Bloating.
Before learning so much about the digestive system through my Naturopathy I thought it was normal for your stomach to be a bit sore and puff out after eating. I thought it was normal for my stomach to look really big by the end of the day and then go back to flat by the morning. I thought it was normal feel uncomfortable, a little bit sore.
So much so that if I knew had something coming up where I wanted to look good and feel sharp, I would avoid eating in the days leading up so that I wouldn’t look “fat” or feel slow with brain fog.
Yeah, so what I went through may be common, but it’s definitely not normal.
My underlying cause turned out to be SIBO (Small Intestinal Bacterial Overgrowth). Same would be true for up to 85% of people suffering with IBS symptoms as well.
And having this bacterial overgrowth meant that no matter how healthy I ate I would still end up with constant bloating.
Good, healthy, nutritious food and my stomach always just felt crap. It was horrible. I felt so ashamed by it, like my body was broken. Never openly talking about it because of all the stigma surrounding digestive issues.
Well actually, I did once show a friend my bloated belly and she wouldn’t believe that I wasn’t puffing it out on purpose. So then I felt even more ashamed and alone.
At my worst point a few years ago I was down to eating only chicken and eggs. These were the only foods I could eat without suffering.
Something had to give. Researching, researching, testing, testing. In 2015 I was diagnosed with SIBO. I had an answer!
Having this answer meant that I knew what I was dealing with. It gave me a sense of hope that I hadn’t felt in a long time!
So a few months of treatment and I popped out the other side SIBO free. Bit by bit increasing my diet back out again. Getting more and more variety which was so good for my gut as well and my sanity and my social life!
Getting to where I am today.
I can eat without suffering.
I can eat food and not look pregnant at the end of the day.
I can go out to dinner with friends again without freaking out about menu choices.
When I eat my stomach says the same! I don’t go from thin to fat in the space of a day.
It is so liberating.
So think you’re alone with your digestive issues?
Not at all.
Bloating is something that affects up to thirty percent of us! And almost 90% of people diagnosed as having Irritable Bowel Syndrome (IBS) list bloating as their number one symptom.
And you don’t have to have been labelled with IBS to be included (I don’t really resonate with “IBS” myself)
In one study on bloating, 75% of patients (who did not have IBS) characterized their symptoms as moderate-to-severe, and over half stated that they had reduced their daily activities to some degree due to their bloating symptoms.
With those statistics it’s likely that one out of every three people you know are suffering in some way.
But no one talks about it.
And you can get through your day dealing with it.
You can still function. Just not optimally.
And it’s hide-able. People don’t see what you feel.
So it’s often something that we ignore. And ignore and ignore and before you know it years have gone by and you’re still trying to convince yourself it’s not such a big deal.
How much of your day do you spend thinking about your stomach and how it feels?
How much of your energy does it take away from things you’d love to be doing?
Stomach bloating isn’t something to be ignored.
While it can certainly be uncomfortable – and even a little embarrassing if accompanied by emergency dashes to the bathroom – it’s actually very often a bigger deal than it’s given credit for.
Stomach bloating can signify a deeper, more serious underlying health condition and should be paid attention to.
It is one of the leading symptoms of candida overgrowth and/or SIBO.
It can lead to other, more chronic conditions like digestive disorders, autoimmune conditions, thyroid problems, hormone imbalances and infertility, allergies, even bowel cancer in some cases.
Scary, but true.
Symptoms of a Bloated Stomach
A bloated stomach is definitely different from a fat stomach, or fat mass around the abdomen area.
Bloating can go up and down within hours. Fat mass takes longer to accumuate or to shift.
Bloating is temporary and is mostly caused by a build up of gasses or air in the belly making it extend outwards.
…it could be just a little distension after meals.
…it could be the excessive food-baby bloating (where you look six to nine months pregnant).
…the bloating that grows one to two hours after eating.
…or the bloating that comes as soon as you start eating, building and building over the day making jeans a really uncomfortable choice.
And it’s not just an aethestic issue. It’s often really uncomfortable. There can be pain and cramping associated as well.
Fortunately in some cases this bloating isn’t too much to be worried about and can be resolved with some simple dietary and lifestyle adjustments.
But unfortunately sometimes it’s a sign of something deeper, something more serious.
Next time you’re having a bout of the bloat, check in with yourself to see if you are having any of these other symptoms too:
- constipation or diarrhoea (or a combination of both)
- skin rshes
- difficulty breathing (can’t quite get a full breath in)
- vomiting or nausea
- unintentional weight loss
- unexplained weight gain
- blood or urine in stool
- fatigue
- brain fog and/or trouble concentrating
- irregular periods …I lost mine for 2 years and 7 months. One of my big life dreams is to be a mum so that was pretty shattering. Happy to report it’s back now and regular once more.
So then,
What causes bloating?
There can be many reasons.
Could be tummy troubles, thyroid disorders, allergies, stress, hormonal imbalances and more.
Can be one or all of the above all at the same time.
The more you can tune into your body when the bloating occurs and what was going on at the time (foods and circumstances), the more you will be able to identify and resolve your triggers.
Very often it is an issue with digestion.
But then going further than that there can be different things affecting your gut health, your metabolism, as well as your elimination.
What’s the culprit?!
Some factors can seem completely unrelated, such as sleep and stress.
(our stress response activates our sympathetic nervous system which is known as our “fight and flight” and shuts down our parasympathetic nervous system which is known as our “rest & digest” or “breed & feed“)
If bloating is caused by a gas build up, what causes the gas build up in the first place?
For most people, it tends to boil down to:
- poor protein digestion
If stomach acid is on the low side then high protein foods don’t get broken down so well. Then that can lead to the food sitting around and fermenting.
Gas is produced as a result of fermentation.
- inability to break down sugars and carbohydrates (fructose malabsorption is common here)
Did you know that just 30g of undigested carbohydrates can cause up to TEN litres of gas??
Digest that for a second. Ten litres of gas. Imagine having ten 1 litre water bottles packed into your abdomen. Squashing your diaphragm, making breathing hard. Making it uncomfortable to even sit.
One simple apple contains around 30g of carbs.
- imbalances in gut bacteria
We host more bacteria in our bodies than there are stars in the Milky Way. Not all of them are “good”, but they are commensal. Meaning that it is totally fine to have some of the “bad”, we just need them in the right place and in the right balance. If the bad guys sense an opportunity to have a party they are absolutely going to take it.
Take your eye off a toddler for while what happens? Chaos!
When the “good” bacteria break down food they do beneficial things like synthesise Vitamin K, produce serotonin, and build our immunity. They profoundly affect the state of our health and vibrancy.
When the “bad” bacteria break down food they don’t really do anything beneficial for us. They just produce gasses and release endotoxins. Which we can handle in small amounts. But we’ll feel really off if their numbers are too high, maybe experiencing headaches, dizziness, brain fog, fatigue, itchy skin, and often cravings for crappy food (which if eaten just perpetuates the cycle).
At the time when I was unwell my gut bacteria was so out of whack I was sore and stiff all over. Allll the time.
I could barely reach down and touch my toes.
A few months prior I was teaching yoga most days and in the best shape of my life. Folding myself in all sorts of crazy pretzel poses.
Definitely a humbling time in my life.
Out the other side it enables me to relate to my clients in a whole new way. So for that I am grateful.
Ten Possible Causes of a Bloated Stomach
- disorders of the digestive system
- constipation
- fluid retention
- dehydration
- food allergies or intolerances
- SIBO
- underlying infections
- hormonal imbalances
- bowel obstructions
- cancer
One by One:
1. Digestive Disorders
IBS would be the number one “diagnosis” of the digestive disorders.
Others include SIBO, Celiacs Disease, Chrons, and Ulcerative Colitis.
Of those with IBS studies show that 23 to 96 percent of sufferers list bloating as their main symptom.
And 56% of people with chronic constipation say its theirs too.
2. Constipation
If you go by the Bristol Stool Chart you want to be having between one and three of the number #4’s on the chart each day (smooth sausage, easy to pass).
It is still possible to have a bowel motion (poo) everyday and actually be “constipated”.
One technical term for it is having “incomplete evacuations“.
You went. But still feels like there’s more not wanting to come out.
Constipation could be one of the most obvious reasons for feeling bloated.
You have that hard, full feeling in your stomach.
Then one step deeper than that, the number one cause for constipation is dehydration. We need water to be drawn into the stools, bulking them up and keeping them soft, so that they can be passed through the intestines.
The other top reasons include: not enough fibre, being too sedentary/not enough physical movement, stress and magnesium deficiency (which is often caused by long term stress).
Think a forcing poop with laxatives is better than no poop?
At least you’re eliminating everyday, right?
No, actually it’s not.
Taking laxatives dries out the colon making stools hard to pass, and they can also decrease the muscle tone of your bowel exacerbating the problem.
3. Fluid Retention
Fluid retention can be felt all over your body.
Clients of mine have commented that anything with an elastic waistband will leave marks and indentations if worn for too long.
Others notice it in their fingers. One day rings may be loose enough to clink, the next tight enough to hurt.
Bodily fluids can also be stored around the abdomen and pelvic area making you feel bloated and uncomfortable.
This fluid can also show an increase in the number on the scale. 1 litre of fluid = 1kg of weight.
(so not 1kg of fat, 1kg of fluid)
You can also experience weight loss at the same time as bloating.
Crohns is a common cause for this (check for associated blood in your stools), and a less common but more serious cause could be stomach cancer.
Stomach cancer symptoms usually take longer to show but can include bloating, nausea, vomiting, weight loss and/or abdominal pain.
Fluid around the abdomen area is called “Ascites” and can be from an abdominal infection, cancer or as a result of liver disease. Other liver signs can include yellowing of the whites of the eyes and/or yellowing of the skin (jaundice) as well abdominal pain.
4. Dehydration
If you’re in tune with your body you may have made the connection between not drinking enough water and actually feeling more bloated and puffy?
Likely more so after a day of eating salty foods and drinking alcohol?
It seems counterintuitive, but the less hydrated you are the more bloated you’re likely to be.
We need water for so many functions in the body and if you’re not drinking it in, the body’s going to take it from where ever it can get it, i.e. your poo.
So 1. You’re pretty much having sewage water being circulated back around.
And 2. You’re likely going to end up constipated.
Back to that full hard mass in the abdomen, so that when do you actually drink again it can build up and make you feel bloated and uncomfortable.
5. Food allergies and intolerances
If you’re constantly eating foods or consuming drinks that your digestive system doesn’t like, it’s going to get upset.
And do it long enough you’re likely going to start reacting to other foods that you could eat just fine before too.
Just like going out in the sun on top of sunburn is going to hurt, putting more food in an already inflamed digestive system can also be distressing.
But you gotta eat.
So while you’re working on taking out the foods that are causing the most aggravation you’ll want to also heal up the digestive tract at the same time.
Imagine hot oil landed on your arm. Really hot oil that caused a lot of damage. Pain, blisters the works.
Yes you need to wash that oil off your arm (just like removing the foods that are causing the damage), but it’s going to need more care than that to repair the damage and return it to its pre-injured state.
Regular dressing and appropriate medical care will be needed to aid the healing process and successfully heal it.
A food allergy generally causes an immune system response and can affect the whole body (such as hives and the throat swelling up). This is an IgE response.
A food intolerance is generally less serious and is often limited to digestive problems, bloating being one of them. This is an IgG response.
The intolerances that most commonly cause the gas build up and bloating are: dairy (lactose intolerance), high sugar foods (fructose intolerance), gluten containing foods (bread, pasta, cereals etc) and then also certain kinds of carbohydrates classified as FODMAPs.
These foods often aren’t getting broken down well enough and so they sit there and ferment.
Remember just that one simple apple not digested properly has the potential create up to ten litres of gas? Apples are high FODMAP.
A great way to pinpoint any intolerances or sensitivities you may have is through keeping a well documented food journal, noting down errrrrrything that passes through your lips.
(I don’t really believe in food intolerance tests, you can read why in this earlier blog post).
Then also take note of any symptoms you’re experiencing and rate them on a scale of 1-10.
When it’s all written down it is much easier to make connections between what you’re consuming and how it’s making you feel.
6. SIBO
SIBO, my speciality! This one is so SO common (up to 86% of IBS cases have SIBO as a root cause), but still not very well known so it’s often missed as a cause for bloating.
SIBO is an acronym standing for Small Intestinal Bacterial Overgrowth.
And in a nutshell it is an overgrowth of bacteria in the wrong spot.
They should be populating our large intestine, not our small intestine. The small intestine should be relatively sterile.
And because the small intestine is where the food goes directly after the stomach the food is still fairly undigested.
If the bacteria are there they kind of get first dibs.
They ferment the food you don’t absorb.
Fermentation cases bloating.
Here’s a more in-depth post about SIBO.
Seriously highly recommend looking into this one.
9 out of every 10 clients I have tested come back positive with SIBO.
SIBO can be caused by a course of antibiotics, it can be caused by a single bout of food poisoning many years ago, it can even be caused by a big stressful event that caused the digestive system to shut down temporarily.
SIBO can be managed with restrictive diets, but it requires treatment to clear it. i.e. herbal antimicrobials and antibacterials.
7. Underlying Infections
If you imagine an infection on your skin, like from a sore that got a bit festy.
It can get red, swollen and inflamed.
The same thing can happen on the inside.
If you have an unresolved infection happening in your body this can result in swelling and bloating.
Check for signs of an infection by looking out for associated fever, redness and pain and/or swollen lymph glands.
You can also get your white blood cell counts tested by your doctor.
These will be elevated in the case of infections.
8. Hormonal Imbalances
This is more for the ladies.
Hormone fluctuations occur during the different stages of our menstrual cycle. But can also occur in peri-menopause and menopause too.
So if your bloating is a monthly occurrence and follows a certain pattern this could explain it.
During the follicular stage of a woman’s cycle (the first bit, the growing of the follicle) oestrogen levels rise and the uterine lining starts to thicken.
Then around ovulation time (the middle of our cycle) more fluids and blood build up. That feeling of fullness again.
Then when our uterus lining sheds (the bleed) we release a lot of the excess fluid, blood and tissue and results in the bloating going away.
Until the cycles starts over again…
9. Bowel Obstructions
If your small intestine or large intestine become blocked food won’t be able to move through properly.
So this one might be easier to pick up on as it’s pretty painful and you’ll likely stop being able to have regular bowel movements.
The blockages can be caused by an actual mass, or by adhesions or scar tissue.
And then there is also the possibility you’re feeling bloated because there is a tumour somewhere in your abdomen.
So if you’re feeling bloated, in pain, not being able to poo properly, and possibly also experiencing nausea and vomiting I would get to your doctor asap.
Left too long it could lead to a rupture and then you’re really in trouble.
A ruptured bowel can be fatal.
10. Cancer
The Big C.
Thankfully this is one of the lesser causes of bloating, but for sure one sign of cancer in the colon would be bloating.
If you’ve tried all the things and stilllll can’t pinpoint the cause of your bloating head to your medical practitioner and investigate this possibility.
The Best and Worst Foods for Bloating
Best Foods for Bloating:
The food and drink you choose to consume play a big role in bloating.
The composition of these foods and your ability to break them down will determine whether or not you end up with trapped air in your guts.
It’s important to make sure you are drinking enough water and eating enough fibre to keep things flowing smoothly through your digestive tract.
As a general guide for water you could aim for around 300ml per every 10 kg of body weight (so a 60kg person should aim for around 1800 mls per day). Might need more in summer, less in winter.
And then for fibre you want to be consuming both soluble and insoluble forms, and at least 25 – 30g per day.
(caveat for SIBO, too much fibre can make you feel worse)
If you’re eating a nice variety of whole foods this is pretty easy to achieve. Think about your veggies, fruits, nuts and seeds (ground flax is awesome!), legumes and if tolerated, your whole grains.
Some of the best foods to mange bloating include:
1. Probioitics
Probiotic means “pro-life” (as opposed to antibiotic which means “against life”).
When you have enough of your good bacteria in your digestive system (and in the right spot) they help to crowd out and keep levels of the “bad bacteria” low. Those “bad bacteria” (which can also include the yeast Candida albicans) are the ones that ferment foods in a non-beneficial way and release the gasses and endotoxins that result in the bloating.
You can take probiotic supplements, or you can get them through your food from sources such as sauerkraut, kimchi, and kefir.
I’m not a huge fan of kombucha, the store bought ones at least, as they’re made with quite lot of sugar and there’s often a fair bit left over. Excess sugar feeds the bacteria you’re trying to crowd out.
2. High Water Fruits & Veggies
Depending on the cause of your bloating and the health of your digestive system different ones are going to be better or worse..
Going for fruits and veggies that are high water are going to help keep you and your intestines hydrated (p.s. if you tend to have dry lips, especially the bottom one, it’s a sign that your digestive tract is dehydrated. Dehydrated guts leads to constipation, leads to build up, leads to bloating).
You can use the Monash FODMAP app to avoid the highly fermentable foods (but just remember that this can help you manage symptoms, but won’t be enough to “cure” them. And don’t stay on a restricted diet for too long or you’ll end up in more of a mess, i.e. reactive to everything).
Some pretty safe veggies include: bok choy, carrots, cucumber, eggplant, kale, lettuce, olives, capsicum, radish, rocket, and tomatoes.
Then some pretty safe fruits include: lemon, limes, banana, avocado, berries, kiwi, rockmelon and pineapple.
3. Spices, Herbs, and Herbal Teas
Food can be your medicine.
If you know about the Doctrine of Signatures you’ll know the connection between ginger and the stomach. The appearance of ginger is actually very similar to the appearance of the stomach, and chemically ginger contains a compound called gingerol. This compound can really help to settle an unsettled stomach.
Ginger can help to promote proper gastric emptying, keeping the food moving along and preventing bloating. It also helps to relieve nausea, be it nausea caused by food, sea sickness, or even morning sickness. Nice little treat to remember.
Then some herbs that can help to soothe and calm spams of the digestive tract include fennel, chamomile (avoid in cases of SIBO), and peppermint.
Aloe vera, Slippery Elm and Meadowsweet are also great ones to soothe an inflamed digestive system.
So those are some good things to include in your diet. Now lets look at what you might want to exclude.
Worst Foods for Bloating:
…this list won’t cover everything. And what works for one won’t necessarily work for another. So if you need help, reach out for it. It’ll save you so much time and effort in the long run to work with someone that is experienced in this field…
The biggest bloating-causing-culprits include:
1. High FODMAP Foods
These are the fermentable carbohydrates found in certain foods.
Onions and garlic are the biggest cause of IBS symptoms as they are really high in fructans, a highly fermentable compound.
There are quite a few lists on the internet, but better yet is to use that Monash FODMAP app I mentioned just before.
2. Most Dairy Products
Often because of a deficiency of the enzyme lactase, which is needed to break down the sugar lactose.
But then sometimes it can be a reaction to the protein molecule casein. And a reaction to casein is usually caused by an allergy (IgE) and is much much harder to resolve, if it is even possible to resolve, for many it won’t be.
These foods include: yoghurt, milk, cheese, chocolate
3. Grains and grain products
Gluten is hard for everyone to digest, not just those that suffer with bloating. Those with a “sensitive” stomach will just feel the effects more dramatically.
Wheat is the worst.
But then is it the gluten in the wheat or the way that it’s grown?
It is common practice for farmers to spray their wheat crops with Round Up (a herbicide not too dissimilar to Agent Orange used in the Vietnam war!) prior to harvesting.
Makes me want to cry.
They do this because it will speed things up and give them a bigger and easier to harvest yield.
Sarah of the Home Economist wrote a whole post on it here.
If you’re having digestive issues see how you feel eliminating foods that contain wheat, rye, barley, spelt, corn and oats.
4. Sugar and Sweetened Snacks
If you’ve been reading all the way thorough this one should be a bit of a no-brainer.
Excess sugar feeds the “bad” bacteria and also candida. Too much for you to effectively digest and absorb will provide food for them to flourish. They ferment the sugar, release the gas, and cause the bloating.
Maybe replace some of your sugar snacks like chocolate, lollies, and even the raw deserts, and add in some fat-satiating nuts and seeds instead.
Did you know that boiled eggs with their shell kept on stay good in the fridge for up to three weeks?
I love boiled eggs.
5. Artificial and Natural Sweeteners
The artificial sweetener Aspartame as well as the the naturally occurring sugar alcohols like xylitol, mannitol, and sorbitol are easily fermentable in the digestive tract.
You’ll find these in diet soda, sugar free chewing gum, and even some toothpastes.
6. Carbonated Drinks
Even soda water. Those little bubbles of air can becomes trapped in your guts and lead to bloating.
7. Chewing Gum
Sometimes it can be because of what they contain (i.e. xylitol in the sugar free gums from point number 5), sometimes it can be simply because you’re swallowing air as you’re chewing.
Extra Steps you can take to Decrease Bloating:
1. Be Honest with yourself about your Stress Levels
Or rather your resilience to the level of stress in your life.
I mentioned it in the beginning, but just to say it again: when we’re stressed we’re in our sympathetic nervous system or our “flight or fight”.
Our digestive system is part of our parasympathetic nervous system, or our “rest and digest”.
When our stress response is turned on our digestion is shut off (to varying degrees).
Have you ever noticed that when you’re feeling anxious or sad your digestion is affected?
Doesn’t have to be “bad” stress, it can be from excitement too. Maybe you’re someone that has noticed they need to run to the loo a couple of times before performing on stage?
There is a big connection between our brains and our gut. “The Gut-Brain Axis”.
With communication between the two happening via our Vagus Nerve, the largest nerve in the body.
High and/or constant stress leads to elevated cortisol levels.
Chronically high cortisol levels can burn you out. Waking up at 3am? You’re on your way.
High cortisol levels also play a role in the development of “Leaky gut”, I talk more about that connection in my blog post on exercise and leaky gut.
2. Move your body
Exercise is great for the body and the mind.
On the physical side it helps keep everything moving. Circulation, lymph fluid, stale air, and even your poop.
And on the mental side it often helps to decrease feelings of stress. “I was so worried I was sick to my stomach”.
That’s that gut-brain connection again.
And a common example of how the emotional can affect the physical.
To benefit your digestion the most I’d recommend getting in some form of exercise most days. Doesn’t have to be long. Doesn’t have to be hard.
My two favourites are surfing and yoga, and I would average one or the other 6 days of the week.
Whatever you choose to do aim for at least twenty minutes. Easy!
And really, it doesn’t (and shouldn’t) need to be too hard.
Too much exercise can cause or worsen a bloated belly.
It puts a stress on the body, gets those cortisol levels up, and plays a role in that connection to elevated cortisol levels and leaky gut.
Find something that makes you feel good.
If you’re feeling drained after exercise you may be doing too much or the wrong kind.
3. Get guidance from a Health Professional.
Ideally a digestive health expert.
We can help you to figure out why you’re getting bloated, and then help you with treatment options to actually fix it.
Before going in to see someone you can read this post on the “Top 5 causes of IBS your doctor might not know about“.
It can help you get a sense of whether the practitioner you’re seeing is well versed in possible causes of bloating and other IBS symptoms, or if you need to seek another opinion.
I did manage to learn and figure out a lot on my own.
There’s loads of great information out there available for us.
After my SIBO diagnosis I holed myself up in my room for two solid weeks reading everything I could find on SIBO.
But a mistake I made during those devastating weeks was getting sucked into the SIBO Facebook groups.
I recommend against heading there and accepting advice.
Every man and his dog has an opinion, telling you what you should and shouldn’t do.
But everyone’s case history is different, therefor there’s no one magic cure that is going to fix everyone. Even if the symptoms are the same.
There’s also an overwhelming feeling of doom and gloom in a lot of these groups.
People sick for years and not getting better.
People spending thousands and thousands of dollars on treatment and “cures” and not getting better.
I got so depressed thinking I was going to be sick forever. That I’d never be able to eat like a “normal” person again. That that was it, my body was broken and my life was pretty much over at age of 32!
But a lot of the people in those groups I was following weren’t seeking professional help, instead they were relying on the advice of others feeling just as sick as themselves.
So I dug deep, pulled myself out of my hole and sought help from a professional that had more experience with SIBO than me.
I got some clarity on what I should be doing.
I worked on my mindset, and got on with doing the work.
3 months later my SIBO was gone.
I’d conquered the root cause of my bloating!
I believe with right know how and the right attitude everyone has it in them to conquer theirs too.
Everyone has the opportunity for their own “Bloated to Brilliant” story.
