7 Steps To Battle Bloating Updated 3/31/2021 and found here
To stop bloating symptoms, you need to identify the root cause. Depending on what is wrong, you’ll need to follow a maximum of seven steps. I’ll reveal the most common “causes” of bloating and how to relieve it. Review the list below first identifying what you’ll learn about reducing bloating and, in many cases, how to get rid of bloating for good.
- Change your diet (sometimes dramatically) and carefully consume pharmaceuticals
- Increase fluids, insoluble and soluble fiber consumption
- Manage your stress (cortisol) and make sure you exercise regularly
- Use good prebiotic foods and take good probiotic supplements
- Take products to clear up toxic bacteria and/or yeast
- Take products to heal your gut lining (if needed)
- Have your hormones balanced (if needed)
Note: An accurate diagnosis of your GI issues may also be necessary.
What Exactly is Bloating?
Bloating is caused by gas, not by fluid retention. You might have a bloated belly but have some fluid retention in other parts of your body (such as your ankles and feet) if you have a condition that’s causing both problems.
Why the excess trapped gas? It’s a combination of issues caused by clinical syndromes which will be described below.
To simplify, consider your gut as a digestion and bacteria factory.
You have inadequate protein, sugar and/or carbohydrate digestion which then causes foods to ferment. You likely also have an imbalance in your gut bacteria.
In the digestive tract, there are trillions of healthy and unhealthy bacteria which compete for space. When “bad bacteria” outweigh the good bacteria, the imbalance can lead to abdominal bloating and excessive gas.
It is unusual but possible for any gastrointestinal bloating to indicate there is fluid collecting inside your belly. This is not bloating. It is a potential medical emergency, and what you think is bloating, we’ll call “distension.” It could mean an infection such as hepatitis or even cancer. It could mean bowel obstruction from scars caused by prior surgery or “adhesions” from ongoing inflammatory bowel disorder. If you have sudden gastrointestinal distention, please see a doctor ASAP!
Does bloating occur without other GI tract symptoms?
Not usually. If so, it is typically due to SIBO or food sensitivities which I’ll address shortly. I’ll review all sorts of GI issues including gas and constipation; two other symptoms commonly associated with bloating. Lower intestinal gas is the primary symptom associated with bloating. Constipation is second and often helped with proper “GI hygiene” measures. Note that toxin issues (biotoxins like mold or Lyme or heavy metals) are beyond the scope of this article, but toxin issues are associated with a host of GI ailments.
General “Gut Hygiene” Measures: How to Reduce Bloating (Basics)
Chewing is the first stage of the digestive process. Enzymes kick in from your salivary glands making it easier on your stomach. Aging or having even a minor reflux disease (heartburn AKA “GERD”) can cause bloating and you will need good digestive enzymes and sometimes betaine too. So, “job one” is to chew your food thoroughly.
In addition, eat enough soluble and insoluble fiber (25-30 grams per day) to keep your colon “moving along.” I take a multi-fiber supplement powder and add it to my morning reds/greens drink. You’ll want to eat a combination of “roughage” or soluble fiber (such as sprouted amaranth) and insoluble fiber (such as organic apples with their skins) on a daily basis. Cruciferous vegetables are not only high in fiber, but they aid in the detoxification process and should be part of each day’s intake.
Hydrate well which just means make sure your urine is clear. Too much fiber added at once will cause constipation. Add fiber slowly and make sure you add more water or fluids to your diet, too. The combination of hydration and fiber keeps the rhythm of the GI tract moving correctly.
Exercise regularly. This activity will also help with the GI tract’s peristalsis or proper movement/propulsion forward.
Eat a healthy diet. Junk food causes gut issues galore from leaky gut to dysbiosis issues. If you are following this blog you know that means eating an Anti-inflammatory, Mediterranean, Keto or Paleo diet. Next, let’s discuss chewing and “upper tract” enzymes which is where digestion starts.
Bloating Due To insufficient stomach acid
Although it seems counter-intuitive, heartburn is the result of insufficient stomach acid. Yes, it is sometimes caused by the H. pylori bacterium, but a short course of antibiotics and proton-pump inhibitor medication (or the natural alternatives) are warranted only in these cases. The bloating for this one condition tends to be around or above the belly-button whereas everything else covered here shows up below the belly button. Usually, PPI medication is continued for prolonged periods of time.
Note this is not how the PPI drug was intended to be used–ever! In these cases and in the instances where people take over-the-counter PPI medications for their symptoms, the low stomach acid impedes the digestive process, making those individuals “set up” for leaky gut and a multitude of other health issues. To correctly treat run-of-the-mill heartburn, you need digestive enzymes containing pancreatic enzymes and bile acids.
If that isn’t enough to quiet down your symptoms, add betaine (HCl) capsules; taken 15 minutes before meals. If you still have bloating (especially below your belly-button), you have lower gut issues. You might have developed food sensitivities, for instance.
Bloating Due To Food Sensitivities
Food sensitivities are not food allergies where you have an immediate allergic reaction such as a rash and/or throat tightening and hives. The foods which cause the majority of food sensitivities are (approximately in this order) gluten, dairy, eggs, corn, soy, shellfish, peanuts, citrus, lectins (namely beans) and nightshade vegetables (eggplant, tomatoes, and peppers.) Because 75% of our immune system is located in the gut, eating these foods can contribute to inflammation and then autoimmune responses such as skin rashes, migraines, weakened immunity and even autoimmune disease.
If you feel the following foods are giving you “GI symptoms,” they might not be actual “systemic sensitivities” in which case you can experiment. Sometimes gas and bloating caused by milk are due to lactose intolerance. Cut out milk products and/or use lactase.
Sometimes GI symptoms are caused by mild wheat or gluten sensitivity. Remove gluten from your diet and see what happens. This probably has something to do with the fact that almost all U.S. wheat is GMO and added to seemingly “everything.” Estimates show a minimum of 30% of the U.S. population has a gluten sensitivity. If this is a problem, there is a greater chance it is causing problems outside your gut as well.
Lastly, GI symptoms can be caused by beans, so either eliminate them or use beano. If you have inflammatory bowel disease or are lectin-sensitive, you’ll want to eliminate them.
Note there are sophisticated tests (Doctor’s Data labs, etc.) that can detect specific food sensitivities if you have eliminated the “frequent offenders,” fixed your gut, and other issues to be discussed below. However, most people find that removing the above foods and then slowly reintroducing them will pinpoint the foods you need to avoid. This doesn’t account for FODMAPS foods (to be discussed).
Bloating due to Leaky Gut
This common condition is often caused by antibiotics and/or anti-inflammatory medications which don’t differentiate between “good” and “bad” bacteria when they are killing off organisms in your gut. It is also potentially caused by just plain eating a good old American sugar, starch, and processed diet. Dust mites can even be the cause! Healing a leaky gut isn’t that hard. If you have one, you are likely not just miserable, but you’re set-up for autoimmune disease.
You need to heal your gut. This entails changing your diet to a gluten-free (preferably grain-free for two months) and dairy-free diet. The rest of the specifics are on this blog, but you’ll be eating what amounts to a Paleo diet for a couple of months. You’ll need gut-lining healing leaky gut supplements such as l-glutamine and several herbals such as DGL and slippery elm. Also, add prebiotic fiber to your diet (such as fermented foods) and take high-quality probiotics. As you heal your gut over two months, your food sensitivities and, therefore, your bloating will diminish. If it doesn’t, it generally means you have SIBO, which is not uncommon in those with leaky gut.
Bloating due to SIBO
Small intestinal bacterial overgrowth (SIBO) is caused by high levels of dysfunctional bacteria living in the small bowel-which is supposed to be sterile. It is associated with anything that disrupts intestinal mucous, the microbiome and is a common, undetected cause of chronic constipation. It is also a common result of chemotherapy, is associated with leaky gut and with CIRS (biotoxin illness).
Treatment includes antibiotics that are not absorbed by the gut (specifically Rifaximin as the most highly researched antibiotic) or with natural substances such as berberine, olive leaf, garlic or caprylic acid. Often, FODMAPS are problematic, and we’ll cover that in the inflammatory bowel disorders section. Note that generally a leaky gut diet and supplements are helpful in cases of SIBO. A particular probiotic is useful for the bloating associated with SIBO, and you can find it below.
Bloating due to a diagnosis of IBS
Many people with a diagnosis of IBS (irritable bowel syndrome) have a treatable disorder. For instance, diarrheal-type IBS just might be BAM (bile-acid malabsorption) or leaky gut. It might be a chronic parasite infection. If you have a diagnosis of IBS, find a Functional Medicine practitioner to get a real diagnosis because it just might be curable! Constipation-type IBS is quite often undiagnosed SIBO. In fact, some studies indicate that up to 80% of those diagnosed with IBS have SIBO!
Combination diarrhea-constipation-bloating IBS is often leaky gut. You get the picture now so get the correct diagnosis! If no one can find a diagnosis other than IBS, a low-FODMAP diet has been found to be helpful along with a pre and probiotic routine. We’ll discuss FODMAPS in the next section.
Bloating due to Inflammatory Bowel Disease
If you have an inflammatory bowel disorder, you started out with a leaky gut, didn’t have treatment and it progressed. It’s not your fault as leaky gut can be asymptomatic (no symptoms) or come with minimal signs you might dismiss such as “eating the wrong things.” If you have a diagnosis of Crohn’s disease or Ulcerative colitis, I suggest reading my article on autoimmune diseases referenced earlier. If you want to get these issues under control, it takes work, but it’s possible. It’s also critical to wean off of toxic pharmaceuticals. However, don’t do this if you’re not under a doctors’ supervision, please.
It takes a Paleo-type diet, digestive enzymes, pre and probiotics, probably treatment of SIBO, and supplements to mimic TNF-alpha, IL-6 and or IL-7 suppression. I have found the addition of stool-bulking modified citrus pectin has been helpful for patients. Recent studies show; eliminating high-FODMAPS from your diet will help with symptoms; specifically bloating. The FODMAPS acronym stands for Fermentable Oligo, Di- and Monosaccharides and Polyols sensitivity. Foods containing glucose, fructose, polyols, and lactose can be “problem” foods for the IBS and inflammatory bowel crowd. Details of specific dietary restrictions are included in the references section.
The basics of your diet plan are the same I recommend for autoimmune patients. However, specific high FODMAP foods which are problematic include foods we think of as GI-friendly such as additive-free coconut milk.
Bloating due to yeast overgrowth
Yeast overgrowth often occurs with SIBO. It occurs in slow-transit-time GI issues such as chronic constipation and leaky gut. It can also happen because you’re eating an unhealthy standard American diet. You’ll practice good overall GI hygiene, eat the “quasi-Paleo” diet and use either medication (nystatin) or natural substances to kill the yeast. It is very important that you seriously exclude all sorts of sugars from your diet as this is what feeds the yeast. Natural yeast-killers include oregano oil and caprylic acid.
Bloating Due to Chronic Stress
The mind and gut are intimately connected. It makes perfect sense physiologically. When you have chronic stress, you have high cortisol levels. High cortisol impacts the integrity of the mucous lining of the gut and the gut’s microbiome as well. Stress can cause leaky gut! High cortisol also slows intestinal motility, causing constipation which can cause SIBO! So, getting your stress under control is a must for achieving optimal health.
As you find your way towards stress-management techniques, you can take supplements to lower your cortisol levels. These are known as adrenal fatigue supplements. A more proper name would be HPA axis dysfunction supplements, but everyone knows the term adrenal fatigue; please no comments about why I use this term. Tip: Type “stress” in the search bar at the end of this blog and find articles on stress management.
Bloating Due to Hormone Imbalance
Low progesterone symptoms include lower abdominal bloating. The way to tell that it’s from low progesterone rather than a GI ailment is the symptoms are usually accompanied by other low-progesterone symptoms such as irritability, sleep disruption, brain fog and are generally (but not always) cyclic. In fact, when you’re perimenopausal, symptoms tend to be more global (occurring much of the time).
Since progesterone helps gut motility, low levels will cause some constipation, so don’t let this symptom fool you.
Can chronic low progesterone lead to SIBO? Or leaky gut? Interesting questions which haven’t been studied but I would say “yes.”
Treatment is simple. Bioidentical hormone replacement with progesterone will clear things up. A stop-gap measure is to use pregnenolone (non-prescription) which partially breaks down to progesterone. Progesterone creams sold over-the-counter are ineffective.
How to Stop Bloating once and for all
Anyone with a gut ailment needs to “clean up their diet.” Common food sensitivities include gluten from wheat and other grains such as rye and then dairy, corn, lectins (beans) and nightshade vegetables (eggplant, peppers, tomatoes). Common gut irritants include caffeine, alcohol and high FODMAP foods. When in doubt, cut it out. Your gut needs two months (on average) to heal so cut out potentially toxic foods for two months to feel markedly better and get rid of your bloating once and for all.
Any time the GI tract is “stressed” I advise patients chew food more carefully, cook meat and veggies more thoroughly, and take digestive enzymes to decrease the GI tract’s workload. The leaky gut “cocktail” I recommend helps anyone with GI lining issues. Prebiotics and natural prebiotic fiber are a good addition to anyone’s diet. An example of suitable prebiotic fiber food is lots of asparagus and an occasional Jerusalem artichoke. Other supplements I reference in this article can be found in more depth on this blog. A special shoutout for taking good probiotics which is an area of increasingly positive research.
The only healthy yogurt is yogurt you make yourself with live cultures. Even then, experts including me suggest avoiding dairy-based yogurt until your gut heals. Initially, your probiotics should be from a capsule(s) and here’s why.
If your gut microbiome is out of whack, you need to use prebiotic fiber to feed a lot of good bacteria (and a little “good yeast”) to overtake bad bacteria. You want 50 to 100 billion probiotic CFU’s per day which is a lot. A mixture (in your main probiotic) of Lactobacillus species and Bifidobacterium species is necessary. Also, add in some friendly yeast called Saccharomyces boulardii (by prescription: Florastor). The latest research supports the use of sporulating probiotics for most conditions. What’s that?
These are species of Bacillus with b. subtilis and b. coagulans being the most studied. If these give you diarrhea, cut back on the dose and even open and empty 1/2 of a capsule if needed.
If you have inflammatory bowel disease, L. casei has been demonstrated to decrease your symptoms. Finally, if you have (the most common variant of) SIBO, your gas and bloating will respond almost immediately to 10 billion units of L. plantarium daily (the best one is by Jarrow).
The vast majority of people find that their food sensitivities start reversing in concert with the reversal of their GI symptoms. However if you have “tried all of this” on your own, it’s more than time to seek the help of a Functional practitioner who is well versed in clearing up a GI tract. That doctor will have the right lab connections (e.g., Doctor’s Data). There just isn’t enough information to either recommend or not recommend the popular Cyrex labs. IMHO, if you are “at this point,” I firmly believe you need a doctor for your treatment plan.
Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge.
Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy
How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach.
Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis
Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review.
Persistent symptoms in patients with Crohn’s disease in remission: An exploratory study on the role of diet.
Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile