Gas-Type Irritable Bowel Syndrome - "My stomach just keeps filling with gas."

1. “It feels like something is built up in my abdomen”

Hello everyone. This is Baekrokdam Korean Medicine Clinic.

Have you ever experienced something like this?

After eating, your abdomen becomes distended, you feel a frustrating build-up of gas as if you need to pass it but can't, something constantly feels like it's coming up from your stomach, and your stomach frequently rumbles. You have regular bowel movements... but your abdomen is uncomfortable all day long. If this continues, it can be truly exhausting.

These symptoms cannot be simply dismissed as 'indigestion.' Today, we will discuss this very symptom: 'gas-type IBS,' a functional bowel disorder centered around gas symptoms such as abdominal bloating, belching, and flatulence.

2. A condition that's real, but without a formal diagnosis?

The term 'gas-type IBS' is not actually a formal medical diagnosis. In modern medicine, it falls under IBS, or Irritable Bowel Syndrome, which is typically categorized into diarrhea-predominant, constipation-predominant, and mixed-type. Cases that don't neatly fit into these categories are often described as 'unspecified type' or 'gas-type'.

“I don't have diarrhea or constipation... but my stomach is constantly bloated.”

“I belch too frequently. To the point where it's embarrassing during meetings.”

“It feels like gas is constantly built up, but it won't come out, which is even more frustrating.”

These are the characteristics of gas-type IBS: immediate abdominal bloating after meals, a heavy, pressing sensation in the lower left abdomen or epigastrium. The feeling of gas being trapped inside and unable to escape. And the more stressed you are, the worse the symptoms become. There are quite a lot of people with these symptoms. However... in most cases, neither diagnosis nor treatment is clearly defined.

3. Why have these symptoms started to gain attention?

In the past, these symptoms were often dismissed as 'due to sensitivity' or 'nervousness.' X-rays show nothing, endoscopy reveals no abnormalities, and blood tests are all normal, yet patients clearly state:

“There's something built up in my abdomen.”

“I'm extremely uncomfortable.”

It was only after the 1990s that these symptoms began to be treated seriously as a disease. With the establishment of the Rome criteria, diagnostic guidelines for functional bowel disorders, the concept that 'even if there are no visible abnormalities, if the intestines are functionally sensitive or abnormal, it is a disease' began to take root.

This was followed by concepts such as gut microbiota, SIBO, and FODMAPs.

“Bacteria in the intestines cause excessive fermentation.”

“Carbohydrates are not properly absorbed, leading to gas production.”

“Stress causes intestinal motility to stop.”

As these trends accumulated, the understanding emerged that these issues are not simply 'all in one's head'.

4. But... why aren't conventional medications very effective?

This is where many people become frustrated. Even when visiting an internal medicine specialist, there isn't much they can do. Gastric motility regulators, antispasmodics, acid suppressants, digestive aids... some might seem to help for a time or two, but soon after, symptoms return to normal, and some medications can even make things more uncomfortable.

The reason is simple: this is not a structural problem but a functional one. The intestines are not damaged or inflamed. Instead, their movement is abnormal, and their reaction is hypersensitive.

Furthermore, this condition is not solely an intestinal problem. Does it worsen with stress? Do symptoms flare up when you go out or feel nervous?

→ This is a reaction of the gut-brain axis, in other words, the autonomic nervous system.

Medications only regulate the gastrointestinal tract; they cannot control the body's entire response system. This is why patients feel like 'they took the medicine, but nothing happened'.

5. That's why more people are seeking Korean medicine

Korean medicine has a framework that can explain such problems as 'naturally occurring.' For example, in individuals experiencing a lot of stress, Liver Qi (肝氣) becomes stagnant, and this stagnant energy presses on the intestines, leading to gas obstruction.

For those with a weak stomach and intestines, digestion slows down, and accumulated food stagnation (食積) leads to fermentation. People with a naturally 'cold' constitution may have a deficient and cold Spleen and Stomach (비위), which prevents gas from passing downwards.

From the patient's perspective, simply 'hearing an explanation of why such symptoms occur' is already half the cure.

Furthermore, Korean medicine can approach these issues holistically, including herbal medicine, acupuncture, moxibustion, abdominal massage, dietary regulation, and lifestyle guidance. Even with the same gas-type IBS, since the cause differs for each person, personalized treatment is possible.

6. How can it be classified by syndrome pattern?

Gas-type IBS can also be divided into several types.

• Liver Qi Stagnation type: When stressed, there's immediate epigastric discomfort and frequent belching. → Prescriptions like Siho-sogan-san (柴胡疏肝散) and Soyo-san (逍遙散).
• Spleen Deficiency type: Feeling drowsy after meals, with abdominal fullness and some diarrhea. → Prescriptions like Bojungikgi-tang (補中益氣湯) and Samnyeongbaekchul-san (蔘苓白朮散).
• Food Stagnation type: Severe bad breath and sour-smelling belching. → Prescriptions like Pyeongwi-san (平胃散) and Jishildoche-hwan (枳實導滯丸) are used.
• Deficient Cold type: Cold abdomen, diarrhea in the early morning, and cold-feeling flatulence. → Prescriptions from the Yijung-tang (理中湯) or Hyangsaryukgunja-tang (香砂六君子湯) families.

Acupuncture points and herbal medicine vary according to the patient's constitution and symptoms.

7. This is not merely an intestinal problem, but a matter of the body's 'directional flow'

Why is it that some people are fine after eating the same food, while others feel like their abdomen is about to burst? The intestines are merely a 'stage' reflecting the body's reactions; the 'direction' that drives them – energy flow (氣運), autonomic nerves, constitution – differs from person to person.

Therefore, simply regulating the intestines with medication is insufficient; a method that adjusts the body's overall balance is necessary. This is the treatment framework for gas-type IBS from the perspective of Korean medicine.

If you are currently suffering from a feeling of 'your abdomen bursting after every meal' or 'gas being trapped inside your intestines,' do not view it as a simple digestive issue. This could be a systemic signal from your body. It is time for a Korean medicine diagnosis and approach.

#IrritableBowelSyndrome #GasTypeIBS #IncheonIBS