COPD and Bloating: Why and What to Do
“Feeling bloated” is an unexpected – but common – symptom of COPD1. Bloating affects everyone differently, but many people who “feel bloated” report flatulence (gas), frequent burping, and abdominal rumbling2. Although about 20% of the entire population experiences occasional bloating2, for individuals with COPD, extra pressure and gas can make breathing even more difficult.
This month, we reached out to the COPD community to learn more about their experiences with COPD bloating. Keep reading to learn more about how bloating affects people with COPD, what causes COPD bloating, and how to prevent and treat this symptom!
Thoughts from the community
“At rehab the other day, two of us were discussing when our ‘babies’ were due”
“I wish people would realize this and quit asking me if I’m gaining weight”
“Talked to my lung doctor about this bloating and pressure under my rib cage… She didn’t know!”
“Ugh, it’s the worst”
As described by COPD community members, bloating can be frustrating, uncomfortable, and even surprising. Many of you shared stories of talking to your doctors about bloating and abdominal symptoms, only for the doctor to say, “I’ve never heard of COPD bloating”. For some of you, after reading comments by other community members, you were surprised to learn that other people experienced bloating too. Although the physical appearance of bloating can be frustrating, know that you are definitely not alone! Many of our community members experience bloating, and we encourage you to connect with your peers and try some of the strategies below for treating and preventing these symptoms.
Why am I bloated?
“I was just going to a gastrointestinal doctor tomorrow to find out why my stomach is so bloated. Well, now I know”
“I was wondering why I feel so bloated”
There are several causes of COPD bloating:
1. “Long Lungs”
For many people with COPD, the lungs can slowly become hyperinflated (aka over inflated). Hyperinflated lungs are sometimes called “long longs”, and are a result of the lungs becoming less elastic over time or from being unable to fully exhale with each breath3. As the lungs become ‘long’, they take up more room in the body4, leading to more pressure on the stomach, diaphragm, and intestines, which can cause bloating.
Solution: Although most people with COPD have some degree of ‘long lungs’, participating in a pulmonary rehabilitation program can help you breathe better, as well as improve your general health. Many COPD patients also find that learning and practicing breathing strategies helps them to manage their COPD symptoms, including COPD-related bloating.
For many COPD patients, feeling tired and out of breath can make exercise and physical activity seem impossible. For this reason, many COPD patients fall into the “de-conditioning cycle”: avoiding physical activity, which may actually make you feel more tired and breathless. Inactivity (or getting little to no exercise) can also lead to COPD bloating.
Solution: In order to combat COPD symptoms and minimize bloating, it is very important to stay active. Be sure to find a physical activity that works best for you! Even a short walk around the house is better than staying seated. Light exercise and regular physical activity may reduce your bloating symptoms, as well as improve your overall health!
3. Difficulty Breathing
For people with COPD, bloating and difficulty breathing can occur in a cycle: Bloating can increase pressure on the lungs, making it harder to breathe. Then, this difficulty breathing can cause you to feel bloated, or make your bloating worse. If you are feeling breathless, you may be more likely to take small, short breaths, which causes you to swallow more air. Swallowing air (known as aerophagia) can cause bloating2.
Solution: For people with COPD, learning and practicing breathing strategies can make a big difference for easier breathing. To manage the cycle of bloating and trouble breathing, check out some of these techniques for better breathing. Breathing strategies are especially important if consider yourself a ‘mouth breather’ or ‘chest breather’, or if you tend to hyperventilate.
Some COPD medications, such as Anoro Ellipta and Spiriva may cause constipation, which can lead to bloating.
Solution: If you experience frequent constipation, consider talking to your doctor about adjusting your medications. You can also ask your medical team about adding more fiber to your diet, or other options for long-term constipation relief. Drinking more water may also help with your constipation symptoms!
- “I found I was becoming anxious and breathless after a heavy meal, and/or several carbonated drinks”
For people with COPD, eating a large meal can leave you feeling short of breath and bloated. When we eat a large meal, our body requires more energy to digest food, causing shortness of breath4, which can lead to the cycle of bloating and trouble breathing (see above). Eating large meals also expands the stomach, causing your stomach and lungs to fight for space in your body. Even for people who do not have COPD, certain foods and drinks will also cause bloating, such as beans, carbonated drinks, dairy products, and wheat.
“Really eating very small amounts at a time is definitely the answer”
Solution: To avoid diet-related bloating, consider avoiding foods that may cause bloating. Proper nutrition is extremely important for people affected by COPD, so consider talking to your medical team about the best food choices for you. To avoid feeling bloated after eating, be sure to stick to several small meals, rather than three large meals every day. If you’re hungry between meals, have a healthy (non-bloating!) snack, rather than waiting for a huge dinner.
Although smoking is not directly related to bloating, the most important step to managing your COPD is to quit smoking. In addition to many other health benefits, quitting smoking may help you breathe easier, reducing your likelihood of entering the cycle of shortness of breath and bloating. There are medications to help you quit smoking, as well as online resources and quit smoking support groups for COPD patients.
To combat COPD bloating, try keeping a journal of when you feel bloated. By writing down your symptoms, you may be able to determine what factors (inactivity, difficulty breathing, medications, or diet) are causing your bloating. Remember, always talk to your medical team before changing your healthcare routines, and join our COPD community to learn more about living a full life with COPD.
- Rutten, Erica P.A., et al. "GI Symptoms in Patients with COPD." Chest, vol. 145, no. 6, June 2014, pp. 1437-38, journal.publications.chestnet.org/article.aspx?articleid=1876107. Accessed 24 Apr. 2017.
- Taiwan, Syed. Abdominal Bloating: A Mysterious Symptom. UNC Center for Functional GI & Motility Disorders, www.med.unc.edu/ibs/files/educational-gi-handouts/Abdominal%20Bloating.pdf. Accessed 24 Apr. 2017.
- Ferguson, Gary T. "Why Does the Lung Hyperinflate?" ATS Journals, vol. 3, no. 2, 1 Apr. 2006, www.atsjournals.org/doi/full/10.1513/pats.200508-094DO. Accessed 24 Apr. 2017.
- COPD Foundation. "Short of Breath After Eating." COPD Foundation, www.copdfoundation.org/COPD360social/Community/Blog/Article/222/Short-of-Breath-After-Eating.aspx. Accessed 24 Apr. 2017.