European medical experts have created new guidelines to help doctors better understand and treat bloating and abdominal swelling. These are two of the most common stomach complaints people experience. The difference is important: bloating is the uncomfortable feeling of fullness, while abdominal distension is when your belly actually looks visibly swollen. The new recommendations explain how doctors should diagnose these problems, what causes them, and the best treatment options—from dietary changes to medications to therapy. This expert consensus brings together the latest research to help patients get better care.

The Quick Take

  • What they studied: How doctors should diagnose, understand, and treat bloating and belly swelling when there’s no underlying disease causing it
  • Who participated: A team of European stomach and digestive health specialists from multiple countries who reviewed existing research and created expert recommendations
  • Key finding: Bloating and belly swelling are very common problems that often happen together, and doctors now have clear guidelines on how to diagnose them without unnecessary tests and how to treat them with diet, medications, or therapy
  • What it means for you: If you experience bloating or belly swelling, your doctor now has evidence-based recommendations to help diagnose your problem accurately and choose the right treatment for you, potentially avoiding unnecessary medical tests

The Research Details

This is a consensus document, meaning it’s not a single research study but rather a summary of expert opinions and existing research. A team of digestive health specialists from across Europe reviewed scientific literature on bloating and abdominal swelling. They formulated important clinical questions and then used a structured voting process called the Delphi method, where experts vote on statements until they reach agreement. This approach combines the latest scientific evidence with practical clinical experience from specialists who treat these conditions every day.

The experts focused on five main areas: how common these problems are, how to diagnose them correctly, what causes them in the body, how to treat them, and which tests are actually necessary. They specifically looked at cases where bloating and swelling occur without an underlying disease like cancer or inflammatory bowel disease.

Before this consensus, doctors didn’t have clear, unified guidelines on how to handle bloating and abdominal swelling. This meant patients might receive different advice depending on which doctor they saw. By creating standardized recommendations based on the best available evidence, doctors can now provide more consistent, effective care. The guidelines also help doctors avoid ordering unnecessary tests, which saves time, money, and reduces patient anxiety.

This is a high-quality consensus document because it was developed by recognized European medical societies and specialists with expertise in digestive disorders. The Delphi voting process ensures that recommendations reflect broad expert agreement. However, it’s important to note that this is a summary of existing research rather than a new research study, so the strength of individual recommendations depends on the quality of the studies they reviewed. The document is published in a respected medical journal, which adds credibility.

What the Results Show

The consensus identifies that bloating and abdominal distension are extremely common symptoms that frequently occur together but are actually different problems. Bloating is purely a sensation—how you feel inside—while abdominal distension is something visible and measurable, where your belly actually gets bigger. Importantly, you can have one without the other: some people feel bloated but their belly doesn’t swell, while others have visible swelling without feeling particularly uncomfortable.

The guidelines establish clear diagnostic criteria based on the Rome IV classification system, which is the international standard for diagnosing digestive disorders. Doctors should diagnose functional bloating and distension only after ruling out serious diseases through careful history-taking and physical examination. The key finding is that if a patient has no warning signs of serious disease, extensive testing like blood work, imaging, or endoscopy is unnecessary and not recommended.

The consensus identifies multiple causes working together: the gut being overly sensitive to normal sensations, problems with how the diaphragm and abdominal muscles coordinate during breathing, irregular intestinal muscle contractions, and imbalances in gut bacteria. Understanding these multiple causes is important because it means treatment often needs to be personalized.

The guidelines note that functional bloating frequently overlaps with other gut-brain interaction disorders, particularly irritable bowel syndrome (IBS). This overlap is important because it affects treatment choices. The document also emphasizes that these conditions are real medical problems affecting quality of life, not just minor complaints, and deserve proper clinical attention.

This is the first comprehensive European consensus specifically addressing functional bloating and abdominal distension. Previous guidelines existed for related conditions like IBS, but this document fills an important gap by focusing specifically on bloating and swelling. It represents an evolution in how doctors understand these symptoms—moving away from viewing them as purely psychological problems toward recognizing the complex physical mechanisms involved.

As a consensus document rather than a new research study, the strength of recommendations depends entirely on the quality of previously published research. Some treatment options may have stronger evidence than others. The document reflects European expert opinion and may not account for all global variations in medical practice or patient populations. Additionally, because bloating and abdominal distension are subjective experiences, some recommendations are based on expert judgment rather than large-scale clinical trials.

The Bottom Line

If you experience bloating or abdominal swelling: (1) See a doctor who can properly evaluate you—most cases don’t require extensive testing; (2) Consider dietary changes first, particularly reducing lactose or trying a low FODMAP diet (moderate confidence); (3) If diet alone doesn’t help, discuss medications like peppermint oil, antispasmodics, or probiotics with your doctor (moderate confidence); (4) If bloating is associated with IBS, cognitive behavioral therapy or hypnotherapy may help (moderate confidence); (5) Avoid unnecessary medical tests if you have no warning signs (high confidence). Treatment should be personalized based on your specific symptoms and underlying causes.

These recommendations apply to anyone experiencing bloating or visible belly swelling, particularly those whose symptoms significantly affect daily life. They’re especially relevant for people with IBS or other gut-brain interaction disorders. People with warning signs of serious disease (unexplained weight loss, blood in stool, severe pain, family history of cancer) should follow different diagnostic pathways and should not rely solely on these guidelines. Pregnant women and children may need different approaches not fully addressed in this adult-focused consensus.

Dietary changes may show improvement within 2-4 weeks. Medications typically work within days to weeks. Therapy-based approaches like cognitive behavioral therapy usually require 8-12 weeks of consistent engagement to see meaningful benefits. Some people respond quickly while others need several weeks to months of treatment adjustment to find what works best for them.

Want to Apply This Research?

  • Track daily bloating severity (1-10 scale), visible belly swelling (yes/no), foods eaten, and any medications or supplements taken. Note timing of symptoms relative to meals and stress levels to identify personal triggers.
  • Use the app to experiment with a low FODMAP diet or lactose reduction for 2-4 weeks while tracking symptoms. Log which foods trigger your bloating to identify your personal patterns. Set reminders for medications like peppermint oil taken before meals, and track whether symptoms improve.
  • Create a weekly symptom summary showing average bloating scores and patterns. Compare weeks to identify which dietary changes, medications, or lifestyle factors correlate with improvement. Share this data with your doctor to guide treatment adjustments. Monitor whether symptoms improve over 4-12 weeks of consistent intervention.

This consensus document provides medical guidelines for healthcare professionals and general information for patients. It is not a substitute for professional medical advice, diagnosis, or treatment. If you experience bloating or abdominal swelling, consult with a qualified healthcare provider for proper evaluation and personalized treatment. Do not self-diagnose or delay seeking medical care for symptoms that concern you, especially if accompanied by warning signs such as unexplained weight loss, blood in stool, severe pain, or difficulty swallowing. Individual responses to treatments vary, and what works for one person may not work for another. Always discuss any dietary changes or new medications with your doctor before starting them.