Bloating is the protrusion of the abdomen, usually caused by gas (and sometimes fluid), and it generally ebbs and flows—many individuals experience a flat abdomen in the morning and by evening, the abdomen is protruding and hard to the touch. Others will have days without bloating and then several days following where bloating is a problem.
Bloating has become an epidemic and is one that is rapidly increasing. For many, the symptoms are daily, relentless, and life altering, but even when symptoms aren’t severe, they’re significant annoyances that can interfere with daily life. Bloating is never a “normal” occurrence and is always a sign that something isn’t quite right in the gut. It is one of the earliest and most common indications that there may be a problem.
- Protruding abdomen
- Abdomen that is hard to the touch
- Abdominal pain
- Gas, both flatulence and burping
- Vasovagal reaction
- Hair loss
- Skin problems: acne, rosacea, eczema, blemishes, rashes
- Food allergies/intolerances
- Under-eye dark circles
- Puffy, swollen appearance
Conditions associated with bloating are:
- Adhesions from previous abdominal or pelvic surgery
- Anatomical variations in the female colon and pelvis
- C. diff
- Celiac disease
- Diastasis Recti
- Fructose malabsorption
- Gallbladder removal
- Gluten intolerance
- Hormone imbalances, such as estrogen dominance
- Irritable bowel disease (IBD): Chrohn’s disease & ulcerative colitis
- Irritable bowel syndrome (IBS)
- Lactose intolerance
- Leaky gut
- Microscopic colitis
- Poor lymphatic flow
- Tumors or other masses (endometriosis, uterine fibroids, or ovarian cysts)
- Yeast overgrowth
The causes of bloating vary tremendously, from common benign conditions, to rare life threatening illnesses. Below are lifestyle factors that may cause bloating:
- Acid-suppressing medications
- Chugging water after exercise
- Bloat-causing liquids (dairy, soda, sports drinks, fruit juices, alcohol, soy milk, caffeine, carbonated drinks, and kambucha)
- Drinking too much liquid during meals
- Eating large meals at night
- Eating too much fiber in one sitting
- Excessive salt intake
- Excessive sugar intake
- Lack of exercise
- Lack of water
- Low calorie sweeteners
- Poor diet
Symptoms like bloating are non-specific, which makes it challenging to arrive at an accurate diagnosis. The story behind your bloating is helpful in arriving at a meaningful diagnosis. Make sure that the information you give your doctor is complete with all the details, and that it’s heard and that key questions are asked.
To help diagnose your bloating, utilize Your Inner Doctor and pay close attention to the feedback your GI system gives you —what makes it feel good and what aggravates it. Over time, the adjustments you need to make to keep your GI tract functioning without symptoms of bloating and abdominal discomfort will become more and more apparent.
If you have bloating and a change in bowel habits and are having a colonoscopy (a test used to investigate the colon during which a thin, flexible tube with a camera on its end is inserted into the rectum), it’s important that biopsies be taken from throughout your colon, including the top, bottom, and middle parts. Inflammation isn’t always visible to the naked eye, and it can be patchy and missed if enough areas aren’t sampled.
Sometimes bloating is confused for other conditions. Occasionally a solid mass in the uterus, ovaries, or colon presents as bloating and causes constant, if not increasing, protrusion of the abdomen, yet this is rare. Belly fat can also be mistaken for bloating.
Be Your Inner Doctor: Is it Bloat or Belly Fat?
If you’re not sure whether your expanding waistline is due to bloat or belly fat, measure your waist several days in a row. If it’s bloat, your waist measurement will vary by more than an inch; if it’s belly fat, there’ll be little variation.
Because bloating can be a symptom of many different diseases, conditions, and lifestyle choices, the treatments for bloating vary greatly. Yet, consuming more water is one of the fundamental concepts for improving bloating: it improves motility, lymphatic flow, stool consistency, and regularity. Living the lifestyle Dr. Chutkan outlines in her books Gutbliss and The Microbiome Solution is also an important step, if not a cure, in eliminating your bloat.
If you think you could have gastroparesis, a hernia, volvulus, scar tissue, tumor, bowel obstruction, or some other serious condition that’s causing your bloating symptoms, a thorough evaluation and clear diagnosis is paramount.
For those with milder symptoms, whose bloating may be caused by lifestyle choices, here are some tips that can help alleviate symptoms:
- Don’t skip meals.
- Eat small, frequent meals.
- Split full meals into two smaller meals a few hours apart.
- Pack snacks.
- Eat your largest meal early in the day and your smallest meal at night.
- Eat out for brunch or lunch rather than dinner.
- Eat your last meal before sunset, as stomach contractility decreases after dark.
- Wait 4 hours after eating to exercise or lie down.
- Go for a walk after meals.
- Limit your consumption of fatty foods, which slows stomach emptying.
- Split up your fiber consumption in smaller portions throughout the day.
- Sip your fluids instead of gulping them to reduce air swallowing.