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PBC and Bloating: How To Relieve Gas

Posted on June 27, 2025

Key Takeaways

  • Bloating and gas are common symptoms that can become more noticeable and concerning for people living with primary biliary cholangitis (PBC), an autoimmune disorder affecting the liver.
  • People with PBC may experience bloating due to several factors including liver damage, fluid buildup called ascites, and potential side effects from medications like ursodiol, which can cause digestive issues and stomach discomfort.
  • Individuals experiencing gas and bloating can try keeping a food diary to identify trigger foods, make lifestyle changes like exercising regularly and eating slowly, and should discuss their symptoms with their healthcare provider to determine the best treatment approach.
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Bloating and gas are common symptoms that happen to everyone occasionally. Usually, these are just everyday issues that come and go.

In the autoimmune disorder primary biliary cholangitis (PBC), previously called primary biliary cirrhosis, problems like abdominal pain and swelling can become more noticeable. These problems may be related to impaired liver function or other complications and signs of disease progression. If discomfort, gas, or a bloated belly is affecting your daily life, it may be time to seek some solutions.

What Causes Bloating and Gas?

Bloating describes the feeling of a full belly. If your abdomen becomes significantly bigger as a result, it’s known as distention. Too much gas, food, or fluids in your digestive system can cause bloating.

About 10 percent of people say they regularly experience bloating. It’s especially common during the menstrual cycle, affecting about 75 percent of women before or during their periods.

Gas is trapped air. It’s either swallowed when eating or drinking or it’s made by bacteria in the intestines during digestion. Foods high in fiber and sugar tend to cause more gas. Gas can cause pain or bloating until it comes out of the body by burping or passing gas.

On average, people pass gas up to 20 times per day. But those with digestive disorders or food intolerances may have excessive gas and other symptoms that affect their quality of life.

A small intestine bacterial overgrowth can also be responsible for more bloating and gas. It happens when the body’s normal balance of bacteria gets disrupted. This can happen to people with PBC and those without PBC.

How Are PBC and Bloating Connected?

For many members of myPBCteam, PBC and gassiness go hand-in-hand. “My stomach seems to be bloated more than usual, and I’m wondering if it may be from the type of food I’m ingesting. I’ve also had some pain in my stomach for the past few hours that I do not normally have,” shared one member.

Others have said:

  • “I’ve lost weight but still have a swollen stomach sometimes.”
  • “Gas pain makes me feel bloated, and my stomach churns with acid.”
  • “I had no real stomach problems before diagnosis and being put on meds … Now it’s gas pains, heartburn, bloating, and ‘gallbladder attacks.’ Even my stomach seems to be getting bigger.”

If you’ve noticed some of these issues, you’re not imagining them. There are a few different ways that PBC can cause bloating. Over time, PBC leads to liver damage. Ascites is a sign of liver disease. It’s a buildup of fluid in the abdomen that can cause a distended belly. It is important to differentiate distension due to ascites from gas bloating, as it could be a sign of a failing liver. An ultrasound scan is usually helpful in detecting ascites. In addition, one of the liver’s jobs is to help absorb fat. But if the liver isn’t working well, fat doesn’t get absorbed, causing oily stools and diarrhea.

Another complication of PBC is portal hypertension. Scar tissue that forms from liver damage begins to block the nearby blood vessels. This leads to areas of high blood pressure in the veins that are close to the liver. Symptoms of portal hypertension include ascites and an enlarged liver and spleen.

Side Effects of Ursodiol

Ursodiol (Urso) is often prescribed to treat PBC. Members of myPBCteam have reported bloating with Urso. “I’m taking 1,000 mg of Urso, and I am experiencing extreme bloating,” wrote one member. “I look like I’m five months pregnant, but I’m not.” Another member wrote, “Lots of gas with ursodiol.”

Some of the known side effects of ursodiol include:

  • Changes in the stool
  • Loss of appetite
  • Indigestion
  • Nausea and vomiting
  • Side or lower back pain
  • Stomach pain

It’s not always easy to tell if your bloating and gas are related to a complication of PBC or your PBC treatment. That’s why it’s important to discuss any concerns with your healthcare provider. Having bowel issues or ascites can affect how ursodiol works. Some people need to use different medications for PBC if they have a lot of side effects from ursodiol or if ursodiol is not effective for them.

Treatment Options for Gastrointestinal Symptoms

Let your doctor know about any sudden changes to your health, including gas, bloating, or stomach pain with PBC. They can help you figure out whether the problem is just a regular part of PBC or if it’s being caused by something else.

There are several ways to treat gas and bloating at home. If you notice that certain foods cause more gas than others, you can try cutting back on them to see if it helps. Common gas promoters include sugar and sugar substitutes, dairy, carbonated drinks, fried foods, and fiber (found in plant foods). You could have issues with one food specifically or multiple types of food.

Keeping a food diary where you write down what you eat and any symptoms you have can help you identify your problem foods. But before eliminating healthy food groups from your diet, meet with a registered dietitian who can make sure you’re getting sufficient nutrition while living with PBC.

In addition to what you eat, your other lifestyle habits can also make a difference. Regular exercise can help move your bowels so gas doesn’t stay trapped in your colon. Eating small portions, chewing thoroughly, and taking your time with meals can also help with digestion. However, drinking through a straw and chewing gum or sucking hard candies should be avoided because they may cause you to swallow more air and increase gas.

Over-the-counter medication for gas relief and digestion can also help. Digestive enzymes are available to help break down lactose (the sugar in dairy) and certain carbohydrates that can cause gas and bloating. You’ll take these with your meal to prevent bloating and gas. Magnesium and peppermint oil are also natural remedies for occasional bouts of constipation.

If you have an overgrowth of unhealthy bacteria in your digestive system, your healthcare provider may recommend antibiotics to clear out your system. They may also suggest probiotics, which are supplements to help boost the number of healthy bacteria in your intestines. A gastroenterologist is a specialist who can evaluate your issues and recommend the best course of treatment.

Talk With Others Who Understand

On myPBCteam, members come together to find support and information about primary biliary cholangitis. This social network connects you with others who understand what it’s like to live with PBC.

What symptoms of PBC impact your daily life? Have you found any strategies to help prevent or relieve gas and bloating? Share your take in the comments section or on your Activities page.

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