Bloating is one of the most common concerns that patients experience. Even if a patient doesn’t come in for bloating, it often comes up at some point during our appointment that they experience bloating related to their menstrual cycle, related to their digestion, or both.

WHY DOES BLOATING OCCUR?

1. Gut flora dysbiosis, including yeast overgrowth – If you were not delivered vaginally, if you were not breast fed, if you have had antibiotics, if you’re stressed out, if you’re taking medications including the birth control pill, if you drink alcohol or smoke, then you may have gut flora dysbiosis. When we kill off the good bacteria, then “bad” or opportunistic bacteria and yeast takes its place. Yeast and bad bacteria ferment foods, causing bloating and gas. It can also cause headaches, fatigue, brain fog, mood disturbance, joint pain, difficulty sleeping, and/or carb and sugar cravings. Learn more about yeast (Candida) overgrowth here.

2. Deficiency of digestive juices – If you often eat on the run, don’t chew your food thoroughly, don’t get hungry before eating, feel like food sits in your stomach and doesn’t digest, or you experience heart burn, you may have deficiencies in digestive enzymes, saliva, and stomach acid, all of which are important for breaking down your food. If food isn’t properly broken down in the upper parts of the digestive tract, then when it reaches the large and small intestines the bacteria there feast on the larger food particles. Bacteria then produce lots of inflammation and gas, which causes you to feel bloated.

3. Eating gas-forming foods – Some foods are more bloating than others, and for some people, their bodies don’t do well with foods that tend to bloat. There is a group of foods called FODMAPs, which stands for Fermentable Oligosaccharides, Disaccharides, Monosachharides and Polyols. FODMAP foods are more readily fermented in the body and are poorly absorbed in the small intestine, causing bloating in the large intestine. Some people with bloating feel much better following what is called the Low FODMAP diet

4. Food intolerances – food intolerances are extremely common, and can be a significant cause of bloating. They can also affect your mood, appetite, bowel habits, inflammation, fatigue, pain, acne, eczema, and headaches. It can be difficult to narrow down the foods that are causing problems because it can be a combination of many different foods, and people don’t feel better if they eliminate some but not all of their food intolerances. In these cases, a food intolerance test is helpful for pinpointing the foods that are causing inflammation, leading to bloating, in your body. Learn more about food intolerances here.

It’s important to note that some people with extreme bloating suffer from celiac disease, which is a severe allergy to gluten. Bloating is accompanied by diarrhea, vomiting, gas, swelling in the ankles and legs, anemia, weight loss and fatigue. A blood test, followed by an intestinal biopsy is needed to diagnose celiac disease, and should be investigated if you experience severe bloating.

5. Hormone fluctuations – high estrogen levels can cause water retention, and low estrogen and progesterone levels can cause body fat composition changes, making it more difficult to maintain muscle mass and easier to store fat cells. Many women are frustrated with this cause of bloating because they have mistaken this hormonal issue with a digestive issue. As a result they’re eating really healthy, working out, and still feeling like their bodies aren’t cooperating. If this is the case, it may be time to do lab testing to determine your hormone levels.

6. SIBO – Small intestinal bacterial overgrowth is a condition where high levels of bacteria have colonized the small intestine. These small intestinal bacteria cause extremely high levels of bloating, and patients will often say, “I feel bloated no matter what I eat”. Read more about SIBO here.

HOW IS BLOATING TREATED?

The most important thing is to determine why bloating is happening. This may involve lab testing, be based on your health history, or be established with a few simple trial-and-error type tests. Once we determine why you’re bloated, we can treat the underlying cause to get rid of it for good.

Your Naturopathic Doctor may work to treat your gut flora dysbiosis by killing off the bad bacteria, SIBO, or yeast, then repairing the gut and replenishing it with good bacteria. If your upper digestion is the issue, your ND might give you lifestyle tricks to stimulate digestive juices or prescribe supplements for added support. Your ND might do a food intolerance test, SIBO breath test, or put you on a diet that is low in foods that cause floating. Lastly, your ND might work to balance your hormone levels, especially if you notice your bloating fluctuates with your menstrual cycle.