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Symptoms requiring routine medical review: Bloating that persists beyond 46 weeks despite dietary modifications and adequate dose titration Symptoms that significantly impact quality of life or ability to maintain adequate nutrition New or worsening heartburn or regurgitation, which may indicate gastro-oesophageal reflux disease (GORD) Changes in bowel habit such as persistent diarrhoea or constipation Concerns about medication adherence due to gastrointestinal side effects Your healthcare professional may recommend investigations to exclude other causes of bloating, particularly if symptoms are atypical or severe

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It could be your iron levels, your stress response (cortisol), or perhaps the speed of your weight loss