For some people, the problem underlying bloating becomes immediately obvious. Visit an Italian restaurant (like Brenda did on her date), devour fettuccine Alfredo with garlic bread and then tiramisu washed down with a glass of white wine, and you’re almost guaranteed bloating will be among that meal’s consequences.
As a medical doctor who specializes in gut health (you can check out my three-day gut reboot here). I take symptoms like bloating very seriously. That’s because while they can sometimes be innocuous (if embarrassing), bloating can also be a sign of underlying gut disorders.
I define bloating as a feeling of expansion in your abdomen, often accompanied by gas. You feel "stuffed," you suddenly wish you were wearing elastic-waist pants, you might burp or pass gas, and uncomfortable abdominal pain may follow suit. Overall, bloating is one of the most common gastrointestinal complaints and easily becomes a miserable experience.
Studies show 15 to 30 percent of Americans experience bloating. With gut disorders, that number turns out to be higher. Researchers find nearly everyone with irritable bowel syndrome (IBS) experiences bloating. In my practice, I find most patients with gut problems encounter some degree of bloating at some point in time.
Studies show bloating’s culprits include dysbiosis (gut imbalances), small intestinal bacterial overgrowth (SIBO), and food sensitivities and intolerances, like lactose intolerance. Patients who experience regular bloating can also have psychological distress as well as increased anxiety and depression, especially when bloating becomes severe. Once the bloating cycle kicks in, it may be hard to tell which comes first for you—the bloating or the mental anguish built up over the anticipation on how a meal may sit in your belly.
For the absolute worst-case bloating scenarios, I determine and treat underlying causes through testing. However, even without testing, the following strategies have helped many of my patients lose the bloated feeling. And as an added "bonus," many of them lose weight, too, without counting calories.
I ask patients to keep a food journal to track symptoms like bloating. The usual suspects often appear—gluten and other food triggers, like dairy, as well as sugar in its many disguises—but other less suspect and oftentimes "healthy" alternatives, like sugar alcohols, carbonated beverages, prebiotic supplements like inulin or resistant starches, and eating too much fiber at once can also create bloating.
Among my favorites include dandelion root (which doubles as a gut-supporting prebiotic and diuretic), strawberries (reduce bloating from water retention), and asparagus (another prebiotic winner). Sipping green tea throughout the day (choose decaf if you’re caffeine-sensitive) also helps many patients relieve bloat.
Bloating, gas, and flatulence within 30 minutes and up to 3 hours after a meal are among the signs your body isn’t making enough digestive enzymes. Try taking a quality comprehensive digestive enzyme supplement about 15 minutes before meals to help alleviate post-meal symptoms.
The most common sign of low stomach acid is a feeling of bloating or stomach expansion immediately after eating a protein-rich meal or within the first 30 minutes, often followed by acid reflux. If you experience this regularly, you most likely have the opposite of what you’ve been taught to think—low stomach acid—and might very well benefit from supplementation. Try a hydrochloric acid supplement (known as betaine hydrochloride) during a protein-rich meal and see how it makes you feel. If you feel less bloated and find the food digests better, that is a true sign you had a deficiency of stomach acid and will benefit from a several months' course of supplementation to help heal your gut lining.
Some researchers believe excessive amounts of highly fermentable but poorly absorbed short-chain carbohydrates and polyols—collectively termed fermentable oligo-, di-, and monosaccharides and polyols or FODMAPs—are strong contributors to the development of gut symptoms like bloating. For those patients, I use a low-FODMAP diet (you can read more about that here).
A healthy gut maintains a diverse balance of mostly good flora with a little bit of bad flora. Recurrent bloating could be a sign of dysbiosis, which I call "bad bugs gone wild." Studies show gut-flora imbalances can produce or perpetuate symptoms of bloating or distention. Research confirms that improving your gut microflora could improve gas-related symptoms like bloating. To do that, I recommend probiotic-rich foods like sauerkraut, but often a high-potency probiotic supplement [LM1] is necessary in order to restore the ideal balance. Look for a dairy-free probiotic supplement that contains at least 30 billion total CFUs of Lactobacillus and Bifidobacterium. Make sure to take it on an empty stomach once or twice a day for at least three months.
While some doctors prescribe short-term rifaximin (an antibiotic often used to treat small intestine bacterial overgrowth, aka SIBO) for bloating, many pharmaceutical drugs including antibiotics can ultimately create more harm than good because they can wipe out all your gut bugs (including the good ones). This often leads to an imbalance that allows yeast like Candida to overgrow. In my practice, I’ve found dietary and lifestyle factors are key interventions for bloating, without antibiotics’ nasty side effects.
If bloating remains a serious problem after you implement all these strategies, it’s time for testing. Among the tests I use to determine the causes of bloating include:
Original article and pictures take www.mindbodygreen.com site
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