Bloating – are you feeling like your belly might just pop?

Is bloating keeping you from going out, fitting into a favorite outfit or just making you uncomfortable and self conscious?

In a widely cited survey of 2000 US adults, 31% of respondents met Rome 1 criteria for functional bloating.

Other studies have shown that over 90% of patients with IBS have symptoms of bloating.

Bloating is uncomfortable, can be embarrassing and makes many people self conscious when their clothes aren’t fitting properly. Bloating can be outside of weight gain or ‘feeling full’ and can change throughout the day. Gas builds up in the digestive system making the belly protrude and feel tight. Many of our patients showing us photos of looking completely different throughout the day at times saying “I look pregnant in this one”.  That’s terrible… why are people living with this?

 

What causes bloating?

  • Food sensitivities and/or allergies
  • Low stomach acid (heartburn/heartburn meds and/or a lot of belching and burping)
  • Low digestive enzymes
  • Thyroid dysfunction
  • Small intestinal bacterial overgrowth (SIBO)
  • Intestinal permeability or “leaky gut”
  • Imbalance in the gut bacteria- too much that isn’t helpful and not enough that is helpful
  • Slow/fast transit (constipation/diarrhea)
  • Candida (yeast) overgrowth in the gut
  • Low neurotransmitters in the gut (*yes these are made in the gut not in the brain)
  • Inability to break down sugars
  • Hormonal dysfunction
  • Dehydration
  • Bowel obstruction
  • Cancer

Often food allergies, sensitivities or intolerances (like lactose intolerance) are common reasons for gas and bloating.

Small intestinal bacterial overgrowth (SIBO) is caused by high levels of bacteria living in the small intestine which is, usually living in the bowel.  The overgrowth causes a large amount of bloating in the belly.  Because SIBO is effecting the microbiome, it is also effecting the ability for us to absorb nutrients.  This can be diagnosed utilizing a home (or hospital) breath test and treated with prescriptions, herbs, diet and lifestyle changes.

Does diet have anything to do with this?
YES! Everything you eat or drink is either feeding or fighting disease. This holds true with how well our microbiome bacteria are being fed or starved so they go ‘looking for food elsewhere’ or how well the poop moves through our system and how much air is trapped.

“What foods should I avoid?”

  • Refined grains
  • Most dairy to include yogurts and those with sugar and artificial sweetners
  • Sugar, alcohol and high glycemimc foods (this ‘feeds’ the candida and gut bacteria to overgrow). This includes agave, maple syrup and honey – and we do not recommend exchanging these for artificial sweetners such as aspartame, nutrasweet, sorbitol, xylitol (stevia is ok)
  • Legumes and beans (to include peanuts and peanut butter)
  • Carbonated drinks and gum
  • Many find avoiding high FODMAP foods is very helpful for reducing bloating

“High fiber diets” – so many go right to the whole grain/whole wheat foods, but as above many times these foods are just what is causing some of the dysfunction.  We recommend high fiber come from vegetables, greens, low glycemic fruit, seeds, nuts and ancient grains such as quinoa.

“What about probiotics?”  Good bacteria helps to support the strength and reproduction of our microbiome and keep the bacteria where it belongs. Probiotic foods such as kimchi, sauerkraut, kefir,  natto, kombucha are helpful.  Prebiotic foods such as artichokes, cucumbers, onions, peppers, radish, sweet potatoes, carrots, quinoa, tomatoes and seeds are helpful as well.

Sadly, many people are not discussing their symptoms with their providers.  Dr Rashini Raj, a gastroenterologist at NYU Langone Medical Center in NYC stated “That’s probably the most alarming part for me, because as you know sometimes this can be a sign of more serious underlying conditions: celiac disease, Crohn’s diease, EPI or exocrine pancreatic insufficiency – so these are symptoms you shouldn’t ignore, and unfortunately a lot of people don’t feel comfortable talking about them”. (or write off as though it’s just “their norm”).

We strongly recommend you to discuss your symptoms with your providers and if you aren’t getting relief seek out a functional medicine practitioner for deep dive microbiome, food sensitivity and SIBO testing. Your belly will thank you!

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