Bloating – What is it and what are the top 6 causes

“I feel so bloated all the time” – the number 1 complaint that many of my clients experience and what you can do about it!

BLOATING – What exactly is it?

A huge number of patients come to see me about gut health, and one of the most common complaints they have is that they feel bloated all the time.

I have had a number of patients say to me “after eating I feel so heavy in my tummy, and like I have trapped gas”. Bloating is the subjective sensation of gassiness, fullness, feeling of pressure or of trapped gas. This can cause a lot of discomfort, even pain, in some people.

Clients also say things like “I look 6 months pregnant even though I am careful with what I eat!”. This is called Distention – the temporary objective increase in abdominal girth. This can cause some people embarrassment or make it hard to wear fitted clothing and tight belts.

Often the two symptoms occur together. It is quite normal to feel bloated and distended after some foods, and many people will relate to the after Christmas dinner feeling they get when they have eaten a lot of rich food, or the swelling up like a balloon some people get after eating a lot of beans for the first time in a while.

However some people feel bloated and/or distended on an ongoing basis and this can cause significant disruption to quality of life. Around 16-31% of the general population reports bloating as a regular problem and 66-90% of people who experience Irritable Bowel Syndrome (IBS) also experience bloating along with other symptoms such as diarrhoea and constipation.

75% of people who experience regular bloating describe their symptoms as moderate or severe and up to 50% of them report that it impacts their daily activities. For example some people may not be able to wear certain clothes because they are so distended, and others might be in such discomfort from bloating that they take time off work.

Interestingly only 25% of patients that report bloating and distention have increased gas in their abdominal cavity, suggesting other factors are at play.

WHAT CAUSES BLOATING AND DISTENTION?

As mentioned some degree of bloating and distention is a normal part of eating and food digestion. When bloating is ongoing and causing discomfort and distress – that’s when we need to look further as to what is causing this.

Some things that can cause ongoing bloating can be medical in nature and it is therefore very important you seek advice from your healthcare practitioner before embarking on any diet or lifestyle change. Disorders such as coeliac disease, irritable bowel syndrome, food intolerances, pancreatic insufficiency, gastroparesis, constipation, hypothyroidism and small intestinal bacterial overgrowth can often have significant symptoms of bloating, so it is important to get these issues investigated by an experienced health professional.

Often the causes of bloating and distention are many and varied. Physical causes play a role, as well as some psychological. Treatment, I have found, usually involves addressing both!

Only 25% of people with ongoing bloating seem to show excess gas in their abdomen. So why do the rest experience sensations of fullness and trapped gas, or blow up like a balloon then? Some of the reasons include:

• Disordered Movement in the gut: things pass through too slowly, quickly or erratically
• Sensitive Gut Nerves: people with IBS in particular have very sensitive nerves in their gut, they will “feel” normal changes in gut volume as painful or uncomfortable and this can further trigger spasm and disordered movement
• Imbalanced Gut Flora: people with bloating often have different levels of bacteria in their gut
• Pelvic Floor Dysfunction: muscles in the gut do not operate normally
• Bacteria in the Wrong Place: some people get an overgrowth of bacteria in their small intestine. Often I find these people bloat very fast after eating, usually within 20-30 mins.
• Disordered Perception: some patients due perhaps to anxiety or eating disorder may fixate more on an aspect of their digestion such as bloating, or believe they look more distended than they may objectively appear.