About 10% of the population is thought to experience it regularly, of those diagnosed with irritable bowel syndrome 90% will experience it and 75% of women may experience it before and after their period.
Bloating is the feeling of tightness, pressure and fullness. Having a distended belly is technically not the same thing – it is believed that about 50% of people who have bloating will also have distended belly which is the physical swelling. Bloating is when there is a build up of gas and it doesn’t move through the gut as quickly as it should.
First of all I need to make it clear that there is no one size fits all.
Bloating can be experienced in many ways –
- A feeling of excessive fullness after eating even small amounts,
- A distended belly and no discomfort,
- A distended belly and feeling uncomfortable or even pain
- Belching or farting
- Pressure at the top of the abdomen
- Cramping below the belly button
- Some will be relieved from farting or pooing, others won’t
- Some wake up bloated
- Some get more bloated as the day progresses
This means that the solution will be different for different people. Sometimes there is one cause. Sometimes there are many.
What can be the causes?
- Movement or motility of food is delayed within the gut – These are usually disorders of the muscles and nerves that sense digestive contents in the digestive tract. It feels like there’s an obstruction when there isn’t e.g. gastroparesis or pelvic floor dysfunction.
- Hypersensitivity and/or abdominophrenic dyssynergia. When the diaphragm doesn’t relax when the gut senses fullness due to food, liquids, or gas and allow for expansion of the stomach. Some people feel like they’re gassy and bloated even when their volume of gas is normal. This is really common in those with IBS. Some people may develop a reaction whereby the muscles relax and stick out when gas is present even if the volume is normal. Some people develop a sensitivity to gas – so even though there is a normal amount passing through it can feel uncomfortable.
- Celiac disease – if you haven’t been diagnosed and suspect you might have celiac’s then get tested. There is a blood test to check for antibodies (tTG-IgA [Tissue transglutaminase] test) and a genetic test (people with celiac disease carry one or both of the HLA DQ2 and DQ8 genes) this doesn’t diagnose it but your risk is increased. Having an endoscopy is the definitive form of diagnosis as specialists can see the damage done. You will need to still be eating gluten to have the blood test.
- Carbohydrate intolerance – you may not have the enzymes required to digest specific carbohydrates such as dairy (lactase), fructose (some fruit and vegetables) and legumes and grains. This can easily be tested and managed. This is a very common reason for bloating and can also result in cramping, diarrhoea and those stinky ‘death farts’.
- SIBO – small intestinal bacterial overgrowth is when the wrong type and the wrong amounts of specific bacteria is growing in the small intestine. These bacteria ferment food and eat enzymes which can cause bloating. This is also easily tested and can be treated. Alongside the bloating SIBO can cause diarhoea, constipation, stinky farts, painful joints, headaches and migraines, iron and B12 deficiency and is associated with a lot of health conditions.
- Indigestion – there are a lot of reasons for indigestion and its not just because you have too much stomach acid so before you reach for the antacids consider the other reasons e.g. not having enough stomach acid, eating too quickly, not chewing your food properly, eating too much in one go. It can take 20 minutes for the brain to get the message from the stomach that it is full. So slowing down is really important. SIBO can also cause indigestion due to the build up of air from the small intestines pushing up on the stomach. Too much fatty rich food can also cause indigestion and bloating as it takes longer to digest fats in the stomach.
- Aerophagia – this is just a fancy term for swallowing air which we do when we sniff lots (watch out those of you with allergies), eating too quickly, stress (we breathe more rapidly), drinking carbonated drinks…all of these can mean that the air is coming from outside and has built up and taking time to move through the digestive tract. Whilst we breathe out carbon dioxide and oxygen sometimes nitrogen is swallowed and that can’t diffuse into our lungs to be exhaled the only way out is through our gut.
- Constipation – when you are constipated the food in your colon backs-up like a traffic jam. The colon can expand to contain the extra volume of waste and this can lead to bloating.
- Bowel Obstruction and Inflammatory Bowel Diseases – your intestines can become blocked from tumours, scar tissue and inflammation. Hernia’s can also cause partial blockages (can also cause indigestion). Inflammatory Bowel Diseases such as diverticulitis, diverticulosis and Crohn’s can cause damage to the lining of the gut which causes strictures and adhesions which can partially block the gut passage.
- Recent weight gain – putting weight on around your belly can actually mean there is less room for your stomach and intestines to function properly.
- Hormones – thyroid, perimenopause and endometriosis – an underfunctioning thyroid can slow down digestion and cause constipation and bloating; high amounts of oestrogen and relatively low progesterone levels can cause fluid retention. This is because oestrogen causes your body to hold onto water whereas progesterone releases it. Estrogen and progesterone can each cause intestinal gas by either slowing or speeding your motility and oestrogen receptors increase that visceral hypersensitivity so you feel bloated even when you’re not.
- More serious causes included pancreatic dysfunction (no longer making enzymes), Ascites (fluid build up), bacterial infections and ulcers, inflammation of the abdominal lymph nodes and cancer including overian, uterine, colon, stomach, pancreatic, mesenteric (membrane surrounding the intestines).
If you have any of the following symptoms then you MUST go to your GP:
- Blood in your poo (stools)
- Difficulty swallowing
- Recurrent vomiting
- Weight loss that is rapid and cannot be accounted for
- Sudden change in bowel motions – suddenly become constipated or have diarrhoea
- ‘Pregnant looking’ belly that does not resolve (never flat)
- Unresolved hiccoughing
My Top Tips
- Go to your GP and get tested if you are worried or have the symptoms above.
- Slow down your eating and chew your food
- Complete a diary of your diet and symptoms to see if it is related to specific food.
- Make sure you are relaxed and not stressed when you eat.
- Don’t over eat.
- Try Deep Belly Breathing – When you breathe in expand your belly like a balloon and when you breathe out squash your belly as flat as you can. Breathe in deeply for 4 seconds, hold for 4 seconds, breathe out for 8 seconds, hold for 4 seconds and repeat.
- Activated charcoal and Iberogast can be really helpful supplements to take when you are bloated and uncomfortable.
- Come and do my 10 day ‘Beat the Bloat and Fix the Farts’ reset – mini course that will look at the causes and some ideas for how to treat bloating this includes what to eat, how to eat, herbs and supplements, mind-body techniques, breathing techniques, abdominal massage, yoga and pelvic floor exercises or book a chat with me to see how I can help find the causes and then the solutions.
There is a YouTube video of this blog. Head over to Sarah’s You Tube Channel if you are interested in watching rather than reading.
Come and join the 10 day ‘Beat the Bloat & Fix the Farts’ reset which started on 8th March 2022 – its not too late to join the fun. It finishes on 17th March so don’t wait. Click here for more info and to sign up NOW: Beat the Bloat Sign Up
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