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Chronic Bloating? Here's the Reason (and How to Fix it)

by Dr. Gina Sam M.D.
19 July 2023

Bloating can result from a variety of causes that aren't related to an underlying condition. A large meal, drinking carbonated beverages, menstruation, constipation, or gas are all examples of such situations.

The symptoms of bloating can vary from excessive gas (flatulence) to frequent burping (eructation) to abdominal rumbling (borborygmi).

Bloating every day isn't normal and may be caused by several factors, along a spectrum of potential severity, so you should see your doctor if you experience it regularly. The condition of bloating affects a significant portion of the population. It is estimated that between 16% and 31% of us experience bloating and distension at some point in our lives.

Bloating is most commonly caused by overeating. So, smaller portions should ease the discomfort, even if you make no other changes. Also, you may feel uncomfortable after eating rich and fatty food—as fat takes longer to digest than protein or carbohydrates, it keeps the stomach full for longer periods of time.

Bloating has many causes. The following are some common culprits when feeling puffy and bloated, particularly in the abdomen:

  • Swallowing air: Aerophagia refers to the excessive and repetitive swallowing of air. This condition can be chronic (long-term) or acute (short-term) and is caused by both physical and psychological factors—with flatulence, bloating, and abdominal distension as common symptoms.

    Further, when air is swallowed and not released through burping, it passes through the digestive tract and becomes gas (flatus).

  • Constipation: Abdominal pain and bloating can be caused by constipation. Bloating and gas occur when bacteria have more time to ferment what's in your stool in the colon.

    The pressure from trapped gas pockets can be quite painful, and hardened stool can be quite uncomfortable, as well.

  • Gastroesophageal reflux disease (GERD): An esophageal backflow caused by stomach acid or a sore throat can cause frequent swallowing. As a result, you may swallow more air than usual, feel bloated, and belch frequently. Belching and bloating may also be a sign of inflammation of the stomach lining.

    The most common sign of GERD is heartburn, which usually occurs after eating, and is worse at night or while resting. Food or sour liquid is regurgitated as backwash at night, often causing irritation and inflammation.

  • Irritable bowel syndrome: Irritable bowel syndrome (IBS) affects the stomach and intestines, also known as the gastrointestinal tract. Cramps, abdominal pain, bloating, gas, diarrhea, or constipation are common symptoms.

    As a chronic condition, IBS will require long-term management.

    Inflammatory bowel syndrome is usually characterized by stomach pains or cramps. You may feel bloated and full in your stomach—accompanied by diarrhea, and you may have watery poop and sometimes need to poop suddenly.

  • Lactose intolerance and problems digesting other foods: The sugar (lactose) in milk cannot be fully digested by people with lactose intolerance. The result is typically diarrhea, gas, and bloating after consuming dairy products. Lactose malabsorption is usually harmless, but its symptoms can be uncomfortable.

    As lactose ferments (breaks down), fatty acids and gasses such as carbon dioxide, hydrogen and methane are produced. Flatulence and bloating are symptoms of lactose intolerance caused by the breakdown of lactose in the colon.

  • Overeating: Bloating after eating can be caused by eating too quickly. A simple solution is to eat more slowly. A satiety signal can take up to 20 minutes to reach the brain and ease your appetite. Experts believe that eating slowly directly prevents overeating.

  • Small bowel bacterial overgrowth: Small bowel bacterial overgrowth or Small Intestinal Bacterial Overgrowth (SIBO) is characterized by unpleasant symptoms such as gas, bloating, abdominal pain, and distension.

    However, if SIBO is not managed, it can cause more serious complications and long-term consequences. It is possible for malnutrition and vitamin deficiencies to result from malabsorption of fats, proteins, and carbohydrates in such cases.

    The SIBO diet aims to relieve symptoms by excluding foods that take longer to digest in the gut. Hence, whole grains, legumes, soft cheeses, and fiber-rich fruits and vegetables are excluded from SIBO diets.

  • Hormones: Sometimes excess belly fat is caused by hormones. As well as regulating metabolism, stress, hunger, and sexual drive, hormones play a crucial role in many bodily functions. A hormonal belly occurs when a person lacks certain hormones, resulting in weight gain around the abdomen. In kind, progesterone and estrogen can both slow or speed your motility, causing intestinal gas. Bloating is also caused by estrogen receptors in your GI tract.

  • Weight gain: Even though bloating can occasionally add a few pounds, it doesn't actually indicate weight gain. You can tell the difference between bloating and weight gain or fat by how your stomach looks and feels. Bloating causes a tight, hard stomach. A soft, thick stomach indicates fat.

    If you gain a few pounds, it won't be much, and once your body digests the extra food or your period arrives and passes, those extra pounds will disappear as well.

    Unintentional weight gain can be caused by a variety of factors. Sleep deprivation, sedentary lifestyles, and eating too much processed and sugary foods can all lead to weight gain, as well.

  • Endo Belly: Many endo belly sufferers feel they "look pregnant," but they're not!

    Endometriosis can cause a variety of symptoms, including endometrial belly. People with endo belly often experience other gastrointestinal symptoms, as well, such as gas pain and increased menstrual discomfort.

    Endo belly often happens before or during a menstrual period and can last anywhere from a few hours to a few weeks and often comes with other, less visible symptoms like nausea.

  • Celiacs Disease: This disruptive condition is caused by an immune reaction to gluten, a protein present in foods such as bread, pasta, and barley. It is possible for people with celiac disease to experience diarrhea, constipation, and abdominal bloating if they eat gluten.

    Taking charcoal pills can help your body keep from reacting to gluten and bind up the 'gluten'. Plus, the use of charcoal pills has been traditionally used to reduce stomach gas.

Prebiotics, Probiotics and Bloating

Some people experience gas, bloating, or diarrhea when using probiotics for the first time. Changing gut bacteria can lead to more gas than usual, causing bloating—but these side effects usually subside within a few days or weeks of taking prebiotics.

Probiotics, especially when combined with prebiotics, can help restore the balance of good and bad bacteria in the gut, which reduces inflammation and gas production. As a result of probiotics, food is digested more effectively, which can lead to reduced bloating with continued use.

Stress and Bloating

The "Fight or Flight" response in the body can result in bloating by negatively impacting gut health and digestion.

Stress affects blood flow to the gut, intestinal motility, intestinal permeability, digestive enzyme production, and protective mucus secretion. Because of this, anxiety often promotes bloating.

Stress can also cause bloating by increasing inflammation and altering gut bacteria. It has been found that symptoms of IBS, such as abdominal distention and bloating, are strongly associated with stress levels. Further, bloating can also be caused by non-gut-related problems, such as pelvic floor dysfunction.

Fat or Bloating?

Bloating differs from belly fat because the stomach expands only when there is excess gas accumulation. Aside from the abdomen, you likely do not notice bulges on the thighs, hips, and back.

Having gas and digestive contents can be the result of eating too much too fast, or it can be caused by food intolerances or other conditions. Menstruation is another common reason for temporary bloating. However, bloating can indicate a more serious health problem in some cases.

Diet and Bloating

Bloating can be caused by a number of factors, but sometimes, it may be just a matter of what you eat. Look carefully at your diet if you're experiencing bloating. For instance, rather than eating foods like apples and dairy products, you may want to replace them with foods like bananas, carrots, and lean protein.

Some people can suffer from stomach aches, bloating, and heartburn when they eat too much chili, onion, or garlic. Also, carbon dioxide is the gas that creates soda fizz. So, drinking lots of carbonated drinks can lead to excess gas buildup (not to mention sugar).

Furthermore, sodium plays a key role in fluid balance. Your body may retain more water when you eat a lot of high sodium foods, causing bloating and puffiness. Therefore, reducing your intake of these foods will prevent those symptoms.

Moreover, drinking water may reduce bloat by eliminating excess sodium from the body. Drinking water before eating can ease bloat, and this step may also prevent overeating.

Bloating after pooping can also be caused by what we eat, such as dairy and high-fiber foods. Your bathroom session may have missed releasing any gas.

Furthermore, nutritional deficiencies may contribute to bloating and digestive upset. A lack of zinc, magnesium, molybdenum, and thiamin is most commonly associated with bloating.

Also, drinking plenty of water and staying hydrated is an effective way to regulate digestion. People who support a water flush for colon cleansing recommend drinking six to eight glasses of lukewarm water per day. Also try eating plenty of fiber & water-rich foods for additional benefits.

Plus, these beverages serve double duty by hydrating while helping to reduce belly bloat:

  • Lemon water can aid digestion. Drink lemon water first thing in the morning on an empty stomach to relieve bloating, gas, and constipation. Minerals in lemons promote healthy digestion, relieve heartburn, and stimulate healthy bowel function by reducing bloat and stimulating bowel movements.

  • Green tea: You may be happy to know that green tea can help with bloating if you are a fan. According to research, green tea may be able to flush out excess water and sodium in the body due to its antioxidant and polyphenol content, aiding to banish ant bloating.

  • Caffeine in coffee can also cause bloating by increasing stomach acid production and slowing digestion. However, not everyone who drinks coffee experiences bloating. In times of persistent gas or bloating, you may want to cut back on java and spruced-up lattes, to see whether it eliminates the issue.

  • Water with lemon or cucumber: Cucumbers are packed with water, so they can help relieve bloating. Staying hydrated with foods with high water content and eating lemons can help alkalize and balance your body’s pH levels.

  • Peppermint tea: The high concentration of flavonoids in peppermint tea makes it one of the best teas for bloating. Basically, flavonoids calm the bacteria in your digestive tract, which often cause high levels of gas and bloating. Moreover, peppermint tea soothes inflammation and relaxes the gut.

  • Fennel tea: Drinking fennel tea can promote healthy digestion, reduce bloating, gas, and cramps, and act as a diuretic. Herbalists recommend fennel seed for digestion. The smooth muscles of the gastrointestinal system can be relaxed and gas, bloating, and stomach cramps can be reduced by sipping some regularly.

    With its relaxing aroma and stomach-settling quality, fennel tea is made by drying seeds from the fennel plant, brewing them in hot water, and steeping it to your desired intensity.

Plus, remembering a few tips can keep bloating and gas at bay. Here are some simple ways to beat the bloat:

  1. Consume smaller, more frequent meals and eat slowly. Drinking or eating too quickly increases the amount of air a person swallows, which can lead to more gas building up in the gastrointestinal tract. For people who eat or drink quickly, this may be a cause of bloating; slowing down the rate at which they eat, along with opting for smaller portions, might help to reduce the problem.

  2. Be sure to chew your food thoroughly. A poorly chewed meal can easily remain undigested in your stomach and intestines, causing bloating, constipation, abdominal pain, cramps and other digestive disorders.

  3. It is best to drink beverages at room temperature. Our gut bacteria can expand at high temperatures, increasing the chances of getting gastrointestinal infections and triggering or worsening symptoms like bloating and diarrhea. Drink room-temperature beverages instead to limit gas and bloating.

  4. Make sure your dentures fit correctly. Partial digestion occurs when your mouth cannot chew food thoroughly, causing your stomach to have difficulty breaking it down. As a result, you can lose nutrients, suffer from bacteria growth potentially leading to indigestion and flatulence if large pieces of food end up nestled in your intestines and colon.

  5. Take part in more physical activity during the day. If you have been exercising hard or gulping down excessive amounts of water, which could lead you to swallow air, you might feel bloated afterward. Bloating is a common side effect of exercise, and you may suffer it if you over hydrate or don't drink enough, in addition to intaking excess air while engaging in physical exercise.

  6. It is a good idea to sit up immediately after eating. Resist lying down after eating: Instead, stay upright for two to three hours after meals to ease digestion and lessen stomach pain.

  7. Once you've eaten, go for a stroll. A quick stroll after eating may aid in controlling one's blood glucose, often known as blood sugar. Daily exercise that is done in moderation can also help with sleep, heart health, and bloating and gas reduction. The disadvantages of walking after eating, though, are possible—including a potential heartburn and stomach discomfort.

Summary

Bloating, gas and abdominal dysfunction can make simple tasks tough and drag down the mood of your day, but you don’t have to suffer in silence. You can easily tweak some dietary and lifestyle habits to turn your discomfort into a balanced and well-functioning state that aids in digestion and overall well-being.

A balance between nutrition and managing gut health with the use of fermented foods, along with increased activity, and the other best practices we’ve shared will have your tummy taught and tinier with ease, over time.

Resources:

  • Lacy, B. E., Cangemi, D., & Vazquez-Roque, M. (2021). Management of chronic abdominal distension and bloating. Clinical Gastroenterology and Hepatology, 19(2). https://doi.org/10.1016/j.cgh.2020.03.056
  • Osborne, M., & Doolan, A. (2015). Effect of a probiotic blend on bloating and colonic transit time in participants with self-reported bloating and constipation. Http://Isrctn.com/. https://doi.org/10.1186/isrctn41607808
  • Sugerman, D. T. (2013). Abdominal bloating. JAMA, 310(15), 1637. https://doi.org/10.1001/jama.2013.280496
  • Staller, K., Barshop, K., Kuo, B., & Ananthakrishnan, A. (2015). Restricted eating patterns in chronic constipation are associated with bloating and abdominal symptoms more so than rectal and stool symptoms. American Journal of Gastroenterology, 110. https://doi.org/10.14309/00000434-201510001-01791
  • Zar, S., Benson, M. J., & Kumar, D. (2002). Bloating in functional bowel disorders. Alimentary Pharmacology & Therapeutics, 16(11), 1867–1876. https://doi.org/10.1046/j.1365-2036.2002.01369.x

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MEDICAL DISCLAIMER

This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Sam MD/MPH nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.