Top 5 Causes of Bloating- your guide to ‘Beating the Bloat’
Do you experience bloating on a daily basis? Does your belly look and feel 20 weeks pregnant? Have you even had to discretely undo the top button of your pants after dinner? Or do you settle with wearing loose fitting clothing when you go out “just incase you look bloated”? 1 in 5 healthy individuals experience bloating, and although 60% of us consider it our most bothersome symptom majority don’t seek professional help, and those who do see a doctor are often left without answers or a solution after sinister pathological conditions are ruled out (1). It is likely that bloating is affecting the quality of life for 50% of people reading this article (2). If this sounds like you or someone your know, ‘go with your gut’, and find out what the top 5 causes of your bloating might be.
- Poor digestion
Optimal digestion is the first step to preventing gastrointestinal upset. This involves proper ingestion, mechanical breakdown and chemical breakdown of food. The action of mastication, crushing and grinding of food with your teeth increases the surface area of food so that enzymes can more efficiently break it down in the gut. The action of chewing also stimulates the release of saliva and other acidic digestive juices. We recommend patient’s to chew their food up to 28 times before swallowing, and to eat slowly and mindfully by putting their cutlery down between each mouthful and taking note of the texture and taste of their food as they eat. The correct amount of stomach acid is essential for the breakdown & digestion of macronutrients, particularly protein. Hypochlorhydria is a condition of low stomach acid caused by age, stress, and the use of medications such as antacids and the oral contraceptive pill (2). If you suffer from reflux, heart burn, burping and bloating antacid drugs can be harmful long term and rather than resolve, they may worsen symptoms. Hydrochloric acid and digestive enzymes are supplements that help restore pH and enzyme deficiencies. Bitters such as apple cider vinegar, lemon juice, gentian and dandelion stimulate the release of digestive juices and enzymes from salivary glands, the pancreas, liver and gallbladder. Our naturopaths also offer Comprehensive Digestive Stool Analysis (CDSA) testing which can identify undigested food, levels of pancreatic enzymes, and markers for low stomach acid in patients.
- Leaky gut
Intestinal hyperpermeability, also known as leaky gut, is a common cause of bloating (2). In year 2000 an Italian scientist call Alessio Fasano discovered that gluten can increase levels of a protein called zonulin in some individuals (3). Increased levels of zonulin triggers tight junctions between intestinal cells to loosen and open like gates, allowing undigested food, toxins and pathogens to leak into the blood stream (3). This puts a huge strain on the immune system and can result in allergies, intolerances and neurotoxicity. Our practitioners can test zonulin levels in patients to determine degree of leakiness, and we often prescribe glutamine, vitamin A and zinc to repair the intestinal lining. Eliminating gluten is also important to resolve intestinal hyperpermeability.
Dysbiosis is a fancy name for bacterial imbalance and can cause bloating in many ways. Undigested food can be fermented by bacteria in our intestines, the by-product of fermentation is the production of methane, hydrogen and carbon dioxide gases that fill and distend the intestines directly and immediately causing bloating, abdominal distension and visceral pain (2). Approximately 70% of our bacteria is found in the large intestine, however in some people our healthy bacteria migrates to the small intestine causing symptoms similar to IBS called small intestinal bacterial overgrowth (SIBO). To prevent and treat dysbiosis, gastrointestinal infections and SIBO it is important to choose the correct strain of probiotic for your symptoms. Studies have shown a strain called Lactobacillus plantarum 299v to reduce the severity and frequency of bloating and abdominal pain from three times daily to once daily in just 4 weeks (5). Clinically we find this probiotic to be very effective for treating bloating, diarrhoea and constipation, you can find Lactobacillus plantarum 299v in our store and in practitioner-only products (5). Fibre and fermented foods also support the diversity of healthy bugs.
Dysbiosis also leaves our bodies vulnerable to infections. Antibiotics are the forth most commonly prescribed drug in Australia however they don’t just eradicate the harmful bacterial infection you have, but also kill all of your beneficial bacteria (4). This leaves us susceptible to “opportunistic” and pathogenic infections that now have space to colonise and invade the body now that we have a lower number of healthy bacteria. don’t come without side effects. Candida, Helicobacter pylori, and Blastocystis hominis are common yeast, bacterial and parasitic infections that cause bloating and gastrointestinal upset. A CDSA test can detect at least 20 different pathogenic bacterial, yeast or parasitic infections, and determine what drug and herbal medicine will be the most effective treatment.
- Allergies & Intolerances
Food allergies and food intolerances are becoming increasingly prevalent in today’s society. Allergies and intolerances begin when the immune system mistakes certain foods as a pathogenic invaders that could harm to the body, like a virus or bacteria. So it calls upon white blood cells like soldiers in a war, and mounts an attack resulting in inflammation, cellular damage and a range of symptoms from bloating, rashes, and bowel irregularities to life threatening anaphylaxis. The immune system can even misidentify it’s own intestinal cells as foreign and start attacking itself, this is known as coeliac disease and is triggered by gluten (3). Food allergies and intolerances can be identified through elimination diets such as the low FODMAP diet with our naturopaths, or allergy testing can be another effective method. Studies show when patients indefinitely eliminate foods they are more likely to develop allergies or intolerance to even more food types. Our naturopaths aim to enable our patients to tolerate problematic foods again, by firstly regulating the immune response and healing the gut, then reintroducing the problematic food to a tolerable dose. Chinese mushrooms such as reishi and shiitake mushroom can regulate the immune system, and albizia, quercetin (apples) and bromelain (pineapple) can reduce inflammation and allergy symptoms (6,7).
In conclusion, the culprit for your bloating could be one or a combination of all five of these causes. If you suffer from bloating, don’t just put up with it, and come see our staff or make an appointment with Des Lardner, herbalist or one of the naturopaths, Emily Grieger or Ebony Jordan to discuss the right treatment for you.
- Lovino, P et al. 2014, ‘Bloating and functional gastro-intestinal disorders’, World Journal of Gastroenterology, 20, no. 39, pp. 14407–14419, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202369/>
- Foley, A et al. 2014, ‘Managing Strategies for Abdominal Bloating and Distension’, Gastroenterology & Hepatology, 10, no. 9, pp. 561-571, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991532/>
- Fasano, A 2013, ‘Zonulin, regulation of tight junctions and autoimmune diseases’, Annals of the New York Academy of Sciences, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/#__ffn_sectitle>
- Australian Statistics on Medicines 2015 <http://www.pbs.gov.au/info/statistics/asm/asm-2015>
- Ducrotte, P, Sawant, P & Jayanthi, V 2012, ‘Clinical trial: Lactobacillus planetarium 299v (DSM 9843) improves symptoms of irritable bowel syndrome.’, World Journal of Gastroenterology, 18, no. 30, pp. 4012-4018, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419998/>.
- Wachtel-Galor 2011, ‘Ganoderma lucidum (Lingzhi or Reishi): A Medicinal Mushroom’, Biomolecular and Clinical Aspects, <https://www.ncbi.nlm.nih.gov/pubmed/22593926>.
- Singh, A, Kumar, S & Vinayak, M 2018, ‘Recent development in antihyperalhesic effect of phytochemicals: anti-inflammatory and neuro-modulators actions’, Inflammation Research, <https://www.ncbi.nlm.nih.gov/pubmed/29767332>.