‘I'm a Gastroenterologist-This Is the First Thing I Ask When a Patient Tells Me They Have Bloating'

If you're regularly dealing with bloating, trying to pinpoint the root cause can feel like a frustrating game of detective. Between all the different foods in your diet (and the ingredients in those foods), medications and supplements, there's a lot of potential culprits. And that's just what you're physically putting in your body. There are other factors to consider, such as hormonal changes and stress.

"Bloating is by far one of the most common GI complaints I see in my clinic. Out of the 20 patients I saw today, four were seen for bloating," says Dr. Sripathi Kethu, MD, FACG, FASGE, a gastroenterologist who shares gut health tips on social media.

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Dr. Asma Khapra, MD, AGAF, a gastroenterologist with Gastro Health, adds that bloating is one of the most common complaints she hears from patients. There are many reasons for bloating, including lactose intolerance, a bacterial infection called H. pylori, constipation, irritable bowel syndrome, small intestinal bacterial overgrowth (SIBO), celiac disease, eating too much fiber at once and endometriosis.

With so many potential causes of bloating, it can be helpful to work with a gastroenterologist to help you figure out the root cause and come up with a treatment plan. After all, no one wants to go through life feeling bloated!

Here, Dr. Kethu and Dr. Khapra share what you can do on your own to troubleshoot your bloating woes versus when to see a G.I. doc. They also share the first step they take when a patient comes to them with bloating.

Related: Why Do I Always Feel Bloated? Here Are the Surprising Causes of Stomach Bloating-And 25 Ways to Get Rid of It

What You Can Try on Your Own

Dr. Kethu says that there's a lot someone can try on their own before they decide to see a gastroenterologist about bloating. First, he recommends nixing carbonated drinks, alcohol and artificial sweeteners from your diet to see if that makes a difference.

If that still doesn't work, Dr. Kethu recommends taking a daily probiotic. "Give it at least four weeks before deciding if it's working; if there's no clear improvement, stop it."

Dr. Khapra adds that taking a probiotic is a great initial step to take if bloating is something you experience regularly. Probiotics can help with bloating by increasing the amount of good bacteria in the gut, bringing more balance and reducing inflammation.

Since lactose intolerance is a common reason for bloating, Dr. Khapra recommends eliminating dairy from your diet for two weeks to see if that alleviates symptoms. If you found your bloating culprit, rest assured that there are plenty of dairy-free substitutions out there-even ice cream.

Related: Why You Always Feel Bloated After Eating-and What Your Body's Trying To Tell You

For in-the-moment relief, Dr. Kethu suggests taking a peppermint oil supplement can help. Dr. Khapra says that over-the-counter products like Beano and Gas X can help too.

If you've tried troubleshooting on your own and are still experiencing bloating regularly, that's when it's a good idea to start working with a G.I. doc. Both gastroenterologists stress that if you are experiencing bleeding when you poop, are losing weight but you don't know why, have a fever or are in significant pain, those are all reasons to see a doctor ASAP.

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The First Step Gastroenterologists Take When a Patient Is Experiencing Bloating

If you decide to see a gastroenterologist about bloating, Dr. Kethu and Dr. Khapra say that you can expect to be asked for a thorough medical history and have a medical exam during your first appointment.

"I want to know the timing and pattern [of when bloating happens]. Does it come on after meals? Is it tied to certain foods? What are their bowel habits like? I'm also listening for red flags, like unexplained weight loss, blood in the stool and persistent vomiting. In the absence of those, I don't jump straight to labs, imaging or endoscopy. A focused abdominal exam to check for distention, abnormal bowel sounds or a mass is usually enough to rule out anything serious quickly," Dr. Kethu tells Parade.

Part of this first step is figuring out exactly where the bloating is occurring. "I like to differentiate if it is more upper abdominal bloating versus lower abdominal bloating," Dr. Khapra says, adding that she figures this out by asking questions about how the symptoms feel and when they occur. For example, if it's post-meal and accompanied by burping or reflex, that indicates an issue in the upper abdomen. If bloating is associated with diarrhea or constipation, that means it's happening in the lower abdomen.

For women, bloating can be a common side effect of menstruation or endometriosis, Dr. Khapra adds, which many people don't realize. For this reason, she also asks women questions related to their cycle.

After this initial visit, Dr. Kethu says he'll recommend cutting out carbonated drinks, alcohol and artificial sweeteners if the patient hasn't done that already. Already did that? Then, it's time to try an elimination diet-a step both doctors say is next.

Elimination diets can look different based on the individual, but both doctors say that a common approach is cutting out dairy for a period of time followed by cutting out gluten for a period of time. If that still doesn't help, both say they would recommend the low-FODMAP diet, which is an eating plan where foods that are hard to digest are avoided. The low-FODMAP diet is not meant to be a long-term eating plan, but it can help identify triggering foods in the short-term.

"The low-FODMAP diet can be very effective, but it really should be done with proper guidance, rather than self-directed long-term over-restriction, which can lead to nutritional gaps and actually harm the gut microbiome. The goal is always to find the most liberal diet that controls symptoms, not to stay restrictive indefinitely," Dr. Kethu explains.

The Mind-Gut Connection To Consider

Besides taking these steps, it's important to think about the mind-gut connection and consider if stress or anxiety could be the cause for bloating. "Stress and anxiety directly worsen bloating by increasing gut sensitivity and altering intestinal motility; it's not just psychological," Dr. Kethu says.

If stress or anxiety are causing bloating or other digestive issues, Dr. Kathu notes that cognitive behavioral therapy and gut-directed hypnotherapy have demonstrated real benefit for bloating linked to IBS, particularly when symptoms persist despite dietary changes or when stress is clearly a driver.

"These therapies work by modulating the gut-brain axis, reducing visceral hypersensitivity and dampening the stress response. They're among the most effective long-term options we have for functional bloating and more patients should know they exist," he says.

What's most important to know is that there are solutions that will work; it just may take a little detective work first. If bloating is interfering with your daily life, take this as a sign to see a gastroenterologist about it. After all, it's their job to help!

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Sources:

• Dr. Sripathi Kethu, MD, FACG, FASGE, gastroenterologist who shares gut health tips on social media.
• Dr. Asma Khapra, MD, AGAF, gastroenterologist with Gastro Health.
• Helicobacter pylori (H. pylori) infection. Mayo Clinic.
• Hungin, A. S. P., Mitchell, C. R., Whorwell, P., et al. (2018). Systematic review: probiotics in the management of lower gastrointestinal symptoms-an updated evidence-based international consensus.Ailment Pharmacology & Therapeutics. 47(8):1054-1070.

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This story was originally published June 8, 2026 at 2:25 PM.