Bloating is a health issue we all face. From the embarrassment of passing gas in public to the heavy, sluggish “ even painful “ feeling of a swollen stomach, understanding the causes and severity of bloating can be like navigating a maze at night. Luckily, you can beat the bloat with mindfulness, a little research, and a well-stocked pantry. Let’s break down some common causes of bloating and, more importantly, what you can do about them.
Gas
Flatulence, or “excess gas”, is no doubt something we’ve all experienced. (Even if we feign ignorance around our partners.) Our GI tract is an impressive petri dish of microorganisms, so things are bound to get funky. There is no single reason for flatulence. Gas is released as digestive bacteria break down food products, passing the good stuff into your bloodstream and the unnecessary stuff out of your body. Certain carbohydrates are not completely digested by the enzymes in the stomach and the small intestine and therefore they reach the colon allowing colonic bacteria to digest them. That process produces mostly odorless gases. Malodorous gases are due to the presence of a small amount of sulfur. Cabbage, Brussels sprouts and broccoli, for example, are notorious for causing increased gas as they contain raffinose which gets digested by the bacteria in the colon. Even swallowing too much air as we sip and gulp can lead to gassy buildup. When that gas buildup reaches its limit, you get the swelling, bloating, belching, and passing of gas.
Solutions
Luckily, there are tons of non-pill solutions to help manage gas-induced bloating. These include teas, oils and whole foods, so you may have some of these items already stocked in your cupboard. Peppermint oil can alleviate gas and bloating, and many people also feel better when they consume chamomile tea. For a real one-two punch, grab a peppermint-chamomile blend during your next trip to the store, or brew your own at home. Foods that contain short-chain carbohydrates called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols) are poorly absorbed and can result in bloating and gas production. A diet that is low in FODMAPs may reduce the amount of gas you produce. Some of the high FODMAP foods to avoid include: wheat, rye, barley, peas, apples, pears, mangoes, peaches, plums, cherries, watermelon, asparagus, cauliflower and artificially sweetened chewing gum and confectionery. Starch can also contribute to increased gas. Potatoes, corn and noodles can cause gas, while rice does not. Other probiotic-rich foods like sour pickles, kefir, tempeh, miso soup and unpasteurized sauerkraut can encourage a healthier digestion, regulating your whole system. Bonus points if you make a concerted effort to eat slowly, chewing well and letting your saliva jumpstart food breakdown so your lower tract doesn’t have to work so hard.
Fluid Retention
It’s no secret. We consume far too much sodium in our diets and consume too little vitamin and mineral goodies like potassium and B-complexes. This leads to bloating, as your body retains more water in direct relationship to salt. (Ever wonder why you get so thirsty after eating movie theater popcorn?) On the other hand, drinking too little water “ i.e. dehydration “ can also produce bloating. Water is critical to good health. If Maslow’s Hierarchy were concerned with nutrition and only nutrition, water would be rung one. When we don’t drink enough of it, our digestive system will be fundamentally impaired resulting in a variety of digestive symptoms including bloating.
Solutions
Avoid a diet rich in salt. That helps not only with fluid retention but also with your blood pressure if you suffer from or you are at risk for hypertension. Water-rich produce is a simple solution to balance fluid retention. Celery, cucumbers, kiwis, and blackberries are some of my top recommendations. What’s more, many of these fruits and veggies’ leaves are actually edible, containing the same bloat-reducing properties as the produce themselves (while also cutting down food waste).
Hormones
Bloating caused by hormones is common in women of all ages. As hormone levels naturally fluctuate, your digestive tract alters accordingly. For women, bloating can be a monthly staple due to menstruation cycles. Premenstrual bloating is caused by the hormone progesterone. As soon as the woman ovulates, progesterone levels start to increase to prepare the lining of the uterus for possible implantation. As a byproduct of the progesterone spike, women can retain more water and digest food slower, resulting in that achy gut bloat.
Solutions
Vitamins and supplements have been tried but it is mostly calcium that was found to help with premenstrual symptoms including bloating. Otherwise, it is important to exercise regularly and to get good sleep as sleep deprivation aggravates the symptoms. Limiting caffeine, alcohol, chocolate and salt also helps.
Digestive Disorders
Several diseases of the digestive system cause bloating.
Celiac disease is a condition where the immune system reacts abnormally to a protein called gluten. Gluten is found in wheat, rye and barley as well as many prepared foods. Celiac disease can result in multiple non specific digestive symptoms as well as other symptoms, such as a skin rash, fatigue and migraines. One of the most frequently reported symptoms is bloating.
Lactose intolerance occurs when the body lacks adequate levels of lactase, the enzyme that helps digest lactose. Lactose is the main sugar found in milk and dairy products. People with lactose intolerance can experience gas and bloating and diarrhea after consuming dairy products.
Irritable bowel syndrome or IBS is a functional disease of the digestive system that can result in various and sometimes fluctuating symptoms and one of them is bloating. IBS can be related to stress or intolerance to certain foods or an imbalance of the normal flora that lives in the bowels, what is known as the gut microbiome. While this is not dangerous or life threatening in any way, it can be pretty debilitating and can affect the patient’s quality of life.
Solutions
Medical attention is required with most chronic digestive symptoms. Bloating and several other symptoms are non specific and can be caused by a variety of conditions and a work up is necessary to ensure no serious disease is causing the symptoms. If celiac disease is diagnosed, the treatment would be to follow a strictly gluten free diet. This is not easy as gluten is found in so many food products, but also in other places that we don’t typically think of such as certain creams and make up products. Nowadays there are so many commercially available gluten free products that it is somewhat easier to actually find products that can cater to most people’s tastes. If you are lactose intolerant, avoiding dairy products gets rid of the symptoms. Otherwise, there are lactase supplements that can be taken before consuming dairy products and these help with the digestion of lactose. The treatment of irritable bowel syndrome can involve various modalities that range from adjusting your nutrition (low FODMAP diet, avoiding certain foods) to using probiotics or antispasmodic medications to relying on relaxation techniques, Yoga and mind-body medicine.
If you are experiencing prolonged bloating and would like expert advice, schedule an appointment with Dr. Charbel at Digestive Care Specialists at 301-288-1319.
