Bloating is probably one of the most common symptoms I see in my clinic. Whether it is the dreaded PMS bloat or all month round bloat that follows you everywhere and pops up just when you do not want it, I think I would struggle to find anyone who doesn’t experience bloating.
Bloating can happen for many reasons so it can take some time to delve in and find what your root cause is. I often hear women saying that it doesn’t matter what they eat and they can’t work out what it is in their diets that makes them bloat. Sometimes even water causes bloating! They’ve tried cutting out x y z and it doesn’t seem to make much of a difference.
I hear you! And understand how frustrating it is to not see any clear patterns. However, whilst certain foods can cause bloating, there are many other reasons which need to be looked at and considered…and can often provide symptom relief without needing to obsess over your food diary.
So here are the most common reasons why bloating can occur (in no particular order):
1) Imbalanced gut bacteria
Bacteria is found all throughout our digestive tract, from top to bottom. We often only talk about bacteria found in the large intestine but there are different strains and quantities of bacteria lining the entire GI tract.
This complex ecosystem of bacteria requires the right bacteria to be in the right place in the right quantity. Any deviation from this can result in bloating and other common gut symptoms such as diarrhoea, reflux and constipation.
Your gut bacteria can be split into the ‘good guys’ and the ‘bad guys’. It isn’t quite this simple but for ease we will go with it. If we have the correct amount of the ‘good guys’ where they are supposed to be, they help breakdown food, provide immune support and produce some vitamins. However, if we have too many ‘bad guys’, especially in the wrong place, they create havoc. The ‘bad guys’ are very good at fermenting, creating lots and lots of gas.
The ‘good guys’ can also cause a problem when they are in the wrong place, which is the hallmark of SIBO, or small intestinal bacterial overgrowth. Essentially, bacteria from the large intestine has moved up into the small intestine where it shouldn’t be. Often bloating will be higher up around or above the belly button with SIBO.
Adding in a probiotic or including fermented foods might help to reduce bloating and is something you could definitely try to see if that eases your bloat. However, if this doesn’t resolve things for you, then it is wise to have a more in depth look at what is happening in the gut.
Suffering with constipation or generally a slow gut transit then I would bet a lot of money that you frequently suffer with bloating. We should be passing a stool at least once a day. It should be easy, pain free and not require you to sit on the toilet willing something to happen.
If this isn’t you, then try upping your fibre intake slowly. Include lots of vegetables, beans, nuts, seeds, pulses and a small amount of fruit (unless you are eliminating any of these foods!). Magnesium can also be great for supporting bowel movements so try upping your intake of dark leafy greens, pumpkin seeds, almonds or 70%+ dark chocolate, as well as Epsom salt baths and considering a magnesium supplement.
3) Food sensitivities
There are certain foods that will cause bloating no matter who you are. For example, the body cannot break down artificial sweeteners so if you over consume these, you are likely to experience gas and bloating (and quite often diarrhoea too!). The body can’t break these foods down so the bacteria found in our guts ‘ferment’ them creating gas which builds up in the intestines, which then creates bloating.
Other foods are more person specific and if you are sensitive or intolerant to certain foods, by cutting them out of your diet for 3-4 weeks you should see a remarkable improvement. The top two sensitivities are gluten and dairy, closely followed by eggs, soy, nuts, seeds, legumes and grains. It is quite a list so I would advise working with a qualified practitioner before taking the whole lot out of your diet as it may not be necessary. If you did want to experiment with a couple of foods, I would recommend starting with gluten and/or dairy and strictly removing them from your diet for 3-4 weeks and see what difference you notice.
4) Low digestive juices
The body breaks down food using different chemical concoctions and physical or muscular contractions at various different points in the gut. For example in the mouth you have saliva which starts the chemical breakdown of food, and you also chew your food which starts to physically break down our meals.
Digestive juices are an extremely important part of digestion and without appropriate amounts, food can be left undigested which causes gas and bloating, as well as not absorbing all the crucial nutrients from our food.
Stomach acid and digestive enzymes are two of the key digestive juices that get negatively affected by modern 21st century living. When we are stressed or don’t pay enough attention to eating, stomach acid production is greatly reduced which has a negative knock on impact on the amount of digestive enzymes released. Think of the digestive tract like a line of dominos, each domino needs to be in place for the next to fall.
Without sufficient levels of stomach acid and digestive enzymes, undigested particles of food sit in the intestines which are then fermented by bacteria. With fermentation, comes gas, which then causes bloating (and maybe wind!).
Dehydration can contribute to a slower moving gut or your stool not forming a nice smooth sausage shape - both which can contribute to bloating. Up your intake of water to 35ml per kg of body weight each day. If that seems like a stark increase from where you are currently, focus on increasing your intake by just 1-2 glasses of water until you feel ready to increase again.
6) Hormonal changes
Our hormones fluctuate throughout the month which can affect how quickly our gut moves and increase water retention. Most women get a little more bloated a few days before their period due to falling progesterone which creates more water retention. Ensuring your gut is moving well, prioritising potassium rich foods, decreasing salt intake, movement and adequate hydration can all help with this.
It is a good idea to track when you get bloated over 2-3 cycles to see if there is any correlation as this will give more clues as to why bloating might be happening for you. Other hormonal conditions such as endometriosis, fibroids and PCOS can increase bloating so if you are concerned, always get this checked via your GP.
Stress shuts down the digestive system. If there was a tiger in your living room, I doubt you would be too fussed about how well you digested your chicken curry for dinner. You would be fussed (probably very!) about getting out of there pronto or if you are feeling matcho finding something to defend your sofa with.
The point I am trying to make is when our stress response is switched on, it is all hands on deck. The stress response is a survival mechanism so when it is triggered, all resources go into that.
The trouble is, we don’t have a tiger sitting in our living room. We have long to-do lists, demanding bosses, constant messages and lack of sleep. We have lots of mini tigers attacking us all day every day so the stress response can stay firmly in the on position.
This means that the digestive system never gets the energy it needs to properly break down food. This means less digestive juices and a slower transit which results in undigested food, and you guessed it, more gas and bloating.
It can take some time to dig in to find out why you are bloated and it can often be a combination of things. Testing can help to get to the root cause faster so if you are interested in learning more, please reach out.