Feeling Bloated? Here’s What Might Be Causing It.
I get a ton of people asking me about how to decrease ‘bloat,’ and I have a lot of feelings about some of the stuff around bloating I see on social media. There are two sides of the coin – the fact that some of you are legitimately bloated, and also, the wellness industry trying to make us all believe that all bloating is a problem.
Let’s get into this.
Why am I bloated?
While bloating is a legitimate concern for a lot of people, and I’m not trying to minimize your struggles, I can’t write a piece about it without addressing what seems to be our fixation on how having a bloated abdomen is always a bad thing.
Social media and the wellness industry are full of influencers and general pseudoscientific charlatans spouting pseudoscientific nonsense about how bloating after meals is just such a scary, horrible thing that you should be afraid of.
Ads for supplements like Arrae, which promises to get rid of ‘food babies,’ are all over my social media. At least, they were, before I reported them for false information. They sicken me. I also noticed that all of their marketing is to women. Horrible.
Check out this pouty AF influencer co-opting the term ‘food freedom,’ which is often used with Intuitive Eating, to sell the illusion of an always-flat belly to women.
Countless images that we’re exposed to every single day portray women’s bellies as perfectly flat, without a hint of protrusion.
So let’s get one thing straight right now: none of that is real or healthy. And if we’re modelling ourselves after those things, and believing that stomachs should be flat all the time, we’re chasing unicorns and destroying our relationships with food and our bodies while we do it.
Abdominal bloating is completely normal under many circumstances. Just eating a regular-sized meal can distend your stomach, which, may lead to complaints of bloating, when what you’re really experiencing is a stomach full of food. That is not a bad thing, people.
You wake up with a flat stomach, because the stomach is empty. You put something into it, the appearance changes. It’s like taking a not-yet-inflated balloon, and filling it with water.
If you have a ‘food baby,’ it’s because you’ve ‘eaten food.’
Is that a bad thing? Why are we pathologizing full stomachs?
Oh right, because our fear of fatness, and our obsession with stomachs that are impossibly flat all the time, is overriding our common sense.
God forbid our stomachs should look like actual stomachs.
But there’s the other side of the coin, which is if you’re one of the people who have bloating and chronic abdominal distension that’s uncomfortable and extreme.
If you’re experiencing these symptoms frequently, here are some things that could be responsible.
Foods that are gas-producing, such as legumes, bell peppers, onions, garlic, broccoli, Brussels sprouts, cabbage, cauliflower, tomatoes, and zucchini, and fruits that are high in fibre and/or fructose, can also cause bloating. So can fatty foods, or increasing your fibre too quickly without drinking enough fluids or giving your body time to adjust.
Please don’t eat a bowl full of broccoli salad or three peaches, and then complain that you’re bloated. No kidding. But again, totally normal, and I would never want you to stop eating healthy food just because it causes you to be transiently bloated.
Sugar alcohols are fermentable carbohydrates (FODMAPs called polyols, we’ll get to that in a second) that are used as a sugar substitute to sweeten foods. They’re low-carb and have far fewer calories than regular sugar, so they’re a favorite of keto dieters, along with people who are trying to lower their sugar intake.
The most commonly used sugar alcohols are xylitol, erythritol, sorbitol, and mannitol. They’re in a ton of food products, from sugar free BBQ sauce to keto desserts.
If a food is labelled as ‘sugar free,’ chances are, it has sugar alcohols in it.
Sugar alcohols bypass the stomach and make their way to the large intestine, where bacteria digest them and use them as food. This can be a great thing, but if you don’t tolerate sugar alcohols, and/or you eat too much of them, they can cause major gastrointestinal distress.
Like the kind I got when I ate an entire bag of sugar free caramels in university. Don’t ever do that. I was literally sweating and doubled over in pain. And OMG. The diarrhea. Was that TMI just now? Sorry.
Even in smaller amounts, sugar alcohols can be extremely farty. Sometimes it’s worth it to just eat a bit of sugar (which, IMO, tastes a lot better than sugar alcohols, which taste like death), instead of something that’s going to make you uncomfortable.
Gas in your drink means gas in your stomach.
Bloating around your period and in perimenopause and menopause is a thing, and yeah, it’s annoying. It happens because of hormonal shifts that can slow down digestion and cause water retention. These are usually transient, though.
Gum can be a double whammy: chewing it can cause you to swallow air, which ends up in your stomach. Sugar free gum can also contain sugar alcohols, so compound that with the air swallowing, and you’ve got bloating.
FODMAPs are fermentable carbohydrates that can cause bloating and gas in some people. Removing FODMAPs from your diet can help manage the symptoms of IBS, but the first step is figuring out which FODMAPs cause you issues.
That’s where the FODMAP diet comes in.
FODMAP is an acronym for:
Oligosaccharides (like fructans, present in inulin, wheat and rye etc.)
Disaccharides (such as lactose, present in dairy)
Monosaccharides (such as fructose, present in a wide variety of fruits and vegetables)
Polyols (present in sugar alcohols, and a variety of fruits and vegetables)
Monash University developed the FODMAP diet, and it has been a game-changer for a lot of people who just didn’t understand why they were having certain symptoms – like bloating and gas after meals – and whose doctors were just like, ‘you have IBS.’
Now, we know that a lot of those ‘IBS’ diagnoses were really a FODMAP intolerance.
The FODMAP diet, which is an elimination diet meant to figure out which FODMAPs you’re sensitive to, but keep in mind that it’s not meant to be forever.
The FODMAP diet is meant to last from 2-6 weeks, and you should always follow it under the direction of a qualified dietitian. It’s not really something that you want to do on your own, because FODMAP groups are removed and added back in in a structured way.
Aside from sugar alcohols, other FODMAPs are present in a wide variety of foods such as onions, garlic, watermelon, stone fruits, legumes, wheat, cashews, snow peas, and certain dairy products.
Boston-based dietitian Kate Scarlata, MPH, RD, who I consider to be one of the best FODMAP dietitians around and who helped me immensely while I was writing this post, has this FODMAP checklist on her site.
Bloating from FODMAPs means that the short-chain carbohydrates are being fermented in the gut, which is actually a good thing – these carbohydrates feed our gut bacteria. If your bloating is tolerable, consider keeping these foods in your diet, for the benefit of your gut.
Scarlata told me this:
When consumption of FODMAPs contributes to pain–adjustment in FODMAP intake may offer some benefit to these uncomfortable symptoms. In short, some bloating is normal after consuming FODMAPs and this is not pathological! It’s the pain component associated with IBS that may impact quality of life–and warrant a trial of reducing FODMAPs in the diet.
Unlike gluten allergies, which involve the immune system, according to the American Academy of Allergy, Asthma, and Immunology, a gluten intolerance involves the gastrointestinal system.
Some estimates place the prevalence of non-celiac gluten sensitivity at around 6% of the population in the US.
Symptoms include bloating, gas, and abdominal pain can occur after you’ve consumed foods containing barley, wheat, oats, and rye. If a person has symptoms that pop up after eating, I usually suggest keeping a food and symptom diary to pinpoint what may be causing them.
If you seem to have GI issues after eating bread, I can highly recommend Promise Gluten Free bread. I’m working with them now, and honestly, their product is incredible. It’s everything other GF breads aren’t: delicious, high in fibre, amazing texture, and there’s several different breads in the line.
By no stretch of the imagination do I agree with everyone taking gluten out of their diet, even though it seems to be perceived as ‘toxic’ by a lot of quack nutrition coaches/naturopaths/nutritionists/doctors/Mr. Bulletproof Dave Asprey/whoever. But if it appears to bother you, you could stop eating it for a month or so and see what happens.
If you’re not pooping often enough, your abdomen can become distended. Constipation can be the result of not eating enough fibre or drinking enough water, a sedentary lifestyle, hormones, medications, or health conditions such as IBS, diabetes, and lupus.
The gut and brain are connected via nerves in what we call the gut-brain axis. When we’re stressed, the brain sends signals to the gut to slow down digestion in the ‘fight or flight’ response.
According to Scarlata, stress can have very real effects on our gut:
Stress related to fear (common when one feels unwell and worried, such as in IBS) is associated with an inhibition of GI contractions and secretions–which can lead to the “fullness feeling” known as bloating.
It’s also important to note that bloating is the subjective feeling of increased pressure in the abdomen while abdominal distention refers to an actual increase in abdominal size.
Slowed digestion means that food is sitting in the intestines for longer, which can lead to bloating and gas.
Small Intestine Bacterial Overgrowth (SIBO).
SIBO is when the normally-present bacteria in the small intestine become overgrown. It’s diagnosed with a breath test, and treated with antibiotics, most often Rifaximin, sometimes the low FODMAP diet, along with probiotics.
Scarlata told me this:
The American College of Gastroenterology’s Clinical Guideline on Small Intestinal Bacterial Overgrowth (SIB0) lists bloating as the most common symptoms of SIBO. As a general rule, symptoms of SIBO mimic IBS symptoms–such as alteration in bowel habit and associated abdominal pain.
If you think you may have small intestinal bacterial overgrowth, discuss this possibility with your GI doctor or GP. Typically, a breath test is undertaken to assess for this condition–followed by antibiotic therapy if the testing is positive.
Some bloating is normal after eating foods that are high in fibre, and it usually means that your gut microbes are feasting on something delicious. This is a good thing! We need those little bugs in our guts to be happy and healthy.
But if your bloating and distension are frequent, and come with pain and discomfort, please speak to a GI doctor and/or a dietitian for help.