Common causes of stomach bloating and how to fix it

Uncomfortable feelings of bloating in the stomach area are a common experience. In America for example, it’s reported 16-31% of people experience chronic bloating or distension of the abdomen [1].

Technically, bloating and distension are two different conditions: Stomach distension is the physical expansion of the stomach that is visible, and bloating is the feeling of pressure from the stomach and intestines.

Occasional stomach bloating is completely normal, but where it disrupts your quality of life, is chronic, painful or associated with constipation or diarrhoea, it needs to be addressed.

Diet and lifestyle should be the first consideration when treating abdominal bloating.

A helpful diet should help to reduce inflammation in the gut, and may include less fibre in the short-term.

The diet should:

• Reduce inflammation by removing inflammatory foods such as processed foods, alcohol, gluten and refined vegetable oils. Dairy can also cause bloating in some people.
• Balance blood sugar – start by avoiding foods made from refined flours and sugars
• Provide the right amount of carbohydrates and prebiotic fibre to feed your gut bacteria but not cause bacterial to over-grow

The paleo diet ticks all these boxes as it is low in allergens and inflammatory foods.

If you aren’t seeing good improvements on the paleo diet in 2 to 3 weeks, it may be that you have an overgrowth of bacteria that is feeding on the fermentable carbohydrates in your diet. This is particularly likely if you have small intestinal bacterial overgrowth (SIBO), or irritable bowel syndrome (IBS).

These short-chain carbs are collectively known as FODMAPs  (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, Polyols). Recent research found up to 86 percent of people with IBS saw improvements in their symptoms while on a low FODMAP diet.

A diet low in FODMAPs can reduce inflammation and bloating in your gut. The low FODMAP diet should only be followed for short amounts of time e.g. 6 weeks, as it limits the fermentable carbohydrates needed to support your gut bacteria.

You can learn about what is entailed in the Low FODMAP diet here.

As well as diet, there are several lifestyle factors which should be considered:

• Psychological and emotional stress. Moving from a feeling of just surviving to thriving can have a profound impact on our nervous systems and reduce bloating.
• Exercises which stimulate the Vagus Nerve such as singing, chanting, humming, gargling water, diaphragmatic breathing.
• Make sleep a priority. 7 hours at the very minimum is needed for your body to function well
• Take time-out for yourself in nature, walking in nature in the sun ticks many boxes
• Breathwork including 4-7-8 breathing

If after four weeks eating following the guidelines above and working to manage your stress levels, you aren’t seeing results, you can try these evidence based supplements to support your gut bacterial ecosystem and digestive function.

High quality research has confirmed the effectiveness of probiotics as a foundation for gut treatment and to reduce bloating.

There are three main categories of probiotic supplements:

1. A blend of Lactobacillus and Bifidobacterium bacteria. Lactobacillus plantarum 299v may be particularly effective.
2. Saccharomyces Boulardii (a healthy yeast)
3. Soil-based probiotics

Most people have a substantially better result when they take these 3 probiotic types simultaneously. Alternatively, you can cycle through the 3 types of probiotics i.e. once you finish a container of one type, you start with a container of the next type.

Follow this protocol for at least 3-4 weeks (longer if you are taking one type at a time).

If after following Steps 1 and Step 2, you are still suffering and bloated, you may want to consider that your digestion may be impaired and causing your bloating.

There are some simple things you can do to support digestion of your food that can have a dramatic impact on bloating. These actions support your body to release stomach acid and digestive enzymes naturally.

• Eat in an unrushed fashion, chewing every bite well (20-30 times)
• Eat away from your desk and avoid eating on the go
• Appreciate each bite of food, savour its smell and taste, and eat mindfully

If you still aren’t seeing significant improvements, you may want to trial supplement digestive enzymes and stomach acid with each meal.

Digestive enzymes are needed to break down carbohydrates, fats, and proteins. Some people don’t make enough of these enzymes and this can cause bloating and abdominal discomfort.

Other people may have low stomach acid, and may benefit from supplementing with Betaine HCL. This can help with digestion, nutrition absorption, and also help prevent bacterial overgrowth.

If you have reached the stage and are still bloated, it may be that there is something else causing your bloating.

As you can see from the possible causes of bloating listed in this article, there can be many causes. Therefore, it may help to work with a practitioner, such as Stephen Ward at Fairfield Nutrition, to help resolve your issues.

Of course, you can work with a practitioner at any stage if you would like the additional support and expertise to guide you.

There are several possible causes of abdominal bloating. Once anatomical or structural abnormalities have been ruled out by your GP or gastroenterologist, it’s likely that the bloating is caused by a functional gastrointestinal imbalance in the gut.

The possible imbalances include an overproduction of gases in the gut due to a bacterial or yeast overgrowth, a malfunctioning vagus nerve, or a reaction to a particular food or group of foods.

Sensations of bloating can also be caused by abnormal perception of gut sensations (visceral hypersensitivity).

Small intestinal or fungal overgrowth is where bacteria or yeast travel to your small intestine and increase gas production and inflammation. This gas pressure causes bloating or feelings of stomach distension.

Irritable bowel syndrome (IBS) and Irritable bowel disease (IBD) may also be associated with bloating.

Have you ever noticed that you gut becomes upset and your stomach bloated when you are nervous or stressed?

This is not a co-incidence as your brain and gut are intimately connected via the gut-brain axis including through the vagus nerve.

Psychological and emotional stress can both disrupt the balance of microbes in the gut, and also change our perception of the signals received from the gut i.e. it can make us hyper-sensitive to the sensation of stomach distension.

Intolerances to foods such as lactose from dairy, gluten, fructose or high histamine foods, as well as foods high in fermentable carbohydrates (FODMAPs) can cause bloating and distension. Though as you improve the health of your gut, you may again be able to tolerate this foods.

Some women report bloating 1-2 weeks before their period and this can be related to an excess of Estrogen and/or a deficiency in Progesterone. These sex hormones exacerbate any mild gut issues. Abdominal bloating can also be a symptom of Endometriosis or ovarian cysts.

When constipated, stools sit in the intestine or rectum for long periods. This allows for excess gas to be produced leading to feelings of bloating.

Delayed emptying of food from the stomach (gastroparesis) can also lead to this sensation.

Scar tissue, causing a bowel obstruction, in the abdomen and pelvic floor may also be the cause of bloating and stomach distension. Scar tissue is a normal response after surgery, infection, injury (trauma) or radiation. This tissue can form between the loops of the bowel and bind them together.