Bloating is one of the most common symptoms of ovarian cancer. However, it can also be caused by other, less serious conditions. Tell your doctor if you are experiencing bloating or other health changes, and make sure to keep up with regular doctor’s visits and yearly women’s health exams.

What Is Bloating?

Bloating is a feeling of fullness or tightness in the abdomen (the area between the chest and the hips). Some people who are bloated may feel like there is a balloon in their stomach, pressing outward. Bloating may lead to abdominal pain, discomfort, and feelings of fullness after you’ve eaten a small amount. Bloating often occurs along with distention, in which the belly sticks out farther than usual.

Bloating in Ovarian Cancer

Experiencing bloating occasionally is normal, even for healthy people. However, women with ovarian cancer are 3.6 times more likely to feel bloated than women without ovarian cancer. About 3 out of 10 people living with ovarian cancer experience bloating.

Symptoms may vary between different types of ovarian cancer. However, all types can cause bloating. Bloating is an especially common symptom for epithelial ovarian cancers and germ cell tumors. This symptom can also occur in stromal ovarian cancer, although hormone-related symptoms are more common. Hormone-related symptoms include facial- or chest-hair growth, changes in menstruation, and early puberty (in adolescents).

Is Bloating an Early Symptom of Ovarian Cancer?

Ovarian cancer is more likely to cause noticeable symptoms during advanced stages, once the cancer has begun to spread. However, doctors are increasingly realizing that symptoms such as bloating can also appear during the early stages of ovarian cancer. Recognizing and quickly telling your doctor about ovarian cancer symptoms, including bloating may, help with early detection. When ovarian cancer is caught early, it can be treated more easily and has a much better prognosis.

Why Does Ovarian Cancer Cause Bloating?

Bloating as an ovarian cancer symptom often occurs due to ascites. Ascites is the buildup of fluid within the abdomen. Extra fluid in this space can press on internal organs and the sides of the abdomen, leading to the full, tight feeling. The extra pressure may in turn cause other symptoms. For example, if fluid presses against the stomach, a person may feel less hungry or become full quickly.

There are a few reasons why ovarian cancer causes ascites. Ovarian cancer often spreads to the peritoneum (the tissue that lines the inside of the abdomen and covers abdominal organs). The peritoneum normally makes small amounts of fluid that help lubricate the organs in the abdomen. The fluid made in the abdomen is absorbed through small channels in the diaphragm. If ovarian cancer spreads to the diaphragm, these channels can become blocked, preventing fluid and leading to a buildup.

Additionally, ovarian cancer may cause ascites when it spreads to the liver. Tumors may lead to high blood pressure within the portal vein (the vein that connects digestive organs to the liver). This extra pressure encourages fluid to leak out of the intestines and liver into the abdomen.

Finally, ovarian cancer can spread to the lymphatic system. The lymphatic system is responsible for fighting infection and removing extra fluid from the body. If the lymphatic system is blocked by a tumor, extra fluid may not be able to drain out of the abdomen.

Sometimes, the belly may also swell due to the size of the tumor itself. If ovarian cancer is not caught early, the cancer can grow very large, spreading from the ovary into nearby tissues. An ovarian tumor may appear as a large lump in the abdomen that makes a person seem bloated.

What Else Causes Bloating?

Many common health changes that are less serious than ovarian cancer also may lead to bloating.

Menstrual Cycle

Many women feel bloated for a few days before their period starts. It is normal to experience this symptom once a month. If you have not yet gone through menopause (that is, if you still have your menstrual cycle), your risk of ovarian cancer is fairly low. Two-thirds of ovarian cancer cases occur in people who are at least 55 years old.

Gastrointestinal Problems

Bloating is often caused by the gastrointestinal (digestive) system. Sometimes, something as simple as swallowing air or eating a large meal can lead to bloating. Additionally, many people use the term “bloated” to mean simply feeling full after eating. Bloating can also be the result of gastrointestinal conditions, such as:

• Indigestion (upset stomach)
• Constipation
• Intolerance to certain foods
• High levels of gas in the intestines
• Irritable bowel syndrome, a disorder that causes bloating, pain, constipation, and diarrhea
• Small intestinal bacterial overgrowth, a disorder caused by high levels of bacteria in the intestines
• Dysbacteriosis, an imbalance of “good” and “bad” bacteria in the intestines
• Gastroparesis, a disorder in which food leaves the stomach too slowly)

Weight Gain

Distinguishing between weight gain and bloating may sometimes be difficult. Additionally, abdominal weight gain is more common as a person ages. During the aging process, the abdominal wall (muscles and tissue that form the outer part of the abdomen) becomes weaker. The abdominal weakness often causes a woman’s stomach to stick out further as she ages.

One way to tell the difference between weight gain and bloating is to notice how your belly size changes throughout the day. Belly fat causes the stomach to appear larger all of the time, whereas bloating tends to make the belly grow larger throughout the day.

Medications

Certain medications can cause bloating. Some people who take Precose (acarbose) to manage diabetes experience this symptom. Additionally, bloating can be a side effect of the laxatives Kristalose (lactulose) or Arlex (sorbitol). Sorbitol may also be found in some foods, including sugar-free products, peanut butter, and fruit preserves.

Other Disorders

Other types of tumors may also cause bloating. People with dumping syndrome (a condition that develops after esophagus or stomach surgery) may also experience bloating. Bloating can also be a sign of pancreas problems.

When Is Bloating a Sign of Something Serious?

Mild or occasional bloating may not be a cause for concern. However, it is a good idea to talk to your doctor if the bloating occurs often, gets worse, occurs with other ovarian cancer symptoms, or doesn’t respond to anti-bloating treatments.

When bloating is caused by less serious conditions, it tends to come and go depending on things like diet or menstrual cycle. Bloating caused by ovarian cancer tends to be persistent — it never goes away, or it happens multiple times per week. If you experience abdominal bloating for three weeks or more, or more than 12 times per month, it is a good time to see your doctor. Additionally, it is a good idea to seek medical care if your bloating becomes more severe over time.

If you have ovarian cancer, you may also have other symptoms. The most common symptoms besides bloating are:

• Belly pain or lower back pain
• Feeling a lump in the belly
• Needing to urinate more often
• Feeling like you need to urinate right away

Other symptoms include tiredness, nausea, constipation, changes in your period, and pain while having sex. If you notice any symptoms or signs of ovarian cancer, tell your doctor what you are experiencing.

Certain steps may help prevent or treat bloating if it is caused by gastrointestinal conditions. Treatments include:

• Eating fewer gas-producing foods
• Eating more slowly
• Avoiding chewing gum and carbonated drinks
• Taking laxatives
• Exercising more

However, if these strategies don’t help, it may be a warning sign that bloating is caused by something more serious.

If your doctor thinks that you might have an underlying health condition, they will recommend tests to diagnose or rule out various diseases. Doctors often use blood tests and imaging tests to help diagnose ovarian cancer. Because bloating is often caused by digestive issues, your doctor may also want you to undergo other tests that can detect gastrointestinal conditions. These may include stool sample tests as well as an endoscopy or colonoscopy (tests in which a skinny tube with a camera is used to look inside of the digestive organs).

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. Members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Are you living with ovarian cancer? Share your experiences in the comments below, or start a conversation by posting on MyOvarianCancerTeam.