Shoulder pain

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Trapped wind, gas and bloating

Everyone has a certain amount of gas in the gut. Some people, however, are sensitive to normal amounts. They experience pain, burp excessively or pass large amounts of wind as the gas passes through the gut.

Occasionally, greater than normal amounts of gas are produced. There are several situations in which this may occur, including air swallowing, dietary factors and, less commonly, bowel diseases.

Changes to the diet, various medicines and products which deodorise gas may be helpful.

What is trapped wind?

Diagram naming the parts of the gut

There is always a certain amount of gas in the bowel. Most of this comes from air swallowed whilst you eat or drink. It can also happen during smoking or when swallowing saliva. Larger amounts can be swallowed when you eat quickly, gulp down a drink or chew gum. The swallowed air goes down into the gullet (the oesophagus).

If you are sitting up, the air tends to go back up the oesophagus and escapes again through the mouth in the process of belching. If you are lying flat, the air tends to pass downwards causing gas in the stomach. This can result in bloating after eating and a hard, swollen tummy. The gas eventually enters the small bowel (small intestine) and escapes through the back passage (anus). People often refer to this as ‘farting’ or, more politely, ‘passing wind’/’passing gas’, or flatulence.

Gas can also be produced due to germs (bacteria) acting on partially digested food in the gut. This is more likely to happen with some foods than others. Broccoli, baked beans and Brussels sprouts are well-known culprits. The number of germs in the bowel also has an effect on the volume of gas produced. The gas that is made is mainly composed of carbon dioxide, hydrogen and methane. It may contain traces of a chemical called sulphur. This is responsible for the unpleasant smell experienced when you pass wind through the back passage.

Abdominal bloating is the term used when the tummy feels blown out, tight or full of gas. It results in a swollen stomach and the waistband of a skirt or a pair of trousers may feel uncomfortable. You may experience crampy tummy pains.

Trapped wind symptoms

Symptoms of trapped wind and bloating include:

Passing a lot of wind.
Crampy stomach pains.
Bloated belly.
Pain in upper abdomen

Gas sometimes settles in the curves of the large bowel (large intestine) under the liver or spleen. This can cause pain in the upper right or upper left areas of your tummy.

Most people who are bothered by these types of symptoms do not actually produce more gas than usual, they are just more sensitive to normal amounts. However, it is now considered that some patients with irritable bowel syndrome (IBS) do produce larger than normal volumes of gas. Irritable bowel syndrome is a condition in which bouts of tummy pain are associated with bloating and changes in bowel habit such as constipation and diarrhoea.

Just to complicate matters further, the amount of bloating does not relate to the seriousness of the cause. People with irritable bowel syndrome may complain of severe bloating, whilst in those with coeliac disease the bloating may be mild, moderate or severe.

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What causes trapped wind?

Everybody has trapped wind symptoms from time to time. In most cases, this is part of the natural working of the body and the symptoms soon pass. Some people complain they are feeling bloated all the time. As mentioned above, people are occasionally sensitive to normal amounts of gas in the tummy. The reasons for this are not entirely clear.

There are some conditions associated with larger than normal amounts of gas in the tummy:

Swallowing too much air

This is called aerophagia. You may not be aware of it but you may be swallowing air frequently or in large amounts. This often happens in people who are under stress. It can be aggravated by chewing gum and smoking. Usually, air swallowed in this way passes into the gullet (oesophagus) and down into the stomach.

However, sometimes air is sucked into the back of the throat (the pharynx) and is burped out before it reaches the oesophagus. This is known as supragastric belching.

Some people swallow air deliberately to cause belching, as they find this helps to relieve symptoms of indigestion.

Diet

Foods which are well known to cause excessive wind in the gut include:

Broccoli.
Brussels sprouts.
Starchy foods such as potatoes, corn and noodles.
Foods high in soluble fibre (eg, fruit, peas and beans).

Lactose intolerance

Lactose intolerance happens when your body has difficulty digesting lactose. Lactose is present in milk and foods which are made with milk. Lactose intolerance causes diarrhoea, stomach ache and bloating.

Intolerance to food sugars

Intolerance to sugars in certain foods can occur. Fructose intolerance is the most common. Foods high in fructose include dried fruit, honey, sucrose, onions and artichokes. Sorbitol is another sugar to which you can be intolerant. It is found in chewing gum and ‘sugar-free’ sweets.

Medicines

Check the leaflet of any medicines you are taking, as wind, gas or bloating can be side-effects. Metformin (a medicine for diabetes) and lactulose (a laxative) are well known to cause these symptoms. Antacids such as magnesium trisilicate help to combat indigestion but they can increase the amount of carbon dioxide produced in the stomach, and aggravate belching.

Diseases causing increased gas

Most people with gas-related symptoms have increased sensitivity to gas or have one of the causes of increased gas production mentioned above. However, occasionally these symptoms can be caused by diseases of the bowel. Sometimes, the illness can be short-lived. For example, acute gastroenteritis (also known as a ‘tummy bug’), often caused by infection with a virus, can result in a short-term condition associated with increased gas.

Occasionally, gas-related symptoms can be features of long-term diseases. All of them can cause at least one gas-related symptom (i.e. tummy pain, excess wind or bloating).

Coeliac disease
Coeliac disease is caused by intolerance to a protein called gluten which is found in certain foods containing wheat, barley and rye. It principally affects the part of the gut called the small intestine. It can occur at any age. Symptoms are relieved by avoiding gluten-containing foods.

Inflammatory bowel diseases
The most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. Ulcerative colitis is a disease in which inflammation develops in the colon and the rectum (the large intestine). Crohn’s disease is a condition that causes inflammation of the wall of the gut (gastrointestinal tract). Any part of the gut can be affected. The main symptoms of inflammatory bowel diseases are tummy pains and diarrhoea, but bloating and other gas-related symptoms can develop.

Diverticulitis
Diverticulitis occurs when small pouches in the wall of the large bowel (‘diverticula’) become infected.

Short bowel syndrome
Short bowel syndrome can be a complication of bowel surgery. If more than half the small bowel is removed during surgery this can cause difficulties in food absorption.

Small intestinal bacterial overgrowth
Small intestinal bacterial overgrowth is a poorly understood condition which is caused by an overgrowth of germs in the small intestine. It can be an aftermath of bowel surgery, and also occurs more frequently in people with diabetes, inflammatory diseases of the bowel and diverticulosis.

It may be associated with irritable bowel syndrome and can cause the same sort of symptoms, particularly bloating. Indeed, it is thought that some cases of irritable bowel syndrome may be caused by small intestinal bacterial overgrowth. Small intestinal bacterial overgrowth is sometimes treated with antibiotics such as metronidazole.

Scleroderma
Scleroderma is a condition which causes thickening of the skin and sometimes the internal organs. When the gut is affected it can cause problems in stomach emptying and irregularity of bowel movement. This can lead to bloating, constipation and diarrhoea.

Ovarian cancer
Ovarian cancer is mentioned here because, although cancer of the ovary is not a disease of the bowel, it can cause symptoms which can be confused with bowel disease. These can include feeling full quickly or loss of appetite, tummy pains and bloating.

Giardiasis
This is caused by infection with a germ called giardia. One of the symptoms is belching up foul-smelling gas.

Do I need any tests for trapped wind or bloating?

Most people with these symptoms do not need any tests. However, you may need tests if you have more worrying symptoms. These can include:

Persistent diarrhoea.
Blood in the stools (faeces).
Weight loss.
Lack of appetite.
High temperature (fever).
Being sick (vomiting).
Features of anaemia.
Difficulty in swallowing (dysphagia).

Shoulder pain

You usually need to do these things for 2 weeks before shoulder pain starts to ease.

It can take 6 months or longer to recover from shoulder pain.

Putting heat or cold packs on your shoulder

pack of frozen peas wrapped in a tea towel for up to 20 minutes, 3 times a day
hot water bottle wrapped in a tea towel for up to 20 minutes, 2 to 3 times a day

Don’t

A pharmacist can help with shoulder pain

A pharmacist may suggest:

the best painkiller – this might be tablets, or a cream or gel you rub on your skin
other ideas for pain relief and things you can buy to help, like heat and cold packs
seeing a GP if you need to

Information:

Video exercises for shoulder pain

Non-urgent advice: See a GP if:

shoulder pain is getting worse or does not improve after 2 weeks
it’s very difficult to move your arm or shoulder

Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:

you have sudden or very bad shoulder pain
you cannot move your arm
your arm or shoulder has changed shape or is badly swollen
you have pins and needles that do not go away
there’s no feeling in your arm or shoulder
your arm or shoulder is hot or cold to touch
the pain started after an injury or accident, like a fall
you develop severe pain in both shoulders
you feel feverish or unwell

These can be signs of something serious, like a broken or dislocated bone, or a torn (ruptured) ligament or tendon.

Treatments for shoulder pain

A GP will examine you to work out what’s causing your shoulder pain.

They might send you for tests (such as an X-ray) to check the cause.

They’ll suggest a treatment based on the cause, for example:

stronger medicine or injections to ease pain and swelling
physiotherapy or exercises to do at home
things to avoid to stop the pain getting worse or returning
seeing a specialist for tests or treatment

Physiotherapy for shoulder pain

The number of physiotherapy sessions you may have depends on the cause of your shoulder pain.

If you’re still in pain after your sessions end, go back to the GP. They might prescribe more physiotherapy or suggest another treatment.

Physiotherapy is available through the NHS, but waiting times can be long. You can also pay to get physiotherapy privately.

Information:

Self-refer for treatment

If you have shoulder pain, you might be able to refer yourself directly to services for help with your condition without seeing a GP.

To find out if there are any services in your area:

ask the reception staff at your GP surgery
check your GP surgery’s website
contact your integrated care board (ICB) – find your local ICB
search online for NHS treatment for shoulder pain near you

Causes of shoulder pain

Shoulder pain that does not improve after 2 weeks might be caused by something that needs treatment.

But do not self-diagnose. See a GP if you’re worried.

Pain and stiffness that does not go away over months or years

Pain that’s often worse while using your arm or shoulder

Tingling, numb, weak arm, feels like the shoulder is clicking or locking

Shoulder instability, sometimes because of hypermobility

Sudden very bad pain, cannot move your arm (or it’s difficult), sometimes changes shape

Pain on top of the shoulder (where the collarbone and shoulder joint meet)

Problems in the acromioclavicular joint, like dislocation or stretched or torn ligaments

Video: shoulder pain

In this video, an expert explains how to prevent and ease shoulder pain and when to get help.

Media last reviewed: 1 November 2021
Media review due: 1 November 2024

Page last reviewed: 22 May 2023
Next review due: 22 May 2026

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Trapped Wind In Shoulder

Shoulder pain

Trapped wind, gas and bloating

In this article :

What is trapped wind?

Diagram naming the parts of the gut

Trapped wind symptoms