Crohn's Disease and Ulcerative Colitis (the two main forms of Inflammatory Bowel Disease - IBD) can often cause you to feel bloated and gassy. You might have questions about how to control excess gas and its effects, such as tummy gurgles and breaking wind.
This information answers some of the queries most often raised about bloating and wind. It also contains suggestions and tips some people have found useful in managing these symptoms.
There are several possible explanations for bloating and wind.
- Gas. A major cause of bloating is gas. Gas can be expelled as wind (flatus), but when trapped in the stomach and intestines (bowels) it causes bloating. See more about this below.
- IBS. Bloating is also a common symptom of Irritable Bowel Syndrome (IBS). This is a separate condition from Inflammatory Bowel Disease (IBD), but both conditions make you more likely to develop IBS. So, it is possible for you to have IBS-like symptoms even when your Crohn’s or Colitis is in remission.
- Constipation. You might be more likely to experience bloating if you have constipation. Eating a lot of fatty food can delay stomach emptying, and this, too, may cause bloating and discomfort.
- Surgery. You may also experience bloating if you have adhesions (scar tissue) as a result of previous surgery.
- Serious complications. Rarely, bloating can be a sign of a more serious condition such as toxic megacolon. This is when inflammation in the gut is extensive and severe, which leads to digestive gases getting trapped in the colon, making it swell up. If you have other symptoms such as high fever and pain and tenderness in the abdomen, as well as bloating, speak to a doctor urgently. It is essential to get treatment quickly for this condition, as surgery may be necessary.
It is normal to have gas in your intestine whether you have Crohn’s Disease or Ulcerative Colitis or not. We all produce several litres of gas a day through the normal processes of digestion. Some of this is reabsorbed into the bloodstream and eventually breathed out, the remainder has to be released as wind. Most of us probably break wind on average five to 15 times a day, even if we are unaware of it.
One possible cause of excess gas is swallowing too much air when eating, drinking or talking, known as aerophagia. Certain foods and fizzy drinks can contribute to this. Smoking can also increase the amount of air that you swallow. Some people swallow air as a nervous reaction.
Normal bacteria in the colon can sometimes produce too much gas when breaking down certain foods. Foods containing complex carbohydrates, for example vegetables such as beans, cabbages and Brussels sprouts, are difficult for the body to digest. They are broken down by the gas-producing bacteria instead. Foods that contain sorbitol, an artificial sweetener, can cause similar problems. Poor absorption of food by the small intestine (often common in Crohn’s) means that more undigested food reaches the colon, where bacteria digest it to produce even more gas.
Lactose intolerance can also cause gas. This is a digestive problem, not an allergy. Lactose intolerance is where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products. Instead, the lactose is fermented by the gas-producing bacteria in the colon.
If you have Crohn’s in your small intestine, you’re more likely to be lactose intolerant than people with Colitis or the general population. Some people with Crohn’s or Colitis only get symptoms of lactose intolerance during a flare-up.
I don’t get as bloated if I eat small, regular meals, around six times a day, rather than larger meals less often.
Unfortunately, there is no simple solution - what works for one person may not work for another. However, some people have found the following ideas helpful:
Think about the way you eat
- Create a relaxed environment when eating, as nervous tension at mealtimes can affect digestion.
- Eat small, regular meals (perhaps five to six a day), as an empty bowel produces more wind and rumbles.
- Some people find that eating a large meal late at night makes them feel uncomfortable. If you find this is the case for you, try to leave a longer period of time between eating and going to bed.
- Eat slowly with your mouth closed to avoid gulping down air with your food, and make sure you chew each mouthful thoroughly.
Work out which foods could be affecting you
You may know that you have an intolerance or are sensitive to certain foods or ingredients. (See What to do if you think you might have a food intolerance below.) If you’re having a problem identifying if any particular foods are causing bloating and wind, it can be helpful to keep a food diary for a week or two. Note down everything that you eat and drink and if it resulted in any symptoms.
Some foods, such as baked beans, onions, cauliflower, other pulses, and whole grains are well known to be ‘gassy’. Although what produces a lot of wind for one person may not for another.
Some people find that the following foods affect them:
- High fat foods and eggs – these can produce bad smelling gas.
- Refined and sugary foods, especially those which contain sorbitol – an artificial sweetener.
- Hot spicy food, particularly if you are not used to it.
- Food with a high content of bran fibre (for example, brown bread and some cereals).
- Raw vegetables, particularly if you have Crohn’s Disease and strictures (narrowing of the bowel). Cooking vegetables thoroughly helps to break down the fibres, which may aid digestion, and may improve bloating and wind symptoms.
- Some carbohydrate foods which are cooked and then cooled become ‘resistant starch’ which may cause bloating and wind, when eaten. Such foods include potato or pasta, and cooked potato products that are eaten after reheating, such as potato waffles and oven chips.
What to do if you think you might have a food intolerance
It may be worth experimenting by cutting out certain foods, like those mentioned above, for a short period (four to six weeks) to see this if this helps. However, bear in mind that cutting out a number of foods can mean missing out on valuable nutrients. It’s important, if you can, to maintain a good balanced diet. Talk to your IBD team to see if they can refer you to a dietitian, particularly if you want to try a longer-term or more extensive exclusion diet.
Consulting your doctor is also a good idea if you think you may be lactose intolerant. There are several types and levels of intolerance, so getting the correct diagnosis will help identify the solution that’s right for you.
Some people with IBS have found that eating a low FODMAP diet helps reduce bloating and wind. FODMAP is an abbreviation for a group of food molecules known as fermentable carbohydrates which are found in foods such as fruit, wheat and dairy products. These molecules are difficult to digest properly, so the undigested molecules pass into the colon where they act as a food source for bacteria. As the bacteria digest the FODMAPs, they can cause symptoms such as bloating and wind. Cutting down food containing FODMAPs is thought to relieve these symptoms. Also, if you have IBS or IBS-like symptoms when your Crohn’s or Colitis isn’t active, a low FODMAP diet might be beneficial. It’s quite a restrictive and difficult diet to follow, so if you want to try it, you should get the help of a dietitian to ensure you do not miss out on important nutrients.
See our booklet Food to find out more about how food affects Crohn’s and Colitis, and suggestions for healthy eating with these conditions.
- Drink plenty of fluids. The British Dietetic Assocation recommend 1.6 litres per day for a woman, and 2 litres per day for a man, dependent on age, climate, physical activity and individual condition. This is around six to eight glasses a day. It is worth checking with your IBD team how much water they suggest you should drink.
- Avoid caffeine in coffee, tea and cola. You could try decaffeinated tea, peppermint tea, green tea, or herbal and fruit teas instead.
- Avoid fizzy carbonated drinks because these contain gas.
- Some people with Crohn’s or Colitis say that drinking a large amount of liquid at once causes a build-up of gas for them, particularly if drunk during mealtimes. You might want to think about the way you drink if you find you are feeling gassy soon after mealtimes. It might help to take sips rather than large gulps of liquid.
- Alcoholic drinks can also increase the amount of gas produced.
- Try to limit stress, which can make you gulp air. For example, when you are tense, practise slow breathing.
- Avoid sitting for long periods. If sitting at work, take regular breaks (at least every hour) to stretch the legs and tummy.
- Try to take regular exercise to help improve intestinal transit. Take a short walk after eating in order to move digested food and gas around.
- Gently, but firmly, massage the abdomen from right to left to release trapped wind.
- Practise anal sphincter exercises to help with uncontrollable passing of wind. There is more information about these exercises in our Managing Bowel Incontinence in IBD information sheet which you can find on our website.
- Wear clothes that are not too tight around your waist, as these can increase the pressure on your abdomen and make it harder for wind to pass along normally.
I find high fat and high sugar foods make tummy gurgles and wind worse for me so I try to avoid them.
We’re often a lot more sensitive to our own smells than other people are. However, if you are concerned about odours, the following ideas may help:
- Try to ensure that the room you are in is well-ventilated.
- Light a scented candle, an aromatherapy oil burner (try lavender or lemon oil) or incense stick.
- Some people find that aerosol air fresheners can help mask smells. Try a solid block freshener that works all the time, or a freshener that releases a fragrance at regular intervals.
- Try neutralising sprays or gels that help eliminate odours, such as Neutradol Spray or Gel (available from chemists and supermarkets), or Fresh Drop Smell Stop (available online).
- Wear underwear or pads that absorb gas. These are available online at flat-d.com and myshreddies.com.
- Use a seat cushion that filters gas. This is available from gasbgon.com.
Some people have found herbal remedies helpful in reducing wind. You should tell your doctor if you are taking any herbal remedies. The following suggestions have not been scientifically proven to relieve symptoms, but may be worth trying:
• Herbal infusions, such as camomile, fennel or peppermint
• Peppermint oil
Some people find that simethicone helps with bloating and wind. It can be bought over the counter in products such as Wind-Eze tablets and WindSetlers. Simethicone is an anti-foaming agent, which disperses tiny bubbles of trapped wind.
Some people with Irritable Bowel Syndrome (IBS) have found that some probiotics are helpful in reducing flatulence and wind. Probiotics are a mixture of live ‘friendly’ (beneficial) bacteria taken by mouth. They’re found in some specially fermented yogurt drinks or in tablet form. Probiotics haven’t been proven to reduce wind for people with Crohn’s or Colitis, so speak to your doctor or IBD team if you’re thinking of taking them.
I have reduced my caffeine and alcohol consumption and I drink more live yoghurt drinks. I think all of these changes have helped reduce bloating and gas for me.
We offer more than 50 publications on many aspects of Crohn’s Disease, Ulcerative Colitis and other forms of Inflammatory Bowel Disease. You may be interested in our comprehensive booklets on each disease, as well as the following publications:
• Living with Crohn's or Colitis
• Taking Medicines
• Managing Bowel Incontinence
• Living With a Stoma
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Last reviewed: April 2019