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How to Treat Bloating Caused by COPD

Aug 21, 2018 11:00:42 AM / by Duke Reeves

Everyone experiences bloating every now and then, often the result of a big meal or a minor stomach illness. However, bloating tends to be a frequent problem for people with COPD for different reasons, and it's a problem that is frequently underestimated.

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Bloating tends to be particularly uncomfortable for COPD patients because it can make it much more difficult to breathe. Common COPD symptoms like chest soreness and coughing can also feel much worse when your belly is bloated and tight.


What many patients don't realize is that their COPD bloating symptoms could be directly or indirectly caused by their disease. In some cases, treating underlying COPD symptoms can relieve and prevent bloating or at least make it much more tolerable.


In this article we're going to help you better understand the connection between COPD and abdominal bloating and what you can do about it. We'll explain how and why COPD bloating happens, how to reduce bloating, and how to better manage your symptoms and feel more comfortable when bloating unexpectedly strikes.


The Connection Between COPD and Abdominal Bloating


Bloated belly


Bloating is a symptom that many people with COPD deal with on a regular basis, and it can make it more difficult to cope with the disease. However, despite how common bloating is among COPD patients, many doctors and patients don't realize that the two conditions could be related.


Sometimes bloating is a direct result of COPD symptoms or medications, and sometimes it's a result of COPD-related lifestyle changes and complications. For example, COPD often makes it difficult to stay active and eat a healthy diet, both of which increase your risk for bloating.


It also works in the opposite direction; being bloated can make COPD symptoms like breathlessness worse. Bloating causes swelling in your stomach and intestines, which causes them to push up on your lungs and diaphragm.


Many COPD patients also have enlarged lungs which require extra room to expand. This combined with the extra pressure that bloating puts on your lungs can make it especially difficult to breathe.


Having a bloated stomach can also make your breathlessness worse when you eat, especially if your lungs are enlarged. Many COPD patients struggle to breathe when they eat because their lungs have less room to expand when their stomach is full.


What is Bloating?


Pink balloon clip art


Bloating is usually described as a feeling of tightness, pressure, or stretching in the abdomen. It is often caused by gas trapped in your stomach or intestines, and it can even cause your stomach to visibly swell up.


Bloating is usually caused by problems with digestion, such as when food moves too slowly through your digestive system; this creates more opportunities for it to be fermented into gas. It can also be caused by food allergies, illnesses, and digestive disorders like irritable bowel syndrome.


However, bloating can be caused by many other things, including medications, stress, inactivity, and swallowing air. Just about anything that can have an effect on your digestive system has the potential to cause bloating.


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The most common reason that otherwise healthy adults experience bloating is a poor diet. Eating too many fried and fatty foods, eating too much, and not eating a balanced diet can all lead to bloating.


Bloating can also refer to water bloating, which happens when your body retains extra water, causing your limbs and abdomen to swell slightly. This kind of bloating can be just as uncomfortable as bloating caused by gas and causes many of the same symptoms.


While bloating isn't a serious symptom on its own, chronic bloating could be a sign of a more serious underlying condition. For people with COPD, frequent bloating is a problem because it can make other COPD symptoms much more difficult to manage.


How COPD Causes Bloating


Bloated belly (illustration)


There are a number of reasons why COPD patients are more prone to getting bloated. In these next sections we'll take a closer look at some of the most common reasons that people with COPD suffer from bloating.


Shortness of Breath


COPD makes it difficult to breathe and causes frequent episodes of shortness of breath. When this happens, it can cause you to gasp, wheeze, or hyperventilate, which can sometimes lead to bloating.


When you struggle to breathe, you tend to take quicker and shorter breaths. This makes it easier to swallow extra air into your stomach along with the breaths you inhale.


This air gets trapped in your stomach, causing it to expand and feel bloated. That, in turn, can put extra pressure on your lungs and make your breathlessness even worse.


Hyper-inflated Lungs




COPD causes many people—especially those with emphysema—to develop enlarged lungs over time. This happens because damaged lungs tend to trap air when you breathe, which prevents your lungs from deflating completely when you exhale.


Over time your lungs continue to trap more and more air, which causes them to stretch out to accommodate the extra pressure. This is known as lung hyper-inflation (also known as expanded lungs or “long lungs”), and it causes your lungs to become larger, less elastic, and take up more space in your chest.


Hyper-inflated lungs press down and put extra pressure on your diaphragm, stomach, and intestines, which can make it more difficult to breathe and eat. This can cause side-effects like poor diet and worsened shortness of breath, both of which can cause bloating.


What's more, having hyper-inflated lungs makes even minor bloating more noticeable and potentially extremely uncomfortable. This is one of the major reasons that bloating is such a problem for so many people with COPD.


Lack of Exercise


Man in chair


Many people underestimate how important exercise is to keep your digestive system running smoothly. Exercise stimulates your digestive tract and is a very effective way to get your metabolism going.


Unfortunately, COPD often makes sufferers feel breathless and fatigued, which makes it difficult to exercise and stay active. This causes many people with COPD to avoid physical activity and lead more sedentary lives, which can lead to bloating.


When you don't get enough exercise, your intestines have a harder time contracting and moving food through. This slows down your entire digestive system and makes your stomach empty more slowly.


The longer food sits in your stomach and intestines, the more likely it is to create gases that make you feel bloated. It can also lead to indigestion, which can make bloating even worse.


On the other hand, when you exercise, it gets the muscles lining your digestive tract moving and helps your stomach empty faster. It also helps move gas through your intestines, making it less likely to build up and cause discomfort or bloating.



 Grapefruit and cucumber


Many people with COPD struggle with uncomfortable feelings of bloating and breathlessness when they eat. This is partially because COPD patients are particularly sensitive to the pressure of a full stomach, which can push up on their lungs and make it more difficult to breathe.


It is much worse for patients with hyper-inflated lungs, who need even more space for their lungs to expand. In fact, some COPD patients experience such severe shortness of breath when they eat that it significantly disrupts their diet.


Some patients have so much trouble eating that they eventually give up on wholesome meals and healthy eating habits altogether. In the worst cases, some patients with advanced COPD experience such severe symptoms when they eat that they end up losing weight or even developing nutritional deficiencies.


Bloating can also trigger a cycle of worse and worse bloating, as it triggers worsened COPD symptoms like breathlessness which can cause you to swallow more air. You are especially prone to swallowing air and becoming bloated if you struggle to breathe while you eat, which is more likely if you are already bloated.


Many people with COPD are older adults who are particularly sensitive to certain foods that are known to cause bloating. Because of this and the other reasons mentioned, mealtimes can be tricky situations for COPD patients to navigate, especially those who suffer from bloating.


How to Reduce Bloating if You Have COPD


Eat Smaller Meals


Pasta with chicken and tomatoes.


Hyper-inflated lungs and breathing problems caused by COPD can make it difficult to eat without feeling bloated. The simplest and quickest way to solve this problem is by eating smaller portions at mealtimes to make sure you never get too full.


Instead of eating the traditional three large meals a deal, try eating five or six smaller meals and spacing them out throughout the day. That way, your stomach is never too full at any given time and you're less likely to feel bloated and breathless when you eat.


Whenever you cook meals or go out to restaurants, try to choose smaller portions and don't rush through your food. Take as much time as you need to eat, stop when you start to feel full, and don't be afraid to save leftovers for later.


If you have trouble eating enough at mealtimes without feeling bloated, make up the extra calories by eating healthy snacks throughout the day. It's important to make sure you get enough to eat in order to prevent malnutrition and other complications like osteoporosis.


Some COPD patients also benefit from using supplemental oxygen when they eat, which helps with shortness of breath and may prevent bloating. It can also help to sip water (but not too much) and take breaks when needed during your meals.


Here are some extra tips for breaking up your meals into smaller mini-meals and snacks:

  • Try to fill your meals and snacks with healthy, whole foods including fruits, vegetables, healthy fats, lean protein, and whole grains.
  • Avoid empty calories like simple carbs, sugar and soda that will just fill you up without providing healthy nutrients.
  • Try to eat the most nutritious foods on your plate first, before you start to feel full.
  • If you have trouble getting enough calories throughout the day, try eating some healthy, calorie-dense foods like nuts and dairy. These will provide your body with lots of calories and nutrients without taking up too much room in your stomach.


Eat More Slowly


Yellow sign that says "slow."


When you scarf down your food too quickly it's easy to swallow extra air along with your food without realizing it. This can cause your stomach to feel bloated, which can make it more difficult to breathe.


Then, if you are struggling to breathe as you eat, you are even more likely to swallow air. This can create a vicious feedback loop where eating makes you feel bloated, being bloated makes you feel short of breath, and being short of breath causes you to become even more bloated.


The solution to this is to eat more slowly, which reduces the amount of air you swallow as you eat and helps prevent you from getting too full. Pacing yourself also gives you the chance to practice breathing exercises while you eat and pay closer attention to how your body and stomach feel.


Another benefit to eating more slowly is that it allows you to chew your food up more before you swallow. This speeds up digestion by giving the food more time to break down in your mouth, reducing the risk of bloating.


Get More Exercise


Man_Doing_Warm_Up_Exercise_CartoonMan_Doing_Warm_Up_Exercise_CartoonMan preparing to exercise


As we mentioned earlier, exercise helps kick-start your digestive system, which helps prevent uncomfortable gas from building up in your stomach. As a result, physical activity can be a powerful tool for reducing bloating and keeping your digestive tract running efficiently.


Exercise increases blood flow to your stomach and intestines, which helps stimulate the muscles that contract your intestines and move food through. This helps your stomach empty faster, which moves gas-creating foods into your small intestine, where they are less likely to cause discomfort.


Exercise also strengthens your abdominal muscles, which helps move gas more quickly through your intestines. This prevents gas from building up in your gut and reduces bloating and discomfort.


As you can see, exercise can be both a treatment for bloating and used as a preventative measure against bloat. If you experience COPD bloating often, then increasing the amount of exercise you get could make a significant difference in how gassy you feel.


Research shows that even a small amount of moderate exercise every week can substantially improve bloating symptoms. Just thirty minutes of physical activity three times a week was be able to significantly reduce bloating in people with irritable bowel syndrome, a common stomach disorder that makes sufferers especially prone to bloating.


If you live a sedentary lifestyle or often have long periods of inactivity, talk to your doctor about putting together a new exercise plan to help you increase your physical activity. Then, it's up to you to build the exercise habits that will help you be healthier and less bloated.


Even if you have limited mobility or exercise seems like a daunting task, there are many different kinds of aerobic and strength training exercises that are tailored for people with breathing disorders and chronic diseases. You can start by taking walks, exercising at home, or taking part in a pulmonary rehabilitation class.


Get Moving After Meals


Man walking down a sidewalk.


Since we know that slow digestion contributes to bloating, and exercise speeds up digestion, then it follows that getting some exercise after you eat can help prevent bloating. This is supported by studies that show mild exercise after a meal can aid in digestion.


If you tend to feel bloated after you eat, then try to plan in some time for light exercise after you finish your meal. For example, you could take a short walk around the block or do some stretching exercises to get your digestive juices flowing.


However, you should save more serious physical activities for at least a couple hours after you eat. Heavy exercise reduces blood flow to your stomach and intestines, showing down your digestion, and could end up making you feel sick or nauseous after you eat.


Watch Your Posture


Silhouette of man standing with arms crossed.


How you position your body during and after eating can have a significant affect on your digestion and how bloated you feel. The best thing to do is sit up straight while you eat and avoid lying down after meals.


Lying down and reclining your body makes it difficult to pass gas and encourages gas to build up in your stomach and intestines. Lying down also puts pressure on your lungs, which can make it even more difficult to breathe when you're bloated.


One study found that simply keeping your body upright can significantly reduce the amount of gas that gets trapped in your intestines. Because of this, keeping an upright posture, especially during and after meals, can reduce bloating and make it easier for you to breathe.


Avoid Foods That Cause Bloating


Rose cocoa beans


There are a variety of different foods that are known to cause bloating, although they don't affect everyone the same. Some people may be extremely sensitive to bloat-inducing foods while others have no problems at all.


Some foods cause bloating because they are difficult to digest or provide fuel for gas-producing bacteria in your intestines. Other types of foods, like fatty foods, cause bloating because they take extra time for your body to digest.


Let's take a closer look at some of the most common foods you should avoid that cause bloating.


Fatty Foods


fried chicken in baskets


Fatty foods, especially greasy and deep-fried foods, are a major cause of bloating. That's because foods that are high in fat take longer to digest and move through your system.


If you tend get bloated after meals, try to eliminate some of the most fatty foods from your diet. Reducing your intake of greasy foods and fried fast foods is especially important.


Instead, try to eat smaller portions of fat as part of a balanced meal along with fruits and veggies, lean protein, and complex carbohydrates. You might find that reducing the amount of fat you eat makes a big difference in how bloated and uncomfortable you feel.


Salty Foods


Iodized salt crystals


Salt causes your body to retain water, which can cause you to feel bloated. While this kind of bloating is different from bloating caused by gas, it can be just as uncomfortable and make it difficult to breathe.


According to the US Department of Health and Human Services guidelines, older adults should limit their salt intake to 1,500 mg or less every day. That translates to about ¾ teaspoon of pure salt.


Unfortunately, it's nearly impossible to stay under 1,500 mg of salt unless you go out of your way to avoid it. That means limiting processed foods, salty restaurant foods, and home-cooked meals that include a lot of salt.


Salt hides in all sorts of unexpected places, which is why the best way to limit how much salt you eat is to cook low-sodium meals yourself. Nearly all processed foods, including processed snacks, processed meats, processed cheese, canned foods, cereals, and boxed meals, contain unhealthy amounts of salt.


You should also check the nutrition labels on all the foods you buy and choose versions that are lower in sodium whenever possible. When you eat out at a restaurant you can check their menu online ahead of time to look for lower sodium options, or ask your server to recommend items that are low in salt.


Carbonated Beverages


Air bubbles


Carbonated beverages are bubbly and fizzy because they are infused with carbon gas. This gas escapes from the liquid over time, which is why carbonated drinks get “flat” after they've been left open too long.


When you drink something that's carbonated like soda or sparkling water, the gas escapes from the liquid while it's in your stomach and intestines. This gas gets trapped in your abdomen, resulting in uncomfortable bloating and gassy symptoms.


If you tend to struggle with bloating, you should try to avoid soda and all other types of carbonated drinks. To make the adjustment easier, you can replace them with other flavored beverages, such as tea, coffee, or water infused with fruit.


Sugar Substitutes


Cubes of sugar in a bowl of cereal.


Foods labeled “sugar-free” usually use sugar substitutes, known as sugar alcohols, as a replacement for normal sugar. Sugar alcohols work because they taste sweet but aren't processed by your body the same as other sugars; this makes sugar alcohols low in calories and usually reduces the effect they have on blood sugar.


However, the downside of sugar alcohols is that they aren't very digestible, which causes many people to experience stomach distress and bloating when they eat them. In fact, health experts say you shouldn't eat more than a couple servings per day of artificially-sweetened foods.


You can recognize the most common sugar alcohols on nutrition labels with the names xylitol, sorbitol, and erythritol. They are most often found in sugar-free foods like candies and desserts and also in sugar-free gum.


Here is a list of all the sugar alcohols you may find in foods:

  • Xylitol
  • Sorbitol
  • Erythritol
  • Maltitol
  • Isomalt
  • Manitol
  • Lactitol
  • Hydrogenated starch hydrolysates


Beans and Cruciferous Vegetables

Beans, legumes, and vegetables from the cruciferous family are all known to cause gas and bloating. This happens because they contain a lot of fiber along with certain types of carbohydrates that many people's bodies have a difficult time digesting.


If you tend to get bloated after eating, you may want to limit the amount of beans and cruciferous vegetables you eat. Instead, replace them with other sources of healthy protein, fiber, and vitamins.


Sometimes these foods cause bloating because your body is not used to them, in which case slowly exposing yourself to them can help. You can try introducing small portions of beans and cruciferous veggies into your diet little by little to see if your stomach can adapt.


Steaming or otherwise cooking cruciferous veggies before you eat them can also reduce your risk of bloating. This helps by breaking down the fiber and making them slightly more digestible.


Here is a list of common cruciferous veggies that are known to cause bloating:

  • Broccoli
  • Cauliflower
  • Green and red cabbage
  • Brussels sprouts
  • Collard greens
  • Kale
  • Arugula
  • Bok choy
  • Radishes
  • Turnips
  • Parsnips


Here is a list of common beans and legumes that are known to cause bloating:

  • Mung beans
  • Fava beans
  • Chickpeas
  • Green peas
  • Edamame
  • Soybeans
  • Black beans, red beans, lima beans, and pinto beans


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Other Problematic Foods

If you struggle with bloating all the time, it could be the result of a food allergy or irritable bowel syndrome (IBS). If taking other steps doesn't reduce your symptoms, then you might want to talk to your doctor about testing for other problems.


For example, lactose intolerance, wheat allergies, and milk allergies can cause a variety of stomach symptoms, including abdominal bloating. If you suffer from a more generalized condition like IBS, there could be a wide variety of foods that irritate your stomach and cause it to bloat.


In the case of IBS, reducing or eliminating certain foods, known as high FODMAP foods, is the first step to reducing gastrointestinal distress and abdominal bloating. You can learn more about low-FODMAP diets and what kinds of foods you should avoid from this detailed list on the IBS Diets website.


Keep a Food Diary


Calendar clip art


All of these foods we discussed above have a potential to cause bloating, but many people can eat them without any symptoms at all. Even if you are sensitive to some of these foods, you are unlikely to be sensitive to all of them unless you suffer from another condition like IBS.


Because of this, it can be difficult to pinpoint what foods might be making you feel bloated. The most accurate way to figure it out is with an elimination diet, which can be a long and difficult process.


A less-intense option is to try keeping a food diary to help you identify bloating triggers. While this is less accurate than an elimination diet, it may give you enough information about your diet and the foods that bother you to help you reduce bloating.


By tracking what you eat every day and when your bloating symptoms appear, you can see whether or not your bloating symptoms are linked to a specific food or groups of foods. Even if your food diary doesn't give you much insight, it could be helpful to your doctor or specialist when they're trying to help you manage your symtpoms.


Reduce Stress


Man holding hands to his head.


If you've ever struggled with acute stress or chronic anxiety, then you probably know first-hand how emotional distress can affect your stomach. Stress and anxiety can cause a variety of digestive symptoms, including bloating, nausea, abdominal pain, and general indigestion.


Because COPD is a chronic, life-threatening disease, COPD patients often have to deal with a significant amount of stress and anxiety. This can lead to a variety of stomach issues, including bloating, if not managed effectively.


If you believe that stress or anxiety may be causing your bloating, then you should talk to your doctor or a mental health professional right away. They can help you understand the cause of your emotional distress and help you find healthy ways to cope.


Your mental health and physical health are closely intertwined, which is why it's just as important to take care of your mental health needs as it is to treat your physical ailments. In the case of bloating, you may find that your symptoms are reduced or disappear once you treat the underlying cause of your anxiety.


Over-the-Counter Remedies

There are some over-the-counter remedies that are known to help treat bloating. However, most of them only work in certain circumstances or for very specific causes of bloating.


For example, Beano is an over-the-counter enzyme supplement that helps prevent gas and bloating when you eat gassy foods. The enzymes it contains break down the problematic carbohydrates that make certain foods like beans, cruciferous vegetables, and other foods difficult to digest.


Peppermint oil capsules are another popular over-the-counter treatment for bloating and other symptoms of indigestion. Studies show that these supplements can improve symptoms in people who have IBS by soothing the nerves and muscles in their intestines.


There is also some growing evidence that probiotics may be able to help people with digestive issues and bloating related to IBS or unhealthy gut bacteria overgrowth. Probiotics are most likely to be effective if you take them in a supplement that is backed by research and is known to treat your specific symptoms (the probiotic L. plantarum is best known for reducing abdominal bloating and gas).


These remedies will only work if your bloating is caused by the specific problem that the supplement is designed to treat. While they won't work for everyone, it may be worthwhile to try one of these remedies if you believe you have one of these underlying problems.


Remember, though, that you should never take any medications without consulting your doctor first. Even over-the-counter medications that are usually safe could cause unexpected complications or interact with other COPD medications you take.


Relieve Constipation

As we've discussed, bloating is more likely when food moves through your digestive system slowly. As a result, bloating is a common symptom of constipation, which slows the movement of food through your intestines.


Eating a healthy, balanced diet is the best way to avoid constipation- and indigestion-related bloating. Getting enough fiber is especially important to prevent constipation and keep your digestive system running smoothly.


However, getting the right amount of fiber is a delicate balancing act, as both too much and too little fiber can cause constipation. If you are getting too little fiber in your diet, you should make sure you increase your fiber intake very gradually; getting too much fiber at once when your body is not used to it can cause constipation and intestinal distress.


Lose Weight




Being overweight or obese can significantly increase your chances of getting bloated and experiencing upper abdominal pain. You may be even more likely to experience bloating if you've recently put on weight.


Unfortunately, obesity is common among COPD patients, especially those who live sedentary lifestyles. This often happens because COPD symptoms like breathlessness and fatigue can make it very difficult to work out and stay active.


If you have COPD and are also overweight, then losing some pounds could help reduce your COPD bloating symptoms. Your doctor can be a great resource for this by helping you develop a healthy diet and exercise plan you can use to reach a more healthy BMI.


Rule Out Other Causes


Gas Bubbles


Sometimes frequent bloating is a symptom of another gastrointestinal disorder, like IBS. It could also be the result of a food sensitivity or allergy such as lactose intolerance.


If you get bloated often and other treatments and preventative measures (like the ones in this article) aren't working, then it might be time to investigate other possible causes. In that case, your doctor should be able to refer you to specialists who can test you for underlying problems.


Testing for food allergies and other conditions that affect digestion may help you narrow down the cause of your chronic bloating and find a better solution. This could involve undergoing medical tests (like a colonoscopy or blood test) or working with a specialist to selectively eliminate certain foods from your diet to see if your symptoms improve.


Manage Your COPD Symptoms

If breathlessness is causing you to get bloated or making you extra sensitive to bloating sensations, then the best thing to do is treat the underlying problem. Frequent bloating caused by shortness of breath may be a sign that you need to better manage your COPD symptoms.


One thing you can do is talk to your doctor to see if your treatment plan needs adjusting. You may need to try a new medication or change your medication dosage to help you breathe better throughout the day.


You could also try other COPD treatments to help you manage shortness of breath, including breathing exercises like pursed lips breathing. By helping you keep your breathing under control, these treatments could help reduce the amount of air you swallow and reduce your bloating symptoms.


Another option is supplemental oxygen, which many COPD patients use to help them breathe while they eat. Oxygen reduces breathlessness and can help with bloating in two ways: it reduces the chance of erratic breathing, which can cause you to swallow air and get bloated, and it makes it easier to breathe, which can make you less sensitive to mild bloating.



Bloating may seem like a relatively mild symptom, but it can cause severe discomfort and difficulty breathing when you suffer from COPD. More than just feeling unpleasant, bloating can cause serious symptoms and difficulty eating for COPD patients and take a significant toll on their lives.


If you have COPD, there's no reason to suffer with bloating in silence when there are plenty of simple solutions and treatments. It may take some trial and error, but there are many different techniques you can try, including changing your diet, medications, and making other adjustments to your eating habits and lifestyle.


Now that you better understand the connection between COPD and stomach bloating and what you can do to treat it, you should be able to work with your doctor to find a solution that works for you. Once you get your bloating symptoms under control, you'll be able to breathe better, eat better, and be better able to manage other aspects and symptoms of your COPD.

Topics: COPD, Medication and Treatment, Respiratory Resource Center, Portable Oxygen, portable oxygen concentrator, oxygen therapy

Duke Reeves

Written by Duke Reeves

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