Most of us have at some point suffered from the unpleasant experience of bloating. This can mean different things to different people, but most of the time it’s the feeling of fullness, distention, discomfort, and heaviness. These sensations often follow a particular meal, eating a specific food, medication use, accompany part of the menstrual cycle, or are just present constantly. Given the many different possible causes of bloating, there are also many different reasons for why it happens in the first place!
So, what exactly is bloating, and why does it happen at all? Nearly 1 in 7 Americans report experiencing bloating over the course of a week! (1). Bloating is, as the name suggests, a buildup of gas and/or water in the abdomen. When this happens, the pressure from these push on the abdominal muscles, organs, and other structures leading to the sensations described earlier. These sensations can be felt with minor gas/water accumulation but when there is significant buildup, we can also see the distention occurring and our abdomens enlarging.
Why is this happening?
Where is this extra water or gas coming from? There are many causes for this and we will touch on the most common causes:
- Food sensitivities/intolerances
We can be intolerant or sensitive to certain foods for a variety of reasons, but often it is due to genetics, underlying disease, or disturbances in the microbiome. When it is the latter, there is gas produced by the bacteria in our microbiome. When healthy, our microbial community is diverse and robust, able to digest most foods without issue. When our microbiome lacks diversity, it may lack the types of microbes that can effectively digest certain foods. When this occurs, the microbes that are present will instead ferment the food and produce gas. - SIBO
SIBO (small intestinal bacterial overgrowth) is a condition that is becoming more and more common. It occurs when bacteria, which should normally only populate our large intestine, take up residence in the small intestine. When bacteria are incorrectly in the small intestine, they are exposed to much more undigested food and when they interact with this, they will often ferment and produce gas as well. - Carbonated beverages
What is a surefire way to add air to your abdomen and increase your chances of bloating? Drinking something that has gas already in it. Gas (specifically carbon dioxide) is what gives the carbonated drinks their bubbly nature. Carbonated drinks are tasty and enjoyed by many, but for those looking to reduce their chances of bloating, they may be best off avoiding them. Carbonated drinks often get their flavors from sugar alcohols such as mannitol and erythritol which also contribute to bloating as well. - Constipation
Constipation is characterized by low frequency of bowel movements (fewer than 3 bowel movements per week) and is often associated with harder, smaller stools. Constipation leads to bloating because when stool remains in the intestines for longer amounts of time, it will begin to ferment and gas is produced from that process. Couple that with the extra space the stool itself inhabits, and bloating is sure to occur. - Menstrual cycles
During the menstrual cycle, hormones are shifting every month. Changes in estrogen and progesterone levels lead to retention of water and salt which can cause the feeling of bloating as well.
What can I do about it?
There are many treatments for bloating. First and foremost, an understanding of the causes mentioned above can help us to better understand why the bloating is occurring in the first place and how we can address it. While many people have bloating, the reason for the bloating is going to be different for every person. A personalized treatment plan taking into account your entire health history will be vital for reducing bloating symptoms. There are many herbs and supplements that we know can often reduce symptoms of bloating, but these often only provide temporary relief and mask the underlying cause. For a comprehensive evaluation and personalized treatment plan, consider scheduling a visit with Dr. Conway at Heart Spring Health!
Dr. Conway’s approach to patient care begins with talking about the gut. The quality and variety of food we put in our bodies is directly connected to the quality of our health. He enjoys supporting patients with a variety of complaints including gas, bloating, abdominal pain, food sensitivities/intolerances, weight fluctuations, and more. Dr. Conway, a naturopathic doctor in Portland, earned his doctorate from the National University of Natural Medicine in Portland, Oregon. Learn more about Dr. Andrew Conway
References:
Oh JE, Chey WD, Spiegel B. Abdominal Bloating in the United States: Results of a Survey of 88,795 Americans Examining Prevalence and Healthcare Seeking. Clin Gastroenterol Hepatol. 2023;21(9):2370-2377. doi:10.1016/j.cgh.2022.10.031
