Let's Talk Bloating
Is bloating normal?
Mild bloating, without pain, after a meal, babe, can I tell you, is normal healthy physical response, and should occur. It is not something to be fear or thought to be wrong.
When food and fluids are consumed, our internal organs need to expand to create room for digestion. In the digestion process, there is increased blood flow to the digestion area and the food/fluids consumed will cause an increase in the volume within the organs.
Mild bloating aka normal GI organ expansion after a meal should be a normal experience.
Social media tells us our bodies should have a flat stomach all day long, and they should not change in appearance. Mmmm
Our amazing bodies are dynamic. By this I mean, they will change throughout the day as a response to our daily behaviours.
What about bloating which may be more than a normal amount, or is experienced with pain and or nausea?
While it is normal to experience some distension in the abdomen area after a meal, what is not normal, is to experience a stomach distension/or bloating that happens quickly or comes with pain and or nausea.
This kind of bloating can be problematic and miserable. It is often associated with altered bowel habits; poor mental performance; fatigue and anxiety, all which can really interfere with everyday life.
There could be many reasons as to why this is occurring, and it is best to seek your GPs advice first, to rule out any “bigger” behind the scenes reasons.
But to speak generally, we can explore possible factors to what could be causing a “more than normal” post meal bloating/distension. We know that physical triggers like swallowing a lot of air, eating quickly, having large meals, stress, dietary intakes of processed salty and fatty foods, foods that naturally produce more gas, lack of fibre and fermented foods, are all possible areas that can play a role in uncomfortable bloating.
Gas is the most common cause of bloating, especially after eating. It builds up in the digestive tract when undigested food gets broken down or when you swallow air.
Everyone swallows air when they eat or drink. But some people can swallow more than others especially when they are eating or drinking too fast; having a large meal; chewing gum; drinking fizzy drinks and if talking while eating.
Wearing tight pants or clothing can also make you feel more bloated as they put more pressure on your abdomen. Excessively tight clothes can constrict your stomach and make it harder for food and gas to pass through which can cause this bloating and discomfort.
Gas Producing Foods
Some people can experience bloating after eating foods containing high amounts of non-digestible and/or poorly digestible compounds. Everyone has a natural threshold to these foods, and it can vary even within the individual (often stress can play a role here). When foods containing these poorly/non—digestible compounds, are consumed, the undigested fibres and sugars end up in the large intestine where the bacteria in the gut ferments leading to increased gas and bloating.
The FODMAP diet, by Monash University, is a scientifically developed investigation tool looking into this phenomenon. “FODMAP” is an acronym for a group of sugars that are poorly absorbed in the small intestine. In some people these sugars can trigger symptoms like diarrhoea, wind, bloating, pain, nausea, and constipation (1,2). There are a range of foods that are high in these compounds which can include garlic, onions, apples, cauliflower, mushrooms, dairy products, chickpeas and wheat. They are also commonly found in low carb “diet foods” – in the form of sorbitol, mannitol, and xylitol. The FODMAP diet is not a lifelong diet. It is an active investigation tool, used for the short term, and should be completed under the supervision of a dietitian (ideally accredited by Monash University, like myself).
There are some other foods that we know increase bloating, due to their natural gas producing content. They include broccoli, cauliflower, cabbage, prunes, beans, and lentils as well as carbonated beverages (3). Not everyone will feel bloated after eating these foods – so keeping track of what foods cause these symptoms may be useful.
Processed and fatty foods
After eating processed and fatty foods, it is common to feel bloated afterwards, as high fat meals take longer to digest by our bodies. As this food is longer in the digestive track, the increased physiological volume occurring, means organ distention will be felt for a longer time period (4,5).
However, some people can feel more uncomfortable bloating after consuming high fat meals, as they have a higher sensitivity fat. The amount of the meal eaten, will vary the response.
Bloating will also occur more from consumption of processed foods high in salt. Salt causes a fluid shift within the body, and the increase water retention, will increase the volume within the digestive organ, which can create more of a bloated symptom.
There are digestive conditions like irritable bowel syndrome (IBS), constipation, and functional bloating that will cause a greater experience of bloating, with pain/nausea.
These digestive conditions usually involve an oversensitivity of the gut, as well as a disruption to the physical and chemical connection between the brain and gut. This can cause a change in how the digestive muscles “mix and move” food, which alter the digestion rate. A slower digestion rate will mean a slower faecal emptying. The more time faecal matter stays in the colon, the longer it can be fermented by gut bacteria’s, which can result in more gas and bloating occurring.
Altered gut bacteria
Gut bacteria is one of the most common talked about terms in health science. And it is a good thing, as we now have the level of technology to understand this science. Evidence is now showing, humans could be more like 99% bugs and like 1% DNA. So bugs (microbiota) has a big role in our everyday function.
A good gut bacteria colony will have a positive effect on our digestion and bloating, weight, immune function, hormones, fertility, mood and more. If a gut dysbiosis occurs (a reduction in bacteria diversity and type), symptoms like bloating can be experienced (6). Gut bacteria is influenced by our diet, exercise, sleep hygiene, use of antibiotics, sanitizers and more.
Diet diversity is one of the strongest influences to having strong gut bacteria supportive of positive health outcomes.
Hormones are involved in almost every function of the body, so fluctuations in them can cause bloating. Hormonal bloating is a common early sign that you are getting your period. Often it might feel like you have gained weight, or that your stomach is tight or even swollen.
This is due to changes in levels of the hormone’s progesterone and estrogen. About a week before you get your period, the level of progesterone falls, which stimulates the uterus lining to be shed. Current research is suggesting that both progesterone and estrogen can cause the body to retain more water and salt, which can make us feel either swollen or tight (7).
In some people stress can slow down digestion, which can cause bloating, pain and constipation. In others, it can speed digestion up, causing diarrhoea. Stress can also worsen digestive conditions like IBS.
The main reason why anxiety can lead to bloating is hyperventilation, that is, when we take in more air than needed. When this happens, it is not uncommon to feel pressure or tightness in your stomach. Even if you aren’t hyperventilating you may find that you start to increase the rate of your breathing which can lead to feeling bloated.
Anxiety also shuts down the part of the brain that handles digesting food. It can create an environment where food that is normally digested easily ends up being digested poorly.
What you can do…..
- Don’t self-diagnose. We want to discuss any symptoms you might be experiencing with your doctor, who will then be able to organise any referrals that you might need as well as possibly ruling out any conditions that might be causing the bloating.
- Keep a food and behaviour dairy to help you identify which foods could be causing your bloating; and also, how the food is eaten (ie while unpacking the dishwasher, talking to your kids and panicked about the morning work meeting). Every personal study is always “n=1”. In your health journey, it is important to find all your pieces to your jigsaw puzzle.
- Slow down and eat more mindfully. When we eat too fast, we swallow more air and we can overeat. Aim to eat slower, chewing every mouthful (they say we should chew our food 20 times before we swallow!). By chewing your food correctly, you are tapping into the first phase of digestion, breaking larger particles into smaller ones. This will help with digestion, reducing the amount of gas and bloating experienced, and reducing overeating helps to reduce total volume consumed and hence the amount the digestive organs need to expand.
- Limit fatty and highly processed nutrient, high salt foods. As a dietitian loves to say, add in more veggies (and fruit, legumes and fermented foods).
- If constipation is what is causing the bloating, focus on treating and managing this through your diet, with regular and consistent fibre and adequate hydration. Taking part in regular physical activity can also help to keep your bowels moving. Foods like kiwi fruits (2 a day) have been scientifically proven to alleviate constipation (8).
- Seek help from an experienced dietitian, where you can receive individualised support, guidance, and suggestions to help manage the bloating.
Working out digestive issues, like long term bloating is not a 45 minute consultation process. It is a journey, looking at each day, each week, and how the daily life activity is affecting your health.
Restore is my individualised 1-1 support program, where I have the privilege to work with ladies every day over 8 weeks. With the right personalised support, anything is possible. Reach your health goals this year babe, and quit the yo-yo dieting game.
Blog: Written by Dietitians Nicole Barber and Makayla Zok.
8. Kiwi fruit for constipation - A blog by Monash FODMAP | The experts in diet for IBS - Monash Fodmap