The constant feeling of bloating, abdominal pain and discomfort after meals is more common than you might think. Sometimes, small changes in eating patterns — such as starting a more structured eating plan — can cause temporary symptoms. This can happen due to increasing daily protein intake, using sweeteners found in light products, or even a sudden change in fiber intake.
However, when symptoms persist for a longer period of time or appear after an acute gastrointestinal episode, it is normal to wonder: what do I have, after all? If you have already undergone several medical tests and no significant changes have been found, it may be time to consider another hypothesis.
1. Reflect on the pattern of symptoms
•Do you have frequent abdominal pain, especially after meals?
•Do you experience bloating, gas or changes in intestinal transit (diarrhea, constipation or both)?
• Have medical examinations (blood tests, endoscopies, colonoscopies) not identified inflammatory diseases, celiac disease or other clear pathologies?
If you answered "yes" to most of these questions, you may be dealing with Irritable Bowel Syndrome (IBS) .
What is IBS, according to scientific evidence?
According to the American College of Gastroenterology, IBS is the most common functional gastrointestinal disease. It is estimated to affect between 10 and 12 percent of adults, especially women under the age of 50.
It is characterized by:
•Recurrent abdominal pain
•Changes in intestinal transit (diarrhea, constipation or both)
•Distension and swelling
The diagnosis is clinical, based on a detailed history of symptoms and the exclusion of other conditions through additional tests. Although it does not cause visible changes in the intestine, it is a real condition that significantly interferes with quality of life.
What can be done?
1) Adjust your diet in a structured way
Start by observing the relationship between foods and symptoms. Many IBS patients notice worsening after certain meals.
Options with better scientific support:
• Low FODMAP diet: can reduce symptoms such as gas and bloating by up to 50%. Should be followed with the support of a nutritionist.
• Avoid restrictive diets without guidance: gluten-free diets or diets based on food intolerance testing (e.g. IgG) have little evidence of effectiveness.
2) Try soluble fiber
• Psyllium (ispaghula) : can help regulate intestinal transit and reduce distension.
• Avoid wheat bran, as it can worsen symptoms.
3) Incorporate moderate physical activity
•Regular exercise helps stimulate the intestines, reduces intestinal transit time and improves mood — which also has an impact on the digestive system.
4) Consider supplements with moderate evidence
• Probiotics: can be helpful for bloating and gas. Choose products with studied strains, such as Bifidobacterium infantis.
• Peppermint oil (in enteric capsules): has been shown to be effective in reducing abdominal pain and discomfort.
5) If symptoms persist, talk to your doctor about specific medication.
6) Assess the emotional impact
•Anxiety, stress and depression are often associated with IBS.
• Psychological therapies, such as cognitive behavioral therapy and hypnotherapy, have shown benefits in improving symptoms.
Conclusion
If you experience bloating, abdominal pain and discomfort even after tests that indicate everything is "normal", Irritable Bowel Syndrome may be behind your symptoms. Although there is no cure, there are several effective strategies to control the situation and improve your well-being.
Rui Lopes
BMS Nutritionists
Ford, Alexander C., et al. “American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome.” American Journal of Gastroenterology, vol. 113, June 2018, pp. 1–18, https://doi.org/10.1038/s41395-018-0084-x. Accessed 20 May 2025.