Do you know that tight, cramped feeling in the stomach when you desperately want to get into looser clothes in the hope you'll feel more comfortable?
Think yourself lucky if you don't know what bloating feels like. While often there is no sinister underlying cause of bloating, it's uncomfortable, it can be very painful, and some can suffer from it on a regular basis.
Bloating is about gas causing a feeling of distention or swelling in the stomach. While this is possibly from excessive gas production, it is now thought abnormal responses to normal gas production are more often the case. Sometimes gas does not travel through the gut as it normally would, causing a build-up, and many people who experience bloating are thought to be hypersensitive to the sensation of distention, intensifying the feeling of bloating.
Bloating is common, and although there are a number of possible causes (see below), it is a discomfort far from being fully understood.
Bloating is a common symptom of coeliac disease, food allergy, lactose intolerance and specific gut disorders, including Crohn's disease and irritable bowel syndrome (IBS), and other serious disorders. If you regularly suffer bloating it's a good idea to talk to your GP to ensure there is no underlying cause that needs specific treatment.
Why am I feeling bloated?
While bloating can be a sign of stress, a specific food intolerance, a digestive disorder or worse, for some there may be much simpler causes and solutions.
Swallowing air
When you breathe, oxygen goes into your digestive tract and normally it's just absorbed. But when we take in too much oxygen, the excess remains in the digestive tract and can cause bloating. For some, swallowing excessive air is a nervous habit which needs to be overcome. For others there are simpler solutions:
- Eat slowly. Chew food well and don't gulp drinks.
- Eat or talk. Don't try to do both at the same time.
- Stop chewing gum or sucking hard sweets.
- Avoid carbonated drinks.
- If you wear dentures, make sure they fit properly.
Over-eating
We expect our stomach to take everything we 'throw' at it, but our gut can get stressed from 'overwork', too.
- Many of us were brought up to eat everything on our plates. While that's fine if you serve yourself, others may give you more than you need or your body can cope with. Give more thought to timings of meals and portion sizes.
- Re-train yourself. It's okay to stop eating and leave food on your plate.
'Gassy' foods
Some foods are notorious for producing gas or bloating – baked beans spring to mind. The amount of gas different foods produce is individual to each of us, but some of the common offenders include:
– dried peas, lentils, beans
– brassica vegetables: broccoli, Brussels sprouts, cabbage, cauliflower, spinach
– artichokes, celery, cucumber, green capsicum, onions
– unripe banana, incompletely cooked potato
– fried and fatty foods
– sugar and sweets
– brassica vegetables: broccoli, Brussels sprouts, cabbage, cauliflower, spinach
– artichokes, celery, cucumber, green capsicum, onions
– unripe banana, incompletely cooked potato
– fried and fatty foods
– sugar and sweets
- To identify a food or foods which cause bloating, unless it's really obvious, keep a Food and symptom diary.
- Emerging research on a wide range of foods containing what scientists call 'short-chain carbohydrates' may help explain the phenomena of 'gassy' foods.
Some medicines and dietary supplements can cause bloating and gas in some people.
- If you suspect a medicine or supplement may be a cause of your bloating, talk to your pharmacist or GP about it.
Other triggers
Triggers for bloating can be very individual. There may be more than one trigger or a number of factors together which cause your bloating. For some, it may be a lack of exercise, for others if their diet is higher in fibre one day, they will feel bloated. If bloating is a regular issue, consult your GP to ensure there is no underlying cause. Keep a food, activity and symptom diary to help your dietitian or nutritionist to identify possible triggers.
New research on bloating and IBS
FODMAPs is an acronym for 'Fermentable, Oligo-saccharides, Di-saccharides, Mono-saccharides And Polyols'. FODMAPs is a promising area of research – especially for those with IBS (Irritable Bowel Syndrome) and other diseases for whom bloating is just one of the symptoms.
The carbohydrates and types of foods included in FODMAPs are:
- fructose found in fruits and in honey
- fructans found in wheat and some vegetables and fruit; lactose found in dairy products
- galactans found in legumes and brassica vegetables
- polyols found in stone fruits and some sweeteners (eg. sorbitol).
From the research to date, it seems poor absorption of these specific short-chain carbohydrates may be an important cause of bloating, wind and abdominal pain in many people. When these carbohydrates are not properly absorbed in the small intestine, the excess is delivered to the large intestine where they provide additional food for bacteria and may cause an imbalance of bacteria and their fermented products.
In one study, researchers found a diet low in these carbohydrates gave relief from abdominal pain, bloating and diarrhoea to more than half of the patients.
Although some people may poorly absorb only one or a few of these carbohydrates or types of food, the effect of poor absorption of these different foods adds up because they affect the intestines in the same way.
People affected may tolerate certain amounts of these carbohydrates (from whichever source), but have a threshold level at which these carbohydrates cause problems – and this level is individual to each person.
More research is required on the effectiveness of a low-FODMAP diet and understanding the amount of the different FODMAPs in different foods.
You may also find the following article of interest, which includes a list of common foods containing FODMAPs, and foods suitable for a low-FODMAP diet.
Are you intolerant to common foods?
Can probiotics help?
Probiotics are live microbial supplements which can modify the balance of bacteria in the gut, and are thought to be beneficial to our digestive system. They are usually found in yoghurt or probiotic drinks. The scientific evidence for their benefits is still emerging but appears quite promising. Some people may find them helpful for bloating and other uncomfortable gut symptoms.
How a food diary can help
It's not a good idea to self-diagnose a food allergy or intolerance and cut out a whole group of foods from the diet when you may not need to. It's a lot easier to have a balanced diet if you find it's only a few foods you need to restrict, so it's worth the effort of keeping a food dairy for a few weeks to really investigate the problem.
Some people will find it easier to discuss their food diary with a dietitian or qualified nutritionist who can help develop a plan to find out which foods you need to restrict. It's important to avoid an overly restrictive diet which may not be nutritionally complete, and to find suitable alternatives to foods you need to restrict. Even though we're calling it a food diary, there are other possible triggers for bloating such as stress or exercise – so it's best to keep track of these, too.
