I’ve had patients describe their bloated stomachs in terms ranging from feeling like ET (yes, the extraterrestrial with the distinctive paunch) to uncomfortable, embarrassing and, at times, extremely painful. Bloating is somewhat controversial. Some experts believe a hypersensitivity to intra-digestive gas may be responsible rather than an outright excess, and others feel there is just too much air in there. Many agree that the air, food and fluid contained within the digestive tract can press outwardly on the gut lining, and cause the symptom of bloat.
Now I must clarify, in the English speaking world ‘bloating’ refers to a feeling, with ‘distention’ the term used for observable ET-esque increase in abdominal girth.
And while we tend to not openly discuss our bowels with others, bloating is a common challenge. One study in Digestive Diseases and Sciences found that within the month prior to interview, “abdominal pain or discomfort (occurred in) 21.8%, bloating or distension (occurred in) 15.9%,” of people. It appears we are suffering alone, together.
Various causes exist for bloating; from the more easily addressed to the serious, with bloating a sign of an underlying sinister illness. Luckily, the latter is not common. Still, I’ll discuss the possibilities here in order to be complete and then share the more common challenge with helpful approaches and insights.
Ready to dive in?
What is bloating and why does it happen?
Your digestive system contains a myriad of gut bugs (your microbiota) and the important process of fermentation, and these produce gas. Too much trapped gas that is unable to escape leads to bloating. In this way, belching, and as my English husband says, trumping (flatulence), are a blessing in that they remove some of the offending air.
There are numerous answers to what can cause bloating. I’ll talk about the common and overlooked condition called leaky gut in a moment. But first, let’s look at an official definition…
According to Richard Hunt and his team, bloating “refers to a feeling of fullness, without any relation to prior food intake to explain this feeling.”
It can be difficult for people to explain, often being reported as feeling full, having a ‘poking out’ stomach or feeling the need to loosen their belt or clothing. Sometimes, bloating is reported in conjunction with other signs and symptoms, like a rumbling tummy or excess wind.
Luckily, bloating is often functional and usually benign. This means that with the positive lifestyle changes we discuss shortly, the opportunity exists to reduce — even eliminate — this potentially embarrassing and uncomfortable issue.
However, on occasion, bloating can be a sign of an underlying and serious health issue. If you have these additional signs and symptoms, please see your health professional promptly:
Anaemia (low iron levels) reveals itself with signs like fatigue, shortness of breath, lightheadedness, brain fog and even confusion and infertility. This combined with bloating can indicate pernicious anaemia, or inflammatory bowel disease (Chron’s disease or Ulcerative Colitis).
An abdominal mass. If you are bloated and feel a lump in your abdominal area, this may indicate the presence of another issue. These may include:
– An ovarian cyst (also look out for pain during intercourse, painful bowel movements, back pain or nausea)
– Fibroids – oh, you have to love being a woman! These uterine tumors are usually benign and can be accompanied by heavy bleeding, pelvic and lower back pain, pressure in your lower abdomen, pain during sex and increased cramping during menstruation.
– Intestinal obstruction. Imagine… what would happen if you blocked the end of a hose while still having it attached to the tap and turned on? Our intestines are designed to move food and fluid from our mouth, through our middle, and out the other end, giving us life sustaining nourishment along the way. When blocked, bloating can occur in conjunction with abdominal pain, nausea and vomiting and strong abdominal cramping. This is a serious and potentially life threatening condition.
– Cancer. While not the likely cause of bloating, this can be a sign of the big ‘C’. If you also experience unexplained weight loss, a retreating appetite, fatigue, blood in or blackness of your stools, or feel something is not quite right, book a consultation with your doctor. Ovarian, colon and stomach cancer may need to be excluded.
– Constipation. Not being able to pass stools can be unexpectedly painful. It can also cause a hard feeling in your lower abdomen.
Permanent abdominal distention
You feel bloated and your abdomen always looks enlarged. You, your family, your friends and your health professional can see it… And it’s not going away. This could be a sign of ascites; the abnormal accumulation of fluid in your tummy region. Ascites is more common with liver diseases, such as cirrhosis.
Nausea, vomiting, and diarrhea
Blood in your stool.
I’ll also make mention of Celiac’s disease here. This allergy to gluten can cause a raft of signs and symptoms, including bloating. Often, a sufferer may notice the bloating is triggered by wheat, barley, rye, and foods like pasta, bread, cakes, cereals and, dare I say it, beer.
Usually in the case of a serious, underlying illness, the bloating does not resolve or change over the course of the day. Now… that’s the unlikely scary stuff out of the way, let’s take a look at a leaky gut.
Naturopaths and other natural health experts have been proponents of the common condition called leaky gut for an eon, and have been treating it effectively. However, this is still a controversial diagnosis in the mainstream medical field. With the ground breaking evidence coming from smaller countries like Belgium and Israel, it has not yet filtered through to common clinical awareness. Scientifically speaking, leaky gut is referred to as increased intestinal permeability.
What is leaky gut?
Our gut should act like a funnel to toxins, directing these from our mouth to our anus and out. However for a variety of reasons, including lifestyle choices, our digestive tract may act like a sieve. This allows unhealthy compounds to irritate and cross our one-cell thick digestive lining, causing inflammation, greater permeability and signs and symptoms like bloating, tiredness, weight fluctuation, heartburn, body pain, and even brain and mood changes.
This begs the question…
How to stop bloating?
Firstly, if you want to dive in and discover all things fermentation and the gut, you’ll find a great article here by Dr Sarah Myhill and Craig Robinson.
Now, how can we stop bloating?
Lifestyle changes and expert advice from a suitably qualified natural health professional are key, as is awareness and action. So…
– Keep a food and drink diary. Note everything you consume, when, and also any signs and symptoms. This will help you identify foods or beverages you are not able to digest and cope with.
– An elimination diet. This is a therapeutic approach that involves eliminating many foods and drinks, and reintroducing each separately and over time. It enables your gut time to rest, repair and rejuvenate, and you to identify offending items so as to avoid them in future. I recommend being under the guidance of a health professional while you do this.
– Limit or cut alcohol consumption. I say limit because I know this is an Achilles heel for some people. If you’re reading this with a glass of red in hand, I apologize. Alcohol is a known gut irritant.
– Supplement as needed, including omega 3 fatty acids, glutamine and a pre and probiotic. This approach is best done under professional guidance as you will be able to determine what to try, what works and what doesn’t, in a more efficient manner.
– Manage stress. If there’s one thing the belly doesn’t love, it’s stress. Walk, meditate, never eat with open bills or an influx of negativity. Watching the news or reading the newspaper is better done away from meal time.
– Sleep. Sufficient shut eye is important for reducing stress and enabling your body to function optimally.
– Exercise regularly.
10 foods that fight bloating… Oh yeah, and drinks!
1) Distilled or filtered water. Ok, so I’m going to be sneaky and start with a beverage. Water is important to flush toxins from your body, remain hydrated and heal. If you find water feels too heavy on your stomach, try sipping warmed water instead.
2) Healthy proteins like fresh fish and wild game. These keep you full for longer, allowing you to avoid potentially hazardous foods. They also provide amino acids to help your gut heal.
3) Vegetables like carrots, celery, beets, zucchini, lettuce, snow peas, sweet potatoes and bell peppers. While you shouldn’t, if your unique make-up brings trouble with these safe foods, include some of our next item.
4) Apple Cider Vinegar. The number of my patients who’ve heartily praised this simple product blows my mind… and my tummy actually. I love it too!
5) Fermented foods. These not-so-popular foods are a good source of the probiotics required for optimal gut health. Think sauerkraut and kimchi, natto and tempeh.
6) Green tea. By reducing inflammation, this tea can help to keep your digestive system and the cells that line it, healthy.
7) Follow the FODMAP. For some people, it’s the… are you ready for it… Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols that cause bloating. To discover which foods to eat and which to avoid, this article is incredibly helpful.
8) Kiwi fruit. This wonderful little fruit has been shown to help aid tissue healing. Enough said!
9) Nuts of a certain persuasion. I’ve pondered the question and I don’t think I could go through a single day without my hit of nuts. Healthy protein, vegetarian friendly fats, the antioxidants important for gut repair. While a few nuts are FODMAP unfriendly, walnuts, Brazil’s, pecans, chestnuts and macadamias all make the good list.
10) Bananas. The humble banana contains fiber, magnesium (a muscle relaxer) and potassium. As bloating can be caused by constipation, and this fast food (just peel and eat!) has nutrients to relax the gut and improve digestive health, it might be just the go-to you need.
Bloating-causing foods you need to avoid
This can look like an impossible list, but with some expert support, a plan and a little will power, avoiding these foods could edge bloating into past memories.
1) Gluten. Gluten and dairy are two food types that I’ve seen throw up numerous health challenges again and again. Bloating most certainly included, in the case of gluten, whether celiac or gluten intolerant.
2) Dairy. Yes, as above.
3) Sugar rich foods, like cakes, candies, pastas and juices. If you’re looking for a sure fire way to upset those crucial bugs living in your digestive system and to alter the types of microbiota present, sugar rich foods are the way to go. Bloating, anyone?
4) Lentils. When I lived in Ireland, I often ate home cooked Dahl. While this is a favorite of mine, I along with my patients, can attest to its wind power. If bloating is an issue, it might be best to either avoid, or not indulge in consecutive, lentil meals.
5) The dilemma of the cruciferous vegetable. While vegetables like broccoli, cauliflower and kale are wonderful for your health, they are well known gas creators. Are these an issue for you? Try avoiding them in an elimination diet and replacing in small proportions, slowly.
It is possible to live a bloat free life. Identify and then reduce — or eliminate if need be — offending foods and drinks, improve your lifestyle, ensure sufficient shut eye and focus on stress management. Become aware of what triggers an episode. Exercise regularly, even if you need to start gently and in the privacy of your own company. And seek out professional support and advice if you are either concerned about the potential for a serious underlying cause, or want insight and support along the way.