poor absorption of carbohydrates, which can upset the balance of helpful bacteria in your digestive system

Swallowed air that moves to your colon

Constipation, since the longer food waste remains in your colon, the more time it has to ferment

Sometimes, gas indicates a digestive disorder, such as irritable bowel syndrome or lactose intolerance.

To prevent excessive gas, it may help to:

Avoid the foods that affect you most. Common offenders include beans, peas, lentils, cabbage, onions, broccoli, cauliflower, whole-wheat bread, mushrooms, and beer and other carbonated drinks. If dairy products are a problem, try low-lactose or lactose-free varieties.

Eat fewer fatty foods. Fat slows digestion, giving food more time to ferment.

Temporarily cut back on high-fiber foods. Fiber aids digestion, but many high-fiber foods are also great gas producers. After a break, slowly add fiber back to your diet. Add products such as Beano to high-fiber foods to help reduce the amount of gas they produce.

Eat slowly. Try to make meals relaxed occasions. Eating when you're stressed or on the run can interfere with digestion.

Get moving. It may help to take a short walk after eating.

Try an over-the-counter remedy. Some products such as Lactaid or Dairy Ease can help digest lactose. Products containing simethicone (Gas-X, Mylanta Gas) haven't been proved helpful, but they're commonly used to help break up bubbles in gas.

Phone for appointment

Mon - Friday: 

08:30 - 16:30 

Tel: +27(0)11 482 8556/7