Do you regularly get a bloated stomach and don’t know why? Sharon Walker investigates the reasons behind bloating. Clue: they’re not what you think
So it’s happened again: you’ve eat a pretty innocuous meal, nothing too crazy, not exactly a Mr Creosote blow out or anything really remotely big, but now, now you feel like you’ve swallowed a Space Hopper. Whole. Your belly is straining at your waistband and people are standing up to offer you their seats on public transport. It’s that BAD. Soon they’ll be calling the midwife.
Midwife jokes aside bloated is no laughing matter. There’s no two ways about it, a big tight barrel of a belly is uncomfortable and embarrassing, especially when it’s accompanied – as it often is – with other gut health symptoms like flatulence and stomach cramps.
42.7% of you reported issues with bloating
And while this might be scant comfort if you’re currently nursing eight-month bloat – you’re not the only one who’s suffering. ‘Bloating is incredible common. It can cause great discomfort and as your clothes get tighter it can be distressing,’ says leading nutritionist Katherine Pardo.
So how common are we talking? VERY. Of those of you who responded to our Gut Health Survey 42.7% of you reported issues with bloating, with an unfortunate 15% experiencing bloating EVERY time you eat. That’s a lot of swollen bellies.
Frustratingly most of us don’t know what’s causing the problem. An obvious issue is too much gas – though that’s not always the issue says Pardo – and if it is too much gas is the culprit, what’s causing the gas and what can we do about it?
Bloating cause #1: SIBO (Small Instestinal Bacterial Overgrowth)
Never heard of SIBO? Nor had we until we talked to Pardo. ‘You can get bloating at different places along the intestinal tract,’ says Pardo. ‘A lot of people focus on bloating in the bowel but now we’re becoming more aware of small intestinal bloating.’
So how do you know if SIBO is the issue? You’ll see similar symptoms to those you get with bloating in the bowel, so discomfort, swelling, gas, diarrhoea and constipation, but often with the added indignity of burping. Nice.
So what’s behind this belching and bloating? Pretty much the same thing that’s behind the cramping bloating and gas further down the intestinal tract: an imbalance in gut bacteria. And the reason our bacteria are out of whack? That’s right you guessed, it’s usually down to diet and lifestyle
‘We need a wide variety of fruit and vegetables which break down into prebiotics and feed the good the good bacteria to help it flourish,’ says Pardo. ‘We recommend seven to nine portions of fruit and vegetables a day,’ says Pardo. ‘Ideally 30-40 different fruits and vegetables across the week.’ Most people don’t eat nearly that amount.
So what’s the fix? Many health professionals including some GPs recommend the FODMAP diet, which excludes typically gassy foods like garlic, onions, bananas, artichokes, beans and pulses – you can see the full list here. For several weeks, maybe up to several months. Before gradually reintroducing them over several weeks.
If your SIBO is very severe, with an overgrowth of negative bacteria, you might need to do a ‘clearance’ using herbal anti-microbials, like Nutri Advanced Candex SIBO, or you may need antibiotics, explains Pardo. To do this you’ll need to see a health professional – your GP, a nutritionist or naturopath should all be able to help – before replenishing the gut with good bacteria using a probiotic.
Pardo recommends the Lactobacillus Acidophilus NCFM which is one of the best researched probiotic strains in the world, backed by over 60 scientific publications.
Another helpful live bacteria strain for use in SIBO is Bifidobacterium lactis Bi-07. ‘Both of these bacteria are resident in a healthy gut and both have been shown to support a healthy microbial balance in research,’ says Pardo.
Bloating cause #2: Crowding out
Just as the ‘bad’ bacteria can get out of hand in the small intestine, they can run amok in your colon causing bloating further along your intestinal tract, says Pardo. That’s when you’ll be nursing a six-month bloated belly (without the baby) and clenching in yoga.
So how have we ended up in this undignified – and frankly painful situation – trapped wind hurts. ‘Certain bacteria and yeast can ‘crowd out’ the beneficial bacteria,’ says Pardo, ‘which leads to a build-up of gases due to fermentation as the bad bacteria feed on the sugars in the gut.’
So what’s the fix? As with SIBO you’ll need to change your diet. If the problem is extreme with excessive gas, higher levels of pain and discomfort, intermittent constipation and diarrhoea, your doctor or health practitioner may recommend a FODMAP diet (see above), though most people will see an improvement with a good probiotic, says Pardo. Research shows that gut symptoms like gas respond to probiotics.
In a 2016 randomised, triple blind trial published in the World Journal of Gastroenterology adult volunteers with IBS were given either probiotic supplements containing Lactobacillus acidophillus NCFM or placebo daily for 12 weeks.
In those with severe to moderate abdominal pain, symptoms were reduced significantly compared to those who took a placebo.
Try: A well-researched probiotic strain, like Lactobacillus acidophilus NCFM.
Bloating cause #3: Leaky Gut
All sort of things can damage the gut wall leading to a ‘leaky’ gut says Pardo. Common culprits include infections like H. pylori overgrowth (the bacteria that causes ulcers) or yeast overgrowth, alcohol and medicines like sleep medications and even common over the counter painkillers can cause damage to the gut wall that leads to a porous intestine or what scientists call increased intestinal permeability.
When you have a ‘leaky gut’ molecules of undigested food pass through the intestine wall. ‘This creates an immune response and you become intolerant,’ explain Pardo, which in turn causes inflammation, water retention and swelling. ‘Once you’re intolerant, it’s hard to digest that food and this can lead to a build-up of gas.’
What’s the fix? ‘Taking Ibuprofen and other NSAIDs too regularly can damage the gut wall, so try not to take them if you don’t need them,’ advises Pardo. Try to get more sleep, limit stress, reduced medications. Cutting down on alcohol and eating refined foods will help too. Pardo also recommends reducing common allergens such as wheat, gluten and dairy.
Cutting down on gut irritants will allow you gut lining to repair itself.
Try: You can speed up the healing process with nutrients such as L-glutamine, an amino acid, which provides fuel for the cells making up the gut wall.
Bloating cause #4: Antibiotics
Antibiotics wipe out all your gut bacteria – the good as well as the bad – and without the friendly bacteria keeping the nasties in check there’s scope for gas-producing bad microbes to proliferate. The result is dysbiosis, or bacterial imbalance, which is the number one cause of bloating.
So what can you do to mitigate the damage? Pardo suggests taking a probiotic to repopulate your gut with good bacteria. And there’s research to show this works.
A 2009 placebo-controlled study investigated the capacity of a probiotic mixture to minimise the disruption of intestinal bacteria in people taking common antibiotics.
One group was given a placebo and the other a probiotic mixture containing the strains B. lactis Bi-04, B. lactis Bi-07, Lactobacillus acidophillus NCFM, L. paracasei Lpc-37 and Bifidobacterium bifidum Bb-02.
The ones taking the probiotic mixture had the least disruption in their healthy gut flora, the research, which was published in the Journal of Medical Microbiology.
Try: Nutri Advanced Ultra Probioplex IB (£36.90 for 30) which contains 60 billion live bacteria of Lactobacillus acidophillus NCFM and B. lactis Bi-07. You can even start taking a probiotic while you’re on antiobiotics to mitigate the damage, says Pardo.
But remember to take them last thing in the evening. That way they’ll have a chance to repopulate your gut overnight before you take your next antibiotic which will wipe out all the bacteria again.
The probiotic yeast Saccharomyces Boulardii is not affected by antibiotics (because it’s a yeast not a bacteria) and so you can supplement with it throughout the course of antibiotics to help prevent antibiotic-associated side effects. You can find it in Nutri Advanced UltraProbioplex Duo.
Bloating cause #5: Stress
Stress can interrupt the digestion process, leading to a big bloated belly. ‘That’s because the stress hormones, like cortisol, divert bodily processes away from non-urgent functions such as digestion and put you into fight or flight mode,’ says Pardo. ‘Your body is prepped for immediate work.’ That’s all very well if you’re making a dash from the nearest sabre-tooth tiger but in our daily lives we can’t run from stress – or make it stop.
If you’re struggling with stress-related digestion problems, Pardo recommends using a ‘broad spectrum digestive enzyme’ formula, to kickstart your digestion and help break foods down. And focus on your food. Eat slowly. And Chew. ‘Make sure your food is enjoyable, you’re focused on what you’re eating rather than eating on the run,’ says Pardo. Focus on the smell of your food and how it tastes – don’t forget digestion begins in the mouth.
Try: Nutri Advanced digestive enzyme Similase (£11.95 for 42).
Bloating cause #6: Your indigestion medicine
If your body isn’t breaking the food down before it reaches the small intestine you’re going to suffer from bloating higher up in your tummy, says Pardo. ‘Inadequate digestion can be down to not having enough hydrochloric acid, which leads to protein-based foods sitting in the stomach and fermenting rather than being transported through the intestines. So you’ll get a lot of burping straight after meals,’ says Pardo.
And the older we get the more likely we are to suffer. ‘It’s quite common that we don’t produce enough digestive acid as we get older,’ says Pardo.
Another issue is the overuse of over-the-counter indigestion and heart medication which suppresses hydrochloric acid and creates a vicious cycle, as the more you use, the more you need to use. ‘You get people who drink bottles of Gaviscon and they can’t stop because the minute they do they start getting symptoms,’ warns Pardo.
Other lifestyle factors that can hamper digestion include stress, medications and nutritional deficiencies. Poor diet is also a concern. ‘If you’re not getting enough B6 or zinc, that can cause problems as you need both for adequate hydrochloric acid.’
The fix? Stop swigging back the antacids and take digestive enzymes, says Pardo.
Bloating cause #7: Lazy bowel
So your gut hasn’t exactly ground to halt but it is rather lazy. That nice squeezing action that keeps things moving isn’t what it could be and as a result your food is sitting around for far too long and fermenting, which causes gas and bloating.
‘Gut motility is affected by nutritional deficiencies,’ notes Pardo, and if you’re not getting enough fluid or the right balance in your diet that could result in poor motility too.
The best fix here is a balanced diet and plenty of water – eight glasses a day.
Try: A magnesium supplement can help to kick-start peristalsis needed to move food along.