Summer is well underway, and for many people that means a change in routine – different food, more alcohol, disrupted sleep, and the kind of low-level stress that comes with travel, even when it is enjoyable. For those prone to digestive symptoms, holidays can bring a familiar unwelcome companion, bloating.
Walk into any pharmacy or scroll through social media and you will find no shortage of products promising rapid relief. But how much does the evidence actually support them? Here we examine when bloating should prompt a conversation with a specialist.
Why bloating is more complex than it seems
Bloating is one of the most commonly reported gastrointestinal symptoms, affecting an estimated 30% of the general adult population. Despite its prevalence, it remains one of the most poorly understood. A 2024 narrative review published in Microorganisms found that functional abdominal bloating has a complex pathophysiology involving gut microbiota imbalances, altered intestinal gas handling, visceral hypersensitivity, and the gut-brain axis. It concluded that effective treatment remains a significant clinical challenge for both patients and healthcare providers.
In other words, bloating is rarely just a case of eating too much. Underlying causes can include IBS, small intestinal bacterial overgrowth (SIBO), food intolerances, gut motility problems, and pelvic floor dysfunction. Certainly, these conditions are not resolved by a supplement and can worsen without appropriate assessment.
Do over-the-counter products actually work?
The honest answer is: some ingredients have limited supporting evidence in specific circumstances, but most products marketed broadly for bloating do not. A December 2025 clinical commentary in GI and Hepatology News noted a paradigm shift in how bloating is now being evaluated – moving away from blanket symptom treatment toward identifying the underlying cause first, precisely because response to any intervention varies so significantly depending on the diagnosis.
The most recent European and American guidelines do not recommend probiotics for the treatment of functional bloating, citing insufficient and conflicting evidence. Most studies in this area have been conducted in IBS patients rather than in people with bloating as a primary diagnosis.
Peppermint oil is conditionally recommended by the American College of Gastroenterology for IBS-related symptoms, but the evidence is rated as low quality, with most trials running for only two to twelve weeks. Digestive enzymes may offer some benefit for specific food intolerances, but response varies considerably depending on the underlying cause of symptoms. The fundamental problem with over-the-counter bloating remedies is that they are designed for a generalised symptom rather than a specific diagnosis — and without knowing the cause, treatment is largely guesswork.
When bloating needs more than self-management
Persistent bloating, particularly when accompanied by a change in bowel habit, significant abdominal discomfort, unintentional weight loss, or blood in the stool, should always be investigated.
An accurate diagnosis is the starting point for effective treatment, whether that involves dietary changes such as a low-FODMAP approach, targeted therapy for an underlying condition, or investigation for something that needs to be ruled out.
Mr Michael Stellakis at the Warwick Bowel and Hernia Clinic has extensive experience in the assessment and management of IBS and related bowel conditions. If you have persistent or troubling digestive symptoms, he would be happy to help. To arrange a consultation, call 01926 492969 or email admin@bowelandhernia.co.uk.
