Persistent bloating: a problem that doesn’t go away even after changing your diet. Many people cut out dairy, gluten, and carbonated drinks, yet the bloating remains. Dr Saurabh Sethi, a US-based gastroenterologist trained at AIIMS, Harvard, and Stanford, says the issue may not be what you eat, but how your body processes it. On July 13, he shared on Instagram that persistent bloating often points to underlying medical conditions, not dietary failure. He urges targeted testing for four hidden gut culprits.
The first hidden cause is SIBO, or small intestinal bacterial overgrowth. Bacteria colonize the wrong part of the gut and ferment food too early, causing gas and swelling. Dr Sethi calls it significantly underdiagnosed, especially in patients who do not respond to diet changes. The second is celiac disease, where gluten triggers an immune attack on the gut lining. He warns that the average patient waits over six years for a diagnosis, often blaming stress or IBS.
The third culprit is lactose intolerance, which can develop later in life. About 65 percent of adults lose the ability to digest lactose after childhood, often without realizing it. Finally, H pylori infection affects roughly 50 percent of the world’s population. Dr Sethi describes it as a stealthy infection that hijacks stomach acid and wrecks digestion. It remains under-tested during routine checkups.
Persistent bloating is a biological puzzle, not a dietary failure. If you still suffer despite diet changes, schedule a targeted medical evaluation for these conditions. That is the most effective next step.