Abdominal bloating is certainly amongst the most common gastrointestinal symptoms that the majority of people have experienced at some stage – a hard, heavy and uncomfortably full feeling that is just UGH!
Obviously, occasional bloating – Christmas we’re looking at you – is totally fine and not worth losing sleep over. However, if you are experiencing bloating regularly it is more than likely that an underlying issue is at play.
Bloating is frequently put down to just overindulging. But there is a bit more to it than that…
Food Intolerances
No surprises here. What you eat directly effects your gut health. Around 20-25% of the global population have a food intolerance of some kind. A common diagnosis of food intolerances and adverse reactions is IBS – irritable bowel syndrome – where a usual complaint is of course bloating. Though by identifying and eliminating symptom triggering foods this is a manageable solution for relieving symptoms. So, what are some common intolerances that can cause abdominal bloating?
Dairy and lactose are prevalent food intolerances that a large percentage of the population experience. In dairy intolerance, individuals are sensitive to the fat present in cow’s milk known as triacylglycerol. However, in lactose intolerance decreased levels of the digestive enzyme lactase is seen which is needed to process the lactose for absorption. Bloating, flatulence and watery stools succeeding dairy consumption are tell-tale signs, though some people may be able to tolerate low lactose foods such as butter, Greek yoghurt and some aged cheeses.
Excessive consumption of various highly fermentable and poorly absorbed carbohydrates can also cause gastrointestinal symptoms. These carbohydrates are known as FODMAPS – fermentable oligo-, di-, and monosaccharides and polyols. Unlike other carbohydrates, these are smaller more active molecules that quickly ferment in the small intestine. Fermentation produces hydrogen and the overgrowth of some bacterial flora that contributes to bloating. A low FODMAP diet focuses on eliminating high FODMAP foods including legumes, fruits like apple, vegetables such as onion, and wheat products to reduce fermentation. Although, unlike 100% lactose intolerance, high FODMAP foods can be slowly incorporated back in after a period of time.
Hormones
Unfortunately, ladies, this one’s for you. Hormones can also have an effect on your gut health. Throughout the course of a full menstrual cycle women’s hormones change and fluctuate at different times. During the last phase of the menstrual cycle aka the luteal phase, sex hormones are at their lowest – estrogen and progesterone – which is then what causes the bleed. It is not uncommon for women to experience bloating and abdominal discomfort in the late stages of the luteal phase. These symptoms are associated with low hormone levels and their impact on gastrointestinal transit time, secretions and contractility.
One third of menstruating women are likely to experience gastrointestinal upset just before and during menstruation and 40% of women sufferers of IBS report having worsened symptoms, including increased bloating, due to hormonal influences. Interestingly, research has found that within the overall population women are more likely to report having nonpainful gastrointestinal symptoms, such as bloating, than men which could propose a link between female sex hormones and gut symptoms.
Hormonal changes are unavoidable though there are some fabulous ways to ease bloat during times of discomfort.
- Mindful eating: take your time, chew your food and sit down. This allows for better breakdown of your food for absorption and creates a less stressful environment than if you’re eating on the go.
- Ginger and peppermint: ginger and peppermint teas are easy natural remedies for relieving upset tummies.
- Light exercise: yoga, walking or stretching are great for getting things moving and aid distention.
Gut Dysbiosis
We can’t talk about bloating without mentioning the gut microbiome. Gut dysbiosis is the decline in beneficial bacteria of the microbiota and an increase or over population of another. These changes occur due to diet, environment, age, gender, medication and even psychological influences.
Often, and increasing in its commonality, this dysbiosis can cause SIBO – small intestinal bacterial overgrowth – that presents with symptoms such as bloating, abdominal pain and diarrhoea. These symptoms of a dysbiotic gut are caused by over-fermentation of particular carbohydrates and considerable gas production, usually in the small intestine, which is comparable to the excessive consumption of high FODMAP foods.
Dietary interventions, like the FODMAP diet, are the safest method for restoring gut microbiota balance. However, there is considerable research around probiotic administration and restoring gut flora. Beneficial bacteria strains like Bifidobacterium and Lactobacillus have a direct effect on composition and function of existing bacteria populations which modulates the microbiota population.
Sudden Change in Diet or Routine
Let’s face it. You can’t control everything. There are times when our normal diet and lifestyle routines get a bit out of whack – Christmas we’re looking at you, again! There may be days of overindulging for longer periods than you normally would or going without your structured exercise that can leave you feeling ‘the bloat’.
There are obvious reasons why you may feel bloated after festive periods or celebrations, however, there are significant effects that movement and physical activity have on gut health. Studies have shown that activities, such as cycling and walking, are associated with ongoing improvement in gastrointestinal symptoms including bloating showing enhanced intestinal gas transit and clearance. However, short duration walks post meal also have a beneficial effect on abdominal bloating. So, maybe encouraging your family on a post meal walk next Christmas will do the trick?
After these periods of sudden change, don’t freak out! Simply get back to what you know and what your body knows. It is smarter than you think.
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