Bloated after every meal? Six causes and how each is treated

1. IBS with visceral hypersensitivity

The commonest cause: a normal amount of gas felt as painful distension. Treated with antispasmodics, low-dose neuromodulators and a supervised low-FODMAP diet.

2. Small intestinal bacterial overgrowth (SIBO)

Bacteria in the wrong place ferment food early. Diagnosed with a hydrogen/methane breath test; treated with targeted antibiotics and correction of the cause (slow motility, PPIs, previous surgery).

3. Constipation

A loaded colon ferments longer. Treat the constipation — and check for dyssynergia if straining is a feature.

4. Lactose or fructose intolerance

Milk, sweets, fruit juice and honey feed the bloat. A breath test tells you which, so you restrict only what matters.

5. Celiac disease

Under-recognised in North India. A simple blood test (anti-tTG) while still eating wheat, confirmed by endoscopic biopsy.

6. Abdomino-phrenic dyssynergia

In some people the diaphragm descends and the abdominal wall relaxes after meals — visible distension with little gas. Biofeedback-based retraining helps.

What Dr Paliwal recommends

Do not self-restrict foods for months. A structured evaluation at a clinic with a breath-test lab and dietitian finds the cause in a couple of visits.

Dr Maneesh Paliwal

MBBS, MD, DM Gastroenterology & Hepatology (SGPGI), SCE (UK). Senior Consultant, PSRI Hospital; founder, Gut Liver Obesity Clinic, Chittaranjan Park. 22+ years; founded Delhi's first luminal GI lab.