Bloating 101: Why You Feel Bloated

If you want to know what bloating is, what causes it, how to prevent it, and what to do to fix bloating, then you want to read this article.

High levels of stress. Poor diet. Prescription use. What do these three things have in common? They can all lead to bloating. We’ve all experienced it before -- the painful, overstuffed, distended stomach that occurs after indulging a bit too much in our favorite foods, or eating something that didn’t quite sit right with our digestive system. Sadly, it seems that bloating is more common than ever these days. And with the increased attention to all things related to gut health and the microbiome in recent years, the issue of belly bloat has never been more scrutinized. A bloated midsection can make an otherwise slim physique look untrained and out of shape. In this article, we’ll discuss what is bloating, the various causes of bloating, and what you can do to rectify the situation. Let’s get started!

What is Bloating?

Bloating is often confused with water retention, and while both may lead to a similar appearance in your midsection, they are very different. Bloating occurs when your stomach looks and/or feels swollen after eating. This swelling is caused by excessive gas production in the GI system, or from disturbances in peristalsis. <1,2> It may also be caused by excessive amounts of liquids or solids in your digestive tract as well. And, as you’ve probably experienced for yourself on occasion, bloating often leads to feeling “stuffed” and uncomfortable as well as sometimes painful. <3> Estimates indicate that roughly 16% of all adults experience bloating at least once a month, and women more often experience symptoms of bloating than men. <3> Additionally, those with GI disorders, such as IBS, are more prone to experiencing bloating than others who do not have the condition.

8 Common Causes of Bloating

Food Sensitivities, Intolerances, and Allergies

Food sensitivities, intolerances, and allergies are relatively common these days. When a person eats a food that they are sensitive to, they can experience gassiness, bloating, cramping, and other GI-related issues. Some of the most commonly cited sources of food intolerances are:

• Eggs
• Fructose
• Gluten
• Nuts
• Vegetable oils
• Lactose
• Gluten
• FODMAPs

FODMAPs stands for fermentable oligo-, di-, monosaccharides and polyols. <4> They are a collection of short-chain carbohydrates naturally occurring in several foods common to the diet, including:

• Beans
• Artichokes
• Apples
• Milk
• Honey
• Lentils
• Broccoli Stalks
• Sugar Alcohols

What makes FODMAPs such a problem for certain individuals is that they are poorly absorbed in the small intestine, which means they travel to the large intestine and serve as food for your gut bacteria. Interestingly, both lactose and fructose are a member of the FODMAPs family.

Medications

A variety of over-the-counter and prescription drugs have been known to induce bloating in some people as well other less desirable GI effects including nausea, diarrhea, and gas when taken. One of the biggest “offenders” in this class are antibiotics. Commonly prescribed to treat infections, antibiotics exert their effects by ridding the body of harmful, pathogenic bacteria. However, certain broad-spectrum antibiotics also kill the "good" bacteria along with the bad. This leads to disruption of the gut microbiome and causes the digestive system to get a bit out of whack, resulting in several GI issues, not the least of which is bloating. To help restore gut balance and increase the number of beneficial gut bacteria, you can take a probiotic supplement or (more preferably) consume probiotic-rich foods such as yogurt, kombucha, sauerkraut, and kimchi.

GI Disorders

Many gastrointestinal disorders including celiac disease, irritable bowel syndrome (IBS), and ulcerative colitis (UC) have bloating as a common side effect. Various studies note that bloating occurs in 23-96% of people with IBS as well as 50% percent of those who live with "functional dyspepsia" -- a chronic form of indigestion where an individual experience the feeling and movement of food in the upper digestive tract.

Infections

Infections are caused by harmful bacteria that lay waste to the body and can induce any/all of the following:

• Bloating
• Diarrhea
• Nausea
• Vomiting
• Abdominal pain

The primary bacteria linked to stomach infections are Escherichia coli (E. coli) or Helicobacter pylori (H. pylori).

Constipation and Bowel Obstruction

Bloating can sometimes be caused by constipation or bowel obstruction, which can be brought on by scar tissue in the small intestine or colon. As the blockages increase and continue to press against your innards, fluid and stool accumulate leading to abdominal pain and bloating. Common, less severe causes of constipation include insufficient fiber intake, not drinking enough water, stress, and being too sedentary. If constipation continues despite rectifying these issues, it’s critical to see a doctor for a potential bowel obstruction as it may lead to a ruptured bowel if not addressed quickly.

SIBO

SIBO is an abbreviation that stands for small intestinal bacterial overgrowth. It occurs when there are abnormal (excessive) levels of bacteria in the small intestine. <5> This over accumulation of bacteria can occur due to a variety of factors including poor digestion, inflammation, or a result of taking antibiotics. This bacterial overgrowth may also cause damage to the stomach lining further exacerbating gut problems and malabsorption of essential nutrients.

Swallowing Air

There are two primary sources ("culprits") of gas in the body. The endogenous gas that is produced from the fermentation of carbohydrates by gut bacteria, and the "exogenous" type, which is the air you swallow when eating and drinking. <6> The single most significant contributor to external gas for most people is soft drinks, carbonated beverages, and soda. These fizzy drinks are carbonated from an infusion of carbon dioxide, and the gas can release from the liquid (and into your stomach) post-ingestion. Drinking liquids through a straw, eating in a hurry, talking while eating, and chewing gum all contributed to increasing the amount of air swallowed.

Gynecological-Related Issues

Endometriosis and hormonal fluctuations accompanying a woman’s regular monthly menstrual cycle can both lead to bloating, fluid retention, and severe cramping.

7 Ways to Prevent Bloating

Don’t Overeat

This may seem rather obvious, but one of the biggest culprits for feeling bloated and having a distended belly, particularly around the holidays, is consuming too much food in a rather brief amount of time. Everyone’s stomach has a limited capacity to expand and for a subset of individuals consuming too much food volume at a given time can lead to unwanted pressure and discomfort in the midsection. The simple fix here is two-fold:

• Eat smaller meals, and
• Thoroughly chew your food.Chewing your full reduces the amount of air you swallow, which is one of the causes of bloating, and it also makes you eat slower. FYI, slower eating is associated with decreased food intake and smaller food portions.

Limit Intake of FODMAPs and Sugar Alcohols

While FODMAPs and sugar alcohols are safe to consume. For many individuals, they merely lead to unwanted GI distress and bloating. Adopting a low FODMAPs diet and reducing your intake of these foods can help limit the onset of bloating, cramping, etc. Notable sugar alcohols to avoid include xylitol, maltitol, and sorbitol. Erythritol is one of the few sugar alcohols that seems to be tolerated better by FODMAP-sensitive folks. But, proceed with caution as large doses of any sugar alcohol can lead to excessive gassiness, flatulence, and bloating.

Use Digestive Enzymes Supplements

With the dramatic increase in gut health in the past few years, there has been an explosion of digestive enzyme supplements. These products typically contain a mix of digestive enzymes that improve the body's ability to break down indigestible carbohydrates as well as proteins and fats. Specific enzymes to keep an eye on if you’re looking to improve your digestion include:

• Lactase -- an enzyme that helps breakdown lactose, the primary sugar (carb) in dairy
• Protease -- an enzyme that helps digest protein
• Lipase -- an enzyme that improves fat digestion
• Alpha-galactosidase -- an enzyme that can help break down the indigestible carbohydrates from various foods, legumes in particular
• Amylase -- enhances the ability to digest starches
• Cellulase -- enhances the body’s ability to break down cellulose (fiber) in vegetables, fruits, grains, and seeds.

Take a serving of digestive enzymes with your meal, and you may witness immediate improvement in your digestion as well as a reduction in your bloating.

Increase Your Probiotic Intake

Probiotics are live cultures of good gut bacteria that improve gut health as well as your ability to digest and absorb food efficiently. As we mentioned above, fermented foods like yogurt, kimchi, and kombucha are packed with gut-friendly probiotics. You can also invest in a high-quality probiotics supplement to further improve the ratio of good-to-bad gut bacteria.

Peppermint Tea or Oil

Antispasmodics are a class of medications that help reduce muscle spasms, such as those that occur in the GI tract which can lead to bloating. Usage of these drugs has been noted to reduce bloating. <7> Peppermint is a plant believed to function similar to antispasmodic medications and documented in several studies to reduce bloating and various other IBS-related symptoms. <8,9> Both peppermint oils and peppermint teas are easily accessible in most grocery stores and provide an all-natural means to beat the bloat.

Reduce Stress

Chronic stress leads to prolonged elevations of cortisol -- the body’s primary stress hormone. In certain situation (attempting a 1-rep max on deadlifts), cortisol can be your friend. However, when we’re chronically stressed it can lead to a number of unwanted consequences including poor sleep, increased fat storage, and exacerbation of GI disorders, which can result in bloating. Taking time each day to unwind is essential to managing stress, limiting fluid-retention, and supporting your muscle-building and fat loss efforts.

Move More

Physical inactivity is a contributor to constipation and bloating. Increasing your movement during the day can help to “keep things moving” in your digestive tract, avoiding unwanted bloating, constipation, and potential stomach pain. As a bonus, the extra movement may also enhance your recovery between training sessions as the light movement increases systemic blood flow which helps clear waste metabolites and supplies your muscles with higher oxygen and nutrients.

Takeaway

Bloating is incredibly common and something we all have to deal with at one time or another. For some of us bloating is a rarity, while others seemingly have to deal with it daily. Use the tips in this article to help identify the biggest culprits causing you to have belly bloat and work to address them in the coming weeks.

References

1. Iovino P, Bucci C, Tremolaterra F, Santonicola A, Chiarioni G. Bloating and functional gastro-intestinal disorders: where are we and where are we going?. World J Gastroenterol. 2014;20(39):14407-19.
2. AGRAWAL, A. and WHORWELL, P. J. (2008), Review article: abdominal bloating and distension in functional gastrointestinal disorders – epidemiology and exploration of possible mechanisms. Alimentary Pharmacology & Therapeutics, 27: 2-10. doi:10.1111/j.1365-2036.2007.03549.x
3. Lea R, Whorwell PJ. Expert commentary--bloating, distension, and the irritable bowel syndrome. MedGenMed. 2005;7(1):18. Published 2005 Jan 10.
4. Gibson, P. R. and Shepherd, S. J. (2010), Evidence‐based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology, 25: 252-258. doi:10.1111/j.1440-1746.2009.06149.x
5. Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol Hepatol (N Y). 2007;3(2):112-22.
6. Lacy BE, Gabbard SL, Crowell MD. Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?. Gastroenterol Hepatol (N Y). 2011;7(11):729-39.
7. Ford AC, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008;337:a2313. Published 2008 Nov 13. doi:10.1136/bmj.a2313
8. Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of Clinical Gastroenterology, 48(6), 505–512. https://doi.org/10.1097/MCG.0b013e3182a88357
9. Cash BD, Epstein MS, Shah SM. A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Dig Dis Sci. 2015;61(2):560-71.
10. Li, J., Zhang, N., Hu, L., Li, Z., Li, R., Li, C., & Wang, S. (2011). Improvement in chewing activity reduces energy intake in one meal and modulates plasma gut hormone concentrations in obese and lean young Chinese men. The American Journal of Clinical Nutrition, 94(3), 709–716. https://doi.org/10.3945/ajcn.111.015164