Nadia Okamoto had the perfect costume for her friend's Rihanna-themed birthday party: a caricature of the pregnant pop star in black lingerie, based on her iconic outfit from Paris Fashion Week.
Okamoto wasn't pregnant, but her stomach was bloated: “My belly was literally the size of a watermelon,” she said.
The 26-year-old TikTok creator has been open about his digestive issues, and one video he posted showing his “bloated, poop-filled belly” while wearing a Rihanna outfit has been viewed 3.8 million times.
“This makes me feel so much better!!” one person commented. “I've had bloating since I was a little kid and it's been making me so anxious today.”
Okamoto is one of many young female creatives who use the app to document and discuss their bloating, some blaming it on menstruation or constipation, but many simply describe the symptoms as mysterious and painful.
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About 158,000 TikTok posts use the hashtags “#bloating” or “#bloated,” and the company did not respond to multiple requests for comment about the trend's growth and popularity.
Women have been discussing bloating in various forums for decades, but the recent uptick in conversations about bloating is part of a broader interest in gut health that has arisen from research into the importance of good gut bacteria. Many recent TikTok videos about bloating encourage viewers not to dismiss bloating as normal or harmless, and many health influencers promote “good gut” products or share tips for improving digestive issues.
Several gastroenterologists said they have experienced an increase in patients complaining of abdominal bloating.
“What I'm seeing is people becoming more concerned about bloating and abdominal distention,” says Dr. William Choi, chief of gastroenterology at the University of Michigan Medical Center. “Now in 2024, bloating and abdominal distention are very common complaints that I see, whereas in years past, they seemed to play much more of a supporting role.”
Experts speculate that this is due to the rise in consumption of ultra-processed foods, many of which are high in gluten and fructose, over the past few decades, and that the trend could also be the result of increased awareness and discussion of abdominal bloating, they say.
“Thanks in part to social media, talking about gastrointestinal symptoms in general is becoming less taboo and more commonplace,” says Dr. Kyle Stoller, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital. “Bloating is so common and bothersome that people are really starting to vent their frustrations online.”
Dr. Satish Rao, a professor of medicine at Augusta University, said some doctors may take reports of abdominal bloating more seriously than they did decades ago because patients record the swelling on their cell phones.
“From the patients' own testimonials, we can actually say, 'Yes, something is wrong,'” he said, adding that cases of abdominal bloating have been steadily increasing over the past 20 years.
One of the catalysts for the proliferation of bloating videos on TikTok was likely a billboard launched in Los Angeles in 2022 by a company called BelliWelli. The billboard bore the now-popular phrase, “Sexy girl has IBS (irritable bowel syndrome).”
Veriweli makes snack bars advertising “zero bloat” for people with intestinal problems, and founder and CEO Katie Wilson said people lined up by the signs hoping to get their picture taken.
“Women were pushing their bellies out, claiming that being bloated was cool,” she says. (The majority of people with irritable bowel syndrome report bloating as a symptom, and women are more likely to have the problem.)
The phrase went viral on social media.
Wilson said the campaign also has a secondary message: “It's not normal to feel uncomfortable every day.”
A sign advertising BelliWelli products. BelliWelli
That message resonated with Alex Hannan, a 23-year-old intensive care nurse in Boston, who has had 1.2 million views on her TikTok video about how drinking caffeine or eating a protein bar on an empty stomach causes her stomach to bloat.
“It's something people may not realize they have, which is another reason why I talk about it,” she said.
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But not all gastroenterologists agree that abdominal bloating is more common than it once was.
“I wouldn't say we've seen a dramatic increase, just a steady increase in people reporting abdominal bloating,” said Dr. Brennan Spiegel, professor of medicine and director of health services research at Cedars-Sinai Medical Center.
Spiegel and Choi co-authored the 2022 study, which found that about 1 in 7 Americans said they experienced abdominal bloating in the past week, but Spiegel said there was no good data on trends over time.
Doctors say that some bloating is normal, especially after eating a large meal, but if you experience bloating chronically, it could be a sign of a medical problem, like IBS or lactose intolerance.
Abdominal bloating can be difficult to treat.
“We try to treat some of the common causes, like constipation, but even after we treat those causes, a lot of patients are still struggling,” Staller says. “And I think that's really why so many people come in and ask, 'What do I do? What's causing this?'”
That element of mystery has led many on TikTok to test and promote treatments, like probiotics and supplements, that aren't fully supported by science.
“Unfortunately, there's not enough science yet to know for sure whether, when or how best to take probiotics,” Spiegel said.
Okamoto is one of those people who has been suffering from abdominal bloating since childhood and doesn't know the cause. She suspects that constipation or gluten intolerance may be the cause, and reduced her gluten intake helped. But even after seeing several doctors, she still doesn't have a clear answer.
Nadia Okamoto, Sophia Wilson
Okamoto said she's tried everything: medication, probiotics, fiber supplements and even enemas.
“Someone told me to swallow two tablespoons of olive oil, so I tried doing that on TikTok and it made me feel ill,” she said.
Changing your diet can help reduce some of the bloating.
After testing for constipation, doctors often test for food sensitivities by putting patients on a FODMAP (fats poorly absorbed in the small intestine)-minimizing diet, typically eliminating categories like dairy, wheat, legumes, and certain fruits and vegetables, then reintroducing them to see which ones cause problems.
In some cases, gas can build up and cause abdominal bloating, so you can try over-the-counter medications like Gas-X or take peppermint oil capsules, but neither of these are long-term solutions.
In other cases, bloating may be caused by an abnormal reflex that causes the diaphragm to descend and the abdominal wall to relax and push out. Swallowing too much air while eating or sleeping may also be the cause, so your doctor may recommend chewing your food slowly and avoiding carbonated drinks, gum, mints, and hard candies.
But there's a big difference between mild and severe bloating, Spiegel says.
“Stomach aches and bloating are very common and are kind of part of being human,” he says, “but it becomes a problem when it's really affecting your quality of life.”
