Who here has joked about having a “food baby” when their lower stomach area is full or protruding?

Who has seen diet products or life-hacks for “banishing the bloat”?

What about just experiencing the uncomfortable tightness of bloating after eating or during menstruation?

Bloating, or swelling of the abdomen, is common. Bloating occurs when the intestines or stomach have a build up of gas or fluids, and thus expand the cavity in our torso and make our stomach area stretch out. The term for the stretch and expansion of the belly area is distension, and it is possible to experience bloat with or without distension. 

People with irritable bowel syndrome (IBS) are the most likely to experience bloating, and 20-30% of the general population (non-IBS patients) report moderate to severe bloating symptoms to their doctor (Foley, Burgell, Barrett, & Gibson, 2014). While bloating can be uncomfortable, it is not necessarily cause for concern, or immediately linked to any disease or illness. 

Common causes of bloating

Changing diets. Our gut bacteria eats the food we eat, and different bacteria prefer or rely on different food. A 42 year-old male omnivore’s microbiome will have a different bacterial species collection than a 42 year-old male who eats a pescetarian diet.  Any change in your regular diet is likely to alter your gut microbiome. The severity and length of reaction is usually relative to the amount of change. 

For example, if you were to eat a bigger salad at one meal than your body is used to, or an extra helping of beans for dinner, your gut bacteria will slightly adjust to that food and you may experience some bloat or changes in your stool over the next couple of hours and then return to your normal state. However, if you were to instantly convert to a full-on plant-based whole-food diet tomorrow, your body may have a more substantial reaction, with bloating for a few days and dramatic shifts in your stool as your gut bacteria shifts its general population.  In this example, the bacteria that rely on fiber from plants would thrive and multiply while the ones relying on animal-based proteins would slowly die out. The mass die-off, as well as the growing new population, affect the condition of the intestines via the gasses and metabolites they produce. To reduce bloating, a dramatic change in diet should be done slowly over time. For example, if you resolve to add more fiber to your diet, start with adding a half serving to each meal, then increase to one extra serving after a week, making gradual changes that allow your microbiome to adjust.

Menstruation. The variation of reproductive hormones during menstruation may influence the gut motility and physical sensitivity of the area. Fluid retention, reported as bloating, affects many women the first day of their menstrual flow and is relieved by the second day. 

Constipation. If your intestines are retaining feces, the backup may cause distension and bloating. While hard or lumpy stool remains in the intestine, bacteria may continue to ferment, thus releasing more gas. 

+More. Other less common causes may include bacterial overgrowth in the small intestine (SIBO), food sensitivities, and allergic reactions. 

What can you do to relieve or reduce bloat?

There are many evidence-based options for you to try in order to reduce bloat. 

-Exercise may help by allowing excess gas to release. Try walking, climbing stairs, or riding a bike.

-Improved posture throughout the day may lead to reduction in bloat and gastrointestinal issues. Try sitting up straight, standing more throughout the day, stretching, and taking breaks to take a short walk. 

-Over the counter products from your local pharmacist may help. Some are designed to be taken before triggering foods, others can be used after.

-Probiotics may help when taken regularly. Look for Lactobacillus and Bifidobacterium species, specifically.

-Take stock of your mental health. Improving your mental health can have positive effects on your digestive system, including bloat. 

-If you have recently changed your diet or plan to change your diet, slowly transition your food choices to allow your gut bacteria time to adjust without as severe adverse effects. 

-If bloating is a persistent problem and other potential causes are eliminated, you can work with your doctor to try an elimination diet in an attempt to see what food is not well tolerated by your digestive system. A low-FODMAP diet is often recommended by professionals for severe cases of chronic bloat. This specific diet restricts foods such as fruits, dairy, wheat, legumes, and more that may not be digested or absorbed well and are more likely to be fermented by bacteria in your intestinal tract, which can lead to bloat and other unwanted symptoms.

-When should you seek professional help? If bloating is interrupting or impacting your daily life, it’s time to talk to your doctor. 

TLDR: Bloating can feel like an uncomfortable tightness or expansion of the gut area, and is caused by a buildup of gas and/or fluids in the stomach or intestines. There are many possible causes, such as changes in diet, constipation, and menstruation, as well as many ways to try to relieve or reduce the discomfort, such as exercising, improving posture, trying probiotics or anti-bloat medications from your pharmacist. If bloating interferes with your daily life, it is time to see a doctor. 

Sources and other info:

Foley, A., Burgell, R., Barrett, J. S., & Gibson, P. R. (2014). Management strategies for abdominal bloating and distension. Gastroenterology & hepatology, 10(9), 561–571. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991532/ 

Houghton, T. S. (2019, July 15). Why your microbiome may be to blame for your bloating – 5 tips for gut balance. T. Collin Campbell Center for Nutrition Studies. https://nutritionstudies.org/why-your-microbiome-may-be-to-blame-for-your-bloating-5-tips-for-gut-balance/ 

Lacy, B. E., Gabbard, S. L., & Crowell, M. D. (2011). Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?. Gastroenterology & hepatology, 7(11), 729–739. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264926/ 

Seo, A. Y., Kim, N., & Oh, D. H. (2013). Abdominal bloating: pathophysiology and treatment. Journal of neurogastroenterology and motility, 19(4), 433–453. https://doi.org/10.5056/jnm.2013.19.4.433 

White, C. P., Hitchcock, C. L., Vigna, Y. M., & Prior, J. C. (2011). Fluid retention over the menstrual cycle: 1-Year data from the prospective ovulation cohort. Obstetrics and gynecology international, 2011, 138451. https://doi.org/10.1155/2011/138451