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Are you having problems with bloating?

By December 3, 2020November 1st, 2021No Comments5 min read

Is it gassiness or feeling distended that’s interfering with your life?

Is it from weaker abdominal walls or is from eating a meal?

Causes of abdominal bloating are multiple, from Swallowed air, delayed stomach emptying known as gastroparesis, impaired gastric movement, small and large intestinal fermentation of poorly absorbed carbohydrates. Gynecologic causes of bloating would include ovarian disorders while liver disorders can contribute to ascites. Whatever the cause it can affect your quality of life.
If you’re tired of you’re abdominal bloating but don’t know how to get rid of it then continue reading.

Swallowed air: many people don’t realize how much air they swallow which can result from belching, gum chewing, snoring associated with sleep apnea, ingestion of carbonated beverages and GERD. Would you think that having a sleep study could put an end to your bloating?

The purpose of the stomach is to grind food into small particles. Within one hour after consuming foods it should be in the small intestines if this process is interrupted it can result in abdominal bloating.

Gastroparesis: A condition where the stomach cannot empty in a normal fashion also called delayed gastric emptying. This disorder is found associated with thyroid disease and cortisol deficiency and diabetes. However, most commonly the cause is unknown. If your noticing bloating, nausea or vomiting associated with pain after eating you may need an endoscopy and lab work to rule this disorder out. Eating smaller juiced meals can help with the symptoms.

Intestinal fermentation: results from carbohydrates that we cannot break down. The normal colon contains billions of bacterial organisms. Colonic bacterial normally ferments unabsorbed carbohydrates into CO2.

Dysbiosis refers to loss of bacterial diversity from chronic antibiotic use. There is bacteria in the gut that is suppose to be there. When there are more bad bacteria than good then it creates a state called dysbiosis. When this occurs in the small intestine a condition referred to as SIBO( small intestinal bacterial overgrowth) occurs. Extreme amount of bacteria in the small intestine alters normal function and affects metabolism than can result in bloating, abdominal discomfort and watery diarrhea. Common cause of bacterial overgrowth IBS, diabetes, hypo or achorhydria and chronic Use of H2 blockers a common therapy for GERD and peptic ulcers. For SIBO there is no gold standard for testing.

Celiac Disease:
Occur when wheat is ingested. There are many symptoms and the rate is increasing in the United States.
The cause is gluten and a host of genetic factors. Proline and glutamine rich protein found in wheat, rye, and barley is the main culprit. The high proline content makes them resistant to digestive enzymes leaving large fragments being absorbed that would normally not this results in an increase of inflammatory markers in the body. Celiac disease is also increased with people with genetic disorders with HLA-DQ2 or HLD DQ8. 40% of the US population is positive for one or both of these gene disorders. But not everyone who has the disorder will have celiac disease, only 1%. Why because you most have a second hit. Like an injury to the wall of the small intestinal lining that allow the large peptides to cross the lining and these molecules bind with the antigen in your blood and it aggravates the immune system. With a Gluten free diet you typically feel better in 2 weeks and by 6 weeks you’re significantly improved.

IBS (Irritable Bowel Syndrome):
90% of patients with IBS have bloating and 17% have SIBO. These patients complain of bloating, pain, cramping usually begin before age 40. Triggered by diet, foods and stress. 1/3 have constipation, 1/3 have diarrhea and 1/3 have both. Usually not associated with weight loss, no bleeding and no malabsorption. People with this disorder are more likely to have chronic pelvic pain, fibromyalgia, migraine headaches and anxiety. Women are more affected by this disorder than men by 2:1. The part of the nervous system that resides in the wall of the gut is called the enteric nervous system. It is responsible for the movement of particles through the intestine it depends on nervous feedback, as it is a sensory component.
IBS causes visceral sensitivity. When something is visceral you feel it in your gut. Nerves endings trigger movement in your gut. 95% of the hormone serotonin in our body is made in the gut lining. Serotonin is the key mediator of organ sensitivity in the gut and motility. Serotonin stimulates receptors, which control certain sensory nerves. Interesting fact, serotonin is a hormone and is commonly found in most depression medications.

We consume 100 gm of fructose daily but we can only absorb 50 gm/day. The remainder gets unabsorbed and goes to the colon and becomes gaseous.
Fructose malabsorption can cause gaseousness. Eating foods high in fructose corn syrup can cause a lot of gas and bloating.
Colonic gas comes from fructose, fructans (large molecules in wheat)
Avoid these foods to that are high in glucose and fructose such as;
Apples, pears, watermelon, honey, fruit juices, dried fruits, high-fructose corn syrup.
Avocados, mushrooms, cauliflower, milk, yogart, soft cheeses, wheat, rye, garlic, onions if you have problems with bloating.
Alternative food sources:
Citrus, berries, bananas, grapes, honeydew, kiwifruit, lactose free dairy products, rice milk, hard cheese, quinoa, cucumbers and eggplant

Low fermentable diet 70% of patients will feel better if they go gluten free even if they don’t have the gene.
There is something to be said about gluten sensitivity.
Probiotics for IBS improve bloating in 60% of women in 4 weeks. I recommend Ultra Flora by Metagenics we carry this in the office for your convince.

STW5 (Iberogast) a herbal formulation for mild symptoms of irritable bowel syndrome and Dyspepsia. Iberogast contains 9 extracts this product is made in Germany it can be purchased on

Primary goal with treating conditions that cause bloating is to return GI functions to normal.

Other forms of abdominal bloating include the liver with the formation of ascites.
Gyn causes (menses, ovarian tumors) another reason to have your annual pelvic exam.

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