When it comes to bloating, I think it’s safe to say we’d all rather avoid it. A “quick” google search winds up giving hundreds of possible causes of bloating – which is overwhelming and often concerning. But I have news for you – bloating is 100% normal. Not only that, it can be a sign of a healthy, functioning microbiome. I have a podcast all about this, but in essence, our microbiome is the ecosystem of beneficial microbes (bacteria, yeasts & fungi) that naturally reside in our gastrointestinal system, most notably the colon (large intestine). There is increasing evidence that our microbiome is linked to many aspects of not just physical health, but possibly mental health as well. In supporting the growth of these microbes, we have to ensure they’re well-fed. When they digest and ferment food, they produce gas as a by-product – hence, our dear old friend, the bloat.
However, when bloating is excessive, causing pain, occurs after almost all meals or is accompanied by other gastrointestinal symptoms (altered bowel habit, excess flatulence, nausea, cramping), it could be a sign of some underlying issues. If you are experiencing any of these symptoms, it is best to seek advice from your GP.
In saying that, there’s a middle ground. Even in the absence of the above symptoms, excess bloating can be distressing and uncomfortable. It’s also something that affects everyone differently. This is why it can seem like you’re constantly feeling the bloat, while your best friend hardly ever seems to experience it. Some of this comes down to the sensitivity of your gut, how much gas your microbiome naturally produces, and how efficient your body is in absorbing it. Take note that true bloating is different from what we now have come to lovingly call “the food baby”; the presence of food or fluid will naturally cause your belly to stick out a little more – this is normal. Bloating on the other hand is due to the gas described in the first paragraph, so more often than not will occur sometime after digestion has started.
It’s not uncommon for people to immediately self-diagnose a “food intolerance”, and blindly start cutting out foods, or even whole food groups, from their diet. While this can sometimes alleviate symptoms initially, more often than not symptoms return some time later. This leads to an endless cycle of cutting out more and more foods, resulting in an increasingly restrictive diet.
There are several issues with this. Firstly, cutting out foods, and especially food groups, unnecessarily increases the risk of nutrient deficiencies. Secondly, it impedes on being able to enjoy a variety of foods in the diet and can be psychologically problematic. Especially when it comes to dining out and socialising, having a list of “banned” foods can make these events more stressful than enjoyable. Thirdly, cutting random foods out of your diet is more likely to exacerbate problems in the long run, rather than help them. For example, often foods most associated with bloating are those that are high in fibre (our microbiomes preferred food), resulting in more fermentation and gas production. But this is also what will help support growth of these beneficial bacteria, so it’s not a good idea to cut these foods out. And finally, self-diagnosing can mean missing an actual underlying problem, which could be treated more appropriately.
Needless to say, if you truly suspect a food intolerance, it’s never a good idea to cut it out blindly. Start a food and symptom diary and get support from a GP or dietitian.
What many people don’t realise, is that the root causes of bloating are often not related to individual foods at all. So before you jump the gun, take some time to consider some of these common non-food causes of bloating. Again, while some bloating is normal, some simple changes can help to reduce the severity or frequency.
Causes of Bloating Related to Eating Behaviour:
Improper Chewing
We don’t think a lot about how we chew foods, but chewing is actually a really proper part in the digestion process. Because of our busy lifestyles and lack of sit-down or extended meal times (which we see a lot more of in other, typically healthier, cultures), eating is often a rushed experience. Depending on the food, we might only chew each mouthful 5 or 6 times before we swallow. Research shows that in order to get the maximum benefit, we should actually be chewing anywhere between 20-40 times, achieving a paste-like consistency, before we swallow. I don’t know about you – but I definitely need to work on this! It certainly takes practice, but it can have a powerful impact on our digestion. Some foods, such as watermelon or porridge, will of course take much less, so this is a guide only.
Chewing digests food through mechanical means (breaking the food into smaller pieces with our teeth) and also chemical means (digestive enzymes present in our saliva). Without utilizing this step of digestion properly, the rest of our digestion can be inhibited. This means more undigested material passes into the lower part of our intestines where most of the microbes are, and so can cause excess fermentation and gas production.
It’s also important to realise that our digestive system isn’t always “on”, as such. Many of the steps in the process are triggered by the presence of food, or as part of a feedback system, where the activation of one step in the process alerts subsequent steps to get ready. Taking time to chew allows your body time to recognise that it’s time to fire up the rest of the digestive system.
Start by counting how many times you chew food at the moment, then intentionally start to chew each bit a little more (e.g. chew an extra 5-10 times to start with, depending on where you’re starting from). Do this consistently for a few weeks, aiming towards the 20-40 times mark, and see if this improves your digestion or bloating.
Eating Too Quickly & In Stressful Environments
This relates to the above point, but with this I’m more relating to the headspace we’re in when we eat. Our brain and gut live in strong communication with each other (think of how nerves cause gastrointestinal shifts – nausea, butterflies, “nervous poos”). From a paleolithic perspective, “fight or flight” was necessary to survive predatory threats. We still possess this trait but more often than not the threat is psychological or emotional, rather than physical – i.e. stress. Nonetheless, our body’s automatic response is to channel all of our energy into parts of the body that would be needed in fight or flight – our legs, lungs, limbs etc. Other processes, including digestion, are switched “off” – production of saliva, stomach acid, and digestive enzymes are all reduced, and there is less blood flow to our stomach and intestines, which inhibits mechanical movements needed in digestion. When eating “on the go” or in a rush, we signal to our bodies to be on high alert, rather than that we are in a safe and calm moment in our day; that no threat is near and it can focus less on survival mode, and more on other bodily processes.
In order to maximise digestion, sit down, try to take a few moments to breathe deeply roughly 5-10 times (see below), and begin to eat. Take your time and be mindful.
As a side note, studies slow show that eating slowly and chewing food more helps to reduce overeating and excessive calorie intake. So if this is something you struggle with, all the more reason to try it out.
Too Large Meals
This one doesn’t need much explanation. But essentially, excessively large meals create a lot of work for our digestive system. Overloading on too much food at once is too much for our body to deal with – it simply cannot digest all that food as effectively. Once again, improper digestion – whether caused by not enough chewing, “fight or flight”, or too much at once, means more undigested food for the bacteria to digest and ferment. As I’ve already mentioned, large meals will also likely result in the food baby, so when this is coupled with bloating, can become particularly uncomfortable.
I feel the need to highlight here there is nothing wrong with occasionally overeating. It’s normal that when we’re celebrating or enjoying our favourite foods, we might overdo it a little. However, if you are someone who is struggling with excess bloating and looking for advice, this is simply something to consider.
Dehydration
There are two reasons why dehydration can worsen bloating: (1) As with every bodily function, our digestive system requires proper hydration to work effectively. Dehydration can result in the muscles of our digestive tract to become sluggish. (2) fluid is critical in adding “bulk” to the stool – around 75% should be made up of water. Inadequate fluid means a smaller stool that is more difficult for your body to move along the GI tract.
These two things in combination, mean an overall longer transit time. Although a certain amount of fermentation is good and part of a healthy digestive process, there’s always a balance. Slow transit time often means that the bacteria start to over-ferment some of the food, producing more excessive gas. Normal transit time is around 28 hours, but in a dehydrated state it can be up to 4 days. One of the most common reasons of constipation (often coupled with bloating) is inadequate fluid intake. So make sure to properly hydrate!
Causes of Bloating Related to Lifestyle:
Swallowing Excess Air (for the nerds: Aerophagia)
This is less common, but worthwhile considering all the same. We swallow air when talking, eating and laughing. usually, this isn’t a problem as it rarely reaches the stomach. However, some individuals swallow an excessive amount, which can result in bloating, distention and trapped wind. This can be exacerbated by certain behaviours, including eating too quickly and improper chewing (see a common theme?), talking while eating/chewing, chewing gum, drinking with a straw, fizzy drinks, smoking, and breathing through the mouth instead of the nose.
Aerophagia can also be related to underlying psychological issues, such as chronic stress of anxiety, where swallowing excess air is part of a coping mechanism.
Modifying some behaviours may therefore help avoid swallowing excess air, including taking smaller bites, chewing well, eating with your mouth closed, diaphragmatic breathing techniques, being aware of mouth-breathing, stopping smoking and avoiding drinking with a straw, chewing gum, carbonated drinks or sucking on hard sweets.
Too-Tight Clothing
We all love the athleisure vibe, especially in lockdown. Listen – I appreciate the flattering effect of high-waisted gym leggings as much as the next gal. But constantly wearing skinny jeans, tight leggings, and other restrictive clothing puts pressure on the abdomen, restricts blood flow and impedes our body’s ability to properly digest foods.
Obviously, occasionally sporting tigher clothing isn’t going to be an issue. But try and make sure you give your body some “unrestricted freedom” – get yourself some Mom jeans, flowy pjs and oversized sweats and embrace the unbridled belly.
Other Useful Strategies:
Okay, so these aren’t “causes” per se, but in tandem with addressing some of the above suggestions, these strategies can help alleviate some of that bloating when it does arise.
Stretching & Gentle Movement
Stretching can help to relax the muscles, including those of the gastrointestinal symptom, while some gentle exercise helps increase blood flow and stimulate the passage of trapped wind out of the body. Be mindful that overly vigorous exercise could have the opposite effect* (remember that fight or flight response), so something like a slow to moderately paced walk is enough. Given the tight links between the gut and brain, doing some stretches and gentle movement also helps to relieve stress, which as a by-product may also alleviate some of that bloating.
*Note: this is relating to times where you are in the midst of bloating. Otherwise, more intense exercise, such as HIIT, can of course enjoyed as part of a healthy lifestyle and is beneficial for overall and gut health.
Heat packs & Abdominal Massages
Like stretching, applying heat to your abdomen relaxes the muscles, and much like all muscles, massages can also help. Try and lie down in a calm space (however, this can be done anywhere if the need arises!), and using a flat hand on your lower abdomen, gently stroke upwards a few times. Next, place each hand on your waist and stroke from your mid-back, down the side of your stomach and towards the groin.
Now turn your hand into a fist. Place your right fist on your lower right abdomen, and firmly slide it up and across. Then use your left fist to continue the direction back down towards your groin. Repeat for a few minutes. Then repeat this, but splitting the previous movement into it’s wo parts – so focus on just your left fist kneading down for 1-3 minutes, then on your right first moving up and across for another 1-3 minutes.
Finish by placing a flat hand anywhere on your lower abdomen, and gently shake. Repeat around 5-8 times, moving your hand to a new spot each time.
Diaphragmatic Breathing
Bloating can be aggravated by improper breathing (as previously discussed). Diaphragmatic breathing can help to “switch on” the parasympathetic nervous system and decrease the sympathetic nervous system – in essence, switching from “fight or flight” to a calmer state. This helps to redirect blood flow from the limbs and brain to other parts of the body, including the digestive system, allowing it to work more effectively. However, even while at rest, some of us take shallow breaths through our chest, rather than breathing using the diaphragm. Chest breathing is designed for short periods of increased exertion, not for prolonged periods of time. Due to our high-stress lives, we can often find ourselves breathing this way as a standard. Practicing diaphragmatic breathing for 8 weeks has shown in studies to improve belly distension, and may be particularly useful for those with IBS-like symptoms.
To do this, take a slow, deep breath in through your nose. It can be useful to place one hand on your stomach, and one on your chest. If you are breathing through your diaphragm, the hand on your stomach should move more than the one on your chest. Then, breath out (mouth or nose, whichever comes naturally to you). If you previously noticed that the hand on your chest moved more, on your next breath, really focus on allowing your belly to move out. Visualise the breath traveling into your stomach, instead of your lungs. If done correctly, your chest should barely move at all.
Sleep & Stress Management
Stress is possibly the number one cause of gastrointestinal distress. As you’ll have discovered by reading this post, this is because it ties in with almost all of the above causes. No amount of dietary changes will make a difference if you are chronically stressed! The gut-brain axis is incredibly powerful, and studies show that individuals with chronic anxiety or stress actually display an altered microbiome. Likewise, even two days of sleep deprivation can decrease microbial diversity in the gut.
We live in a stressful environment a lot of the time, but implementing stress management strategies and ensuring adequate sleep are essential for a healthy microbiome.
Implement More Bitter Foods
In Western society, bitter foods have been pushed to the wayside in preference for salty and sweet-tasting options. This is one reason why a lot of people dislike a lot of vegetables, many of which are more bitter than you might be used to. This is especially true for some lesser-liked vegetables, such as kale and Brussel sprouts.
Bitter-tasting foods can help to trigger the production of digestive juices (saliva, stomach acid and pancreatic enzymes). In some cultures, it’s common to start a meal with a salad, which often is based on bitter leaves such as rocket, radicchio or chicory. This is thought to help prepare the digestive system for heavier parts of the meal, like meat, beans and grains.
The evidence of this is limited, but given the overall health benefits of such foods it’s worth a try!
Learn More:
If you want to learn more about gut health and the microbiome, make sure to take a listen to my podcast episode on “The Better Bite”: #8 The Gut Microbiome: Understanding the Basics. Available on Spotify, Apple Podcasts and all main podcast platforms.
