Bloating is–thankfully–usually just an annoyance. Your belly inflates and you feel uncomfortable, but you move around, drink some water, or sleep it off and it goes away. You chalk it up to your upcoming period or something you ate, like broccoli, beans, or too much fruit.
Every once in a while, though, bloating can be a sign of a more serious illness. For instance, it can be one of the first symptoms women notice of ovarian cancer. In a recent survey, UK charity Target Ovarian Cancer found that just 34% of women would talk to a doctor if they were regularly bloated; 50% said they’d make a change to their diet instead. A previous survey by the same group found that just 20% of women knew that bloating could be a symptom of ovarian cancer.
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Feeling bloated in and of itself isn’t enough to point to cancer. There are other things to look for that can help you distinguish bloating that's just a nuisance from bloating that warrants medical attention. Here are the symptoms you should talk to your doctor about.
Pain
Ovarian cancer bloating is due to a buildup of fluid (called ascites) in your abdomen and can also come with pain. Most of the fluid is formed from cancer cells, but it can also be the result of blockages in the lymphatic drainage system or intestinal blockages caused by the presence of cancer, says Lauren Cobb, MD, assistant professor of gynecologic, oncologic, and reproductive medicine at the University of Texas MD Anderson Cancer Center.
Painful bloating could also signal a bowel obstruction, a blockage in the small or large intestine that stops food from passing through.
Bloating that doesn’t go away
For bloating to be potentially worrisome, it generally needs to have lasted for more than two weeks in a month, says Monique Swain, MD, an obstetrician and gynecologist at Henry Ford Health System in Detroit.
If bloating doesn’t go away after making simple diet swaps or going to the bathroom, speak up. “If bloating is persistent and does not vary with changing eating habits or bowel movements, it is a good idea to seek medical care,” adds Alex Hewlett, DO, associate professor of medicine at the University of Nebraska Medical Center.
Changes in bathroom habits
Another clue that bloating could be a sign of ovarian cancer is a change in your bathroom behavior. Out-of-the-ordinary bowel or urinary issues can be a tip something is wrong.
For example, you might suddenly need to go to the bathroom more urgently “if a mass is big enough and pressing on the bladder,” says Dr. Swain.
Appetite changes
Bloating can also be a sign of other cancers, like breast, pancreatic, colon, and stomach cancer, if the cancer appears along the lining of the abdominal cavity, says Dr. Cobb.
Large masses that take up a lot of space in the abdominal area can lead to changes in appetite, like feeling full very quickly or not wanting to eat. Some people with bloating due to cancer also experience nausea and vomiting.
Fatigue
Liver disease–which can be caused by alcohol use, hepatitis C, cancer, and more–can also lead to bloating and fluid buildup.
“Normally, this is a slow, insidious process where you just start to feel it in the lower belly,” Dr. Hewlett says. “As it progresses, your belly becomes more and more distended with fluid.”
If your bloating is due to liver disease, you might also feel tired, bruise easily, or develop jaundice, a yellowish tinge to the skin and eyes. “Seek medical care if there are other symptoms associated with bloating like these,” Dr. Hewlett adds.
Congestive heart failure can also result in bloating, not just in the abdomen but with swelling in the legs too.
In both heart failure and liver disease, bloating is usually a later symptom of the condition. “Once you get bloating and fluid retention, it may mean the disease process affecting your liver or heart is advanced,” says Dr. Hewlett. It’s important to speak up about your symptoms sooner rather than later.
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