Gynecological Obstruction and Gastrointestinal Bloating

Gynecological Obstruction
If abdominal bloating is persistent rather then cyclical, it might be due to a mass such as an ovarian cyst or uterine fibroid, or, especially in women over 50, an ovarian cancer tumor. "Age makes a difference," Dr. Janik says. "An increase in abdominal size is much more concerning in women in the postmenopausal range."

To determine if a mass is present, gynecologists will usually perform a transvaginal ultrasound so that they can see if there is a mass on the ovaries that is putting pressure on the bladder or bowel and causing abdominal distension. Women with ovarian cancer may also have ascites, which is excess fluid around the abdomen that can cause bloating.



Gastrointestinal Bloating
Bloating that is not hormonal in nature is often due to gastrointestinal problem. Lin Chang, MD, an associate professor of medicine in the division of digestive diseases at University of California, Los Angeles, says that the first step in figuring out the cause of abdominal bloating is taking a detailed history to determine, among other things, if it's associated with eating or drinking and or with other symptoms.

Bloating can be caused by diet, particularly if someone who has a high salt intake or eats a lot of gas-producing foods such as cruciferous or leafy vegetables or beans. Calcium supplements can also cause gas in some people. Doctors may recommend that people avoid these foods to see if they're the culprit.

But the most common gastrointestinal cause of abdominal bloating, Dr. Chang says, is irritable bowel syndrome (IBS). IBS is a common condition characterized by abdominal discomfort and diarrhea and/or constipation and abdominal bloating.

Women with IBS do not usually have more gas and bloating than other people, but instead have a hypersensitivity to gas. While IBS is difficult to treat, it may be helped by medications that ease constipation, tricyclic antidepressants or even psychotherapy.

Other women may have only abdominal bloating, Dr. Chang says. This may be the result of a partial or complete intestinal blockage. There are many possible causes of these blockages, including scar tissue from prior surgeries, certain medications, abdominal infections and hernias.

Those who have bloating, along with discomfort in the upper gut, may have a food intolerance such as an intolerance to lactose, the sugar in milk, or fructose, the sugar in fruit. Such intolerances can be handled by simply avoiding lactose or fructose. Women with lactose intolerance may also choose to treat milk products with the enzyme lactase.

In rare cases, women may have parasitic infection or an inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis. Dr. Chang notes that bloating is not the prominent symptom of IBD; these diseases are usually distinguished by red-flag symptoms such as blood in the stool or a family history of IBD.

Bloating is very common in women, but if you have bloating that's making you uncomfortable, especially if it's persistent, experts say that getting it checked out is worthwhile.