Bloating, abdominal distension, and diarrhea are common digestive symptoms that are often overlooked, according to Master, Doctor Nguyen Hoang Oanh, from the Department of Gastroenterology at Tam Anh Polyclinic District 7. Depending on the underlying cause, these symptoms may resolve on their own within a few days or persist for weeks, significantly impacting daily life.

Doctor Oanh highlighted several common causes of bloating with diarrhea:

**Gastroenteritis** is often caused by viruses (such as Norovirus, Rotavirus), bacteria (like E. coli, Salmonella, Shigella), or parasites, typically following the consumption of unsanitary food or drink. The condition usually begins abruptly with symptoms including cramping abdominal pain, stomach rumbling, abdominal distension, bloating, nausea or vomiting, and sometimes a low-grade fever.

**Irritable bowel syndrome** is associated with abnormal gut motility, increased visceral sensitivity, psychological stress, and imbalances in gut microbiota. Common signs of irritable bowel syndrome include abdominal pain, bloating, distension, and changes in bowel habits, which can manifest as diarrhea, constipation, or alternating episodes of both. Patients may also experience frequent loose, watery stools, a sensation of incomplete evacuation, prolonged constipation, or alternating constipation with loose stools.

Doctor Oanh examines a patient's abdomen. Photo: Tam Anh General Hospital

**Chronic inflammatory bowel disease**, a prolonged inflammation of the digestive tract due to immune dysfunction, encompasses ulcerative colitis and Crohn's disease. Ulcerative colitis primarily affects the lining of the colon and rectum. Crohn's disease can occur in any part of the digestive tract, causing deep inflammation throughout the entire bowel wall, leading to a higher risk of complications. Common symptoms include abdominal pain, distension, bloating, and prolonged diarrhea, which may involve entirely watery stools or stools mixed with blood. Patients might also experience weight loss, fatigue, and occasional low-grade fever. The disease typically progresses in episodes, alternating between flare-ups and periods of remission.

**Food intolerance and malabsorption disorders** arise from various causes, including intestinal, pancreatic, or biliary diseases. These conditions prevent nutrients from being fully absorbed, increasing osmotic pressure within the intestines and leading to prolonged diarrhea, often accompanied by micronutrient deficiencies and malnutrition. **Exocrine pancreatic insufficiency** occurs when the body does not produce enough digestive enzymes, particularly those for fat digestion. This results in incomplete food absorption and chronic diarrhea. **Celiac disease** is an autoimmune condition linked to gluten consumption, which damages the lining of the small intestine and destroys the villi. Patients with celiac disease often present with chronic diarrhea, bloating, abdominal distension, along with iron-deficiency anemia, fatigue, and weight loss. **Lactose intolerance** is another common cause. When there is a deficiency of the enzyme lactase, undigested lactose draws water into the intestines and is fermented by bacteria, causing watery diarrhea, stomach rumbling, and bloating.

**Medication and metabolic effects**: According to Doctor Oanh, certain medications, such as antibiotics and laxatives, can induce diarrhea and bloating. These drugs can disrupt the gut microbiota or increase intestinal motility, leading to digestive disturbances.

If symptoms persist for more than two to three days without improvement, recur frequently, or are accompanied by severe signs such as high fever, dehydration, weight loss, or blood in the stool, patients should seek medical attention for examination and diagnosis.

Patients should adjust their diet and lifestyle appropriately. It is important to eat thoroughly cooked food and drink boiled water, limit foods high in fat and refined sugar, while increasing soluble fiber intake and drinking enough water. Do not self-medicate without a doctor's prescription.

Thao Nhi