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Bloating! If there were an invention that beat the bloat, the inventor would be an instant billionaire, and if you, like many others, are constantly asking, 'why am I bloated?', do not be dismayed. It may sound like an oxymoron, but sometimes the 'bloat' can be a blessing in disguise if used as an investigatory tool to uncover other underlying issues. So let's address the benefits!


Dietary triggers

Thankfully, dietary modifications can make a profound difference here because sometimes your bloating may be triggered by hypersensitivities to certain foods. Some foods are notorious for causing digestive issues such as bloating and gas, but luckily studies have shown that restricting specific triggers can help achieve symptom reduction, if not resolution, in some cases.


FODMAP

Reducing FODMAP foods has been proven to be highly effective in some people (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). FODMAP foods tend to be poorly absorbed or slowly absorbed in the small intestine which can contribute to a sensation of bloating in sensitive individuals(1). In fact, one study documented a 50-82% decrease in bloating following dietary FODMAP restrictions (2), and emerging evidence also indicates that a low FODMAP diet may reduce histamine load and histamine intolerance by up to 800% (3).

However, it is essential to note that not everyone should avoid FODMAPs. In fact, FODMAPS are considered healthy for most people and function as prebiotics which are helpful for the beneficial bacteria in your gut.

Lactose intolerance

If you notice an increase in the bloat after consuming milk and milk-based products, you may be lactose intolerant. Lactose is a sugar that is naturally present in milk and milk products. In fact, it's estimated that 68% of the world's population has lactose digestion issues (4). Do not worry if this is you because there are great-tasting alternatives to lactose-containing products. Such as plant-based milk alternatives. Clients often find great relief when making these small but achievable adjustments. You may also want to incorporate into your diet foods that contain Lactobacillus acidophilus such as coconut yoghurt. Favorable clinical responses have been seen from yoghurts containing L. acidophilus (5). Just check the label on the yoghurt and ensure the cultures are active and live.



Lay off the Fizzies

When I had IBS, fizzies was my absolute vice. I can bashfully recall drinking 500ml of Lucozade a day and then being in absolute agony with bloating, distension and gas a few hours later. If you already experience sensitives to gassy foods, it's likely that carbonated drinks will also contribute to your bloating. Switch these out with water, herbal teas, or juice.


Eat mindfully

Eating mindfully is a key one that I find clients often miss and can provide relief to many digestive and bloating complaints. If you find that you often scoff or woof down your food after 1-2 bites, take your time and slow down because the digestive process begins in your mouth first. When you do not chew your food enough, you may not produce enough enzymes to break down your food, contributing to bloating and other issues such as cramps and gas and means that your stomach must work that much harder. Another benefit is that it may even help with weight control as you may get fuller more quickly. You may be surprised to know that some experts actually suggest chewing your food 32 times per bite in some instances.

Time of the month

If you notice that you tend to bloat a few days before your period, your hormones may be playing a key role in your symptoms. Up to 85% of women report some symptom of PMS in the days leading up to their period. Which can include abdominal bloating, distension and water retention. If this is you, you may find that increasing B6, magnesium and potassium-rich foods (such as green leafy vegetables) may offer you some support. A pilot study has found that modified-release magnesium was effective in reducing PMS symptoms in women with PMS (6).


Stress!

While some stress can be healthy, excess stress can adversely affect health. If you notice that the severity of your bloating symptoms becomes exasperated during periods of stress, it may be prudent to implement some lifestyle adjustments. Some physiological effects of stress include inhibition of digestion and stimulation of colonic motility, contributing to the risk of bloating. It is important to remember here that your internal reaction to stress is highly individualized. What your body may experience as stress, will be entirely different to someone else's experience, so do not be too hard on yourself.

Other underlying issues:

Bloating may also be indicative, but not limited to, other underlying issues such as (7):

  • malabsorption (for example pancreatic insufficiency)

  • Dysmotility (medications)

  • Bacterial or fungal fermentation (SIBO and SIFO)

  • Surgical intervention (Gastric banding surgery)

  • Infections (bacterial i.e SIBO (small intestinal bacterial overgrowth and parasitic i.e giardiasis)

  • Altered reflect muscles of the abdominal wall

  • Malignancy (i.e bowel or gastric malignancy )

So, what lifestyle changes can you implement today:


  • Give yourself an abdominal massage. Research has shown that abdominal massages can reduce the severity of gastrointestinal symptoms and is a safe, effective and non-invasive form of bowel management (8).

  • Avoid Gum and artificial sweeteners. Sugar malabsorption and intolerance seem to be frequent in individuals with functional abdominal bloating and gas-related complaints (9). Also, sugar substitutes, such as sucralose or sorbitol that you find in some sugar-free chewing gums can contribute to bloating so try to avoid them.

  • Mild exercise can help reduce symptoms of abdominal bloating and enhance clearance of intestinal gas (10).

  • Practice mindful eating. Your body is ill-prepared for food when you are stressed or rushed. Take 2 minutes to still your mind before eating. Chew slowly and if possible, chew a minimum of 15-20 times after each bite.

  • Drink Carminative Teas for bloating and gas. Carminatives help to expel gas from the intestines, and they do that by increasing motility and will help with the pain of distension, so it's a lovely tea to have 30 minutes or more after meals and will helps support symptomatic control. Just ensure that there are no contraindications with any medications that you are taking.

  • Spend time outside daily. Fresh air is good to reduce stress and shift energy.

  • Prayer. Implement and recognize things in your life that recharge you and use tools to nurture yourself, like being out in nature and prayer. Studies have found prayer to have a positive effect on stress levels, cortisol output and wellbeing.

Footnotes:

3Foley A, Burgell R, Barrett JS, Gibson PR. Management Strategies for Abdominal Bloating and Distension. Gastroenterol Hepatol (N Y). 2014;10(9):561-571.

4Foley A, Burgell R, Barrett JS, Gibson PR. Management Strategies for Abdominal Bloating and Distension. Gastroenterol Hepatol (N Y). 2014;10(9):561-571.

5McIntosh, K. Reed, D.E. Schneider, T. et al. (2017). ‘FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial’, Gut, 66, pp. 1241-1251.

8Quaranta, S. Buscaglia, M. Meroni, M. et al. (2007). ‘Pilot Study of the Efficacy and Safety of a Modified-Release Magnesium 250mg Tablet (Sincromag??) for the Treatment of Premenstrual Syndrome’, Clinical Drug Investigation, 27(1), pp.51-58

9Foley A, Burgell R, Barrett JS, Gibson PR. Management Strategies for Abdominal Bloating and Distension. Gastroenterol Hepatol (N Y). 2014;10(9):561-571

10Foley A, Burgell R, Barrett JS, Gibson PR. Management Strategies for Abdominal Bloating and Distension. Gastroenterol Hepatol (N Y). 2014;10(9):561-571

11McClurg, D., et al. (2016). Abdominal massage for the relief of constipation in people with Parkinson’s: A qualitative study. Parkinson’s Disease, 2016.

12 Fernando Fernández-Bañares, MercéRosinach, Maria Esteve, Montserrat Forné, Jorge C. Espinós, Josep Maria Viver, Sugar malabsorption in functional abdominal bloating: A pilot study on the long-term effect of dietary treatment, Clinical Nutrition, Volume 25, Issue 5, 2006, Pages 824-831

13https://pubmed.ncbi.nlm.nih.gov/17029608/, Lacy BE, Gabbard SL, Crowell MD. Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?.Gastroenterol Hepatol (N Y). 2011;7(11):729-739.


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