Do you feel bloated? Bloating is commonly reported by people of all ages! 90% of the patients I see report experiencing this unpleasant feeling in the stomach. And often, there doesn’t seem to be reasonable explanations for the bloating.
In this episode, I address:
What bloating is, the top reasons why people are bloated, and how to eliminate bloating,- Believe it or not, food sensitivities, a lack of fiber, and even constipation can contribute to bloating.
Make sure you listen to the full episode to hear all of the reasons.
If someone you know is experiencing bloating, please share this episode with them!
Dr. Ann-Marie Barter: Hey guys, Dr. Ann -Marie Barter here. Today, I want you to do a quick video and podcast on an overwhelming question that we’re getting and that I address every single day in practice. Which is: Why am I bloated?
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Dr. Ann-Marie Barter: Here are some of the top reasons that you could be bloated and this is a shortened list, so it can be more than that. So we’re going to do some follow-up videos. We want to take this in smaller bite-sized pieces. Abdominal bloating is commonly reported by both men and women of all ages, so it can affect you if you’re really small. I’ve seen really young kids with a lot of bloating to elderly adults. It can be across the board.
It’s just a very unpleasant and irritating complaint that I would say about 90% of my patients come in with. It’s one of their top five complaints. A lot of times there’s no rhyme or reason to the reasoning that they’re experiencing bloating or when it happens. Bloating actually occurs with nearly all patients that have irritable bowel syndrome or have been diagnosed with irritable bowel syndrome. The main problem with this is that there’s not just one management solution on bloating because we have to get to the cause of what’s actually causing the bloating and decide what it is for you, because every person that presents with bloating does not have the same resolution. So we have to figure out what it is for you specifically.
There was a survey that was done and they found that 31% of the U.S. Population is actually functionally bloated, and 90% of patients with IBS are bloated. That is miserable and that is an incredibly high number. So the first thing I want to dig into because there’s a common misconception around this is: What is bloating?
Bloating is defined as abdominal distension, or maybe a little bit of a food belly baby there, more than three times a month. Three times a month. That is considered bloating. So a lot of times I hear patients say, hey well, I’m really not that bloated. It doesn’t happen to me every day, or it doesn’t necessarily happen. It only happens to me once a week, it’s not that big of a deal. But it still is a symptom and your body is trying to tell you something and it’s screaming that it needs to be addressed and symptoms don’t go away. They continue to build on each other until maybe you have bloating and then you have gas and then the bloating becomes more frequent and it just becomes very uncomfortable. So it’s something that needs to be addressed. Some patients with bloating only get bloated at the very end of the day and then they wake up the next day and their stomach is flat. So it is very variable when people are getting bloated and how people are getting bloated.
So, let’s talk about some of the common things that can be contributing to your bloating and maybe some steps that you can kind of tease out potentially what’s going on. The first one is, it could be something that you’re eating, which is pretty common. So, I want to go through the most common inflammatory foods first with you, that can be at the root cause of your bloating. The big ones that I like to rule out first are dairy or lactose intolerance, grains, wheat sensitivity, or even celiac disease. The first thing I do is I put people on an elimination diet for 30 days when they come into my office and it’s like an AIP diet. So what we focus on are protein, fruits, and vegetables, and the reason for that is because we pull out a lot of the common allergens that can contribute to bloating. At the end of the 30 days, we start to add those allergen foods back in and see what happens. So in the 30 days, if you eat protein, fruits, and vegetables, and you feel great, then we know that something that you’ve eliminated is contributing to your problems.
For example, at the end of the 30 days, the first thing that you reincorporate is cheese. Let’s say you do a hard cheese and you feel okay. The next week you incorporate a soft cheese and you feel bloated. So there can be variations within the dairy community. There could be some things that are actually bothering you more than other things are bothering you. So I recommend slow incorporation back in, and also to keep a food journal of how you’re feeling. A lot of times what folks do, a big mistake that they make when they are incorporating food back in is, they will incorporate, for example, pizza. That pizza maybe has wheat and cheese and some other things that maybe you’re reacting to, and then they don’t know what was actually the major cause of the bloating. That’s the first thing, so I would encourage you to do it step-by-step. When we’re doing more of an elimination diet, I also like to do organic fruits and vegetables just to limit the chemicals that you’re being exposed to. I also like to do free-range chicken and organic chicken, grass-fed, grass-finished beef, and freshwater fish.
The reason for that is: they’re higher, especially the beef and the fish. They’re higher in omega threes, versus omega-six. So omega-six is very pro-inflammatory and it creates inflammation in our body, contributing to our gut inflammation. So we can limit that inflammation down and really see how these foods are affecting us then we can get a good idea if anything that we’re eating on a fairly regular basis is contributing to our discomfort or potentially our bloating. So just to summarize, I eliminate a lot of inflammatory foods for 30 days. At the end of the 30 days, you’re going to slowly reincorporate, but you’re also going to keep a journal of how you’re feeling and what might be causing some bloating or some discomfort.
The second common cause of bloating is constipation. It is a huge reason for bloating. Most people don’t know that they’re constipated. So you really need to fully eliminate your bowels at least once a day. That doesn’t mean little pebbles, and that doesn’t mean going multiple times in the morning, you should be able to have a bowel movement and feel like you’re fully eliminated. What I like to equate this to is you’ve cleaned your house. You’ve just scrubbed it down, you’ve cleaned everything, but you never decided to take out the trash. If you don’t take out the trash, guess what, there’s fruit flies in the house, maybe it smells a little funny and the same thing is going on with your gut.
So that means that things can ferment in your gut. You can overproduce some bad bacteria, things can slow down. So we want to make sure that we are fully taking out the trash every single day, so that we have the correct and the appropriate microbiome, and we don’t get an overgrowth of opportunistic bacteria that could potentially have an impact on our bowels and also make us feel more bloated.
We want to be able to have a fully eliminated bowel movement every day, where we feel a flatter stomach. It should come out in one string versus itty bitty pellets. So the first thing that we would like to try if you’re having some trouble with your bowel function is number one, increase your water intake. A lot of times, especially in the summer, we tend to get electrolyte deficient, especially for those folks that are drinking enough water. In other places on YouTube, you’ve probably heard about magnesium, et cetera, and that definitely can help move the bowels. But, another one that is really important for eliminating bowels and helping with muscle contraction is another electrolyte; potassium, which we don’t hear as much about. So that is going to help your smooth muscles contract in your gut to move things through. There’s actually a disorder called paralyzed gut when we don’t have enough potassium in our body to create that gut-brain connection. So, number one, make sure you’re drinking enough water, and number two, if you’re sweating a lot, make sure that you have enough electrolytes. Potassium is a really simple test that is run on your blood work. So if that is low, we know that that can be a contributing cause to bloating, to sluggish digestion.
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Fiber is the next thing that can contribute to constipation. We really need about 20 to 50 grams of fiber per day. Most Americans on average get about 10 grams of fiber, so it’s way below where it really needs to be to feed that good bacteria in our gut microbiome. The first step would be to maybe increase fruits and vegetables and see how you’re feeling. Now, in some people, that’s going to make them more bloated, and that means that there’s another issue going on. In other people, it’s going to be the key to really moving their bowels, and that is just simple: hey, if we increase your fiber, then guess what? You’re going to have a much easier bowel movement. We’re going to feed that good microbiome and that good bacteria to really build that backup.
So, let’s say that it makes you more bloated. If fiber makes you more bloated, then we know that you’re probably feeding pathogenic bacteria. If you’re feeding pathogenic bacteria then that is going to make you more bloated. There’s a commonly known condition called SIBO or small intestine bacterial overgrowth. What happens with SIBO is this completely slows down your gut. It’s been found in about 80% of IBS patients, and you feel worse when you eat a lot of fruits and vegetables. It doesn’t really matter what you eat, you get bloated. I think the first line of defense is to figure out if you have SIBO and eradicate the high amounts of bacteria so that you feel less bloated. Generally, that’s done through specialized testing. So, if you increase your fiber, you feel worse. There’s probably an underlying infection that is going on, that actually needs to be addressed first.
Another thing that is going to contribute to bloating is not having enough good bacteria in your gut. There’s a lot of things that will cause a depletion of good bacteria. One of the ones that I have seen just be pretty major is chronic long-term stress, which really depletes your good microbiome and good bacteria. So a lot of times, the lactobacillus family, and the bifido family are very helpful for treating constipation and for helping with that. So if you don’t have enough of that good bacteria, you can feel bloated, and so some people like to try a probiotic. Some people like to try fermented food. Again, if those things make you better, then you were probably depleted of those things. If they make you worse then you probably have a low-grade infection going on. Again, that needs to be diagnosed from specialized lab testing to figure out: Hey, is this contributing to some of the functional bloating that’s going on in your gut?
The last thing we’re going to talk about today is digestive enzyme insufficiency, specifically pancreatic enzymes. Pancreatic enzymes lead to a huge increase in bloating, and the reason for that is because, if you don’t have enough of these pancreatic enzymes, it pools a ton of water into your intestine, specifically your small intestine. What happens is you get very, very bloated as you’re trying to digest these foods because of all the water that’s pooling in there. A lot of folks get massive loose stools or massive diarrhea, and they just do not feel good. So, digestive enzyme insufficiency, specifically pancreatic enzyme insufficiency.
So those are a few things that can contribute to some of the bloating. The list is not comprehensive. I want to keep it short. We will do a follow-up on some other things that can cause some bloating here, but I just did not want to give you just an exhaustive list. These are pretty common things. If you want to hear more of something, please let us know below in the comments. It was awesome to be with you guys today. Take care. Bye-bye.
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Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”. https://altfammed.com