There is nothing worse than a bloated belly that feels extremely uncomfortable, makes you look like you are expecting a child and prevents you from buttoning your jeans without pain. Bloating is common in both men and women of all ages, with studies showing that approximately 90% of patients with irritable bowel syndrome (IBS) experience bloating.
Bloating is defined as a sensation of increased abdominal pressure, whereas distention indicates the increase in abdominal growth that makes it difficult to button your jeans. Bloating is often painful and can be debilitating but the good news is that bloating is typically benign. There are a lot of different causes of bloating, many that stem from imbalances in the gut microbiome like small intestinal bacterial overgrowth (SIBO), slower transit times, food intolerances, and more. There is also a connection between eating disorders and functional gastrointestinal disorders that can lead to bloating, constipation, gas, and abdominal pain—this should be addressed with an eating disorder specialist.
My client, Alexa is in her mid 20s and had constant bloating after every meal, frequent gas and regular nausea. She was eating paleo and doing crossfit regularly. After working together for six months, she reported that her bloating and nausea have completely subsided and her gas only happens very occasionally. She can also tolerate way more foods like beans, onions and other foods that used to give her issues. If you are like Alexa, here are some of the tips that I would recommend starting with.
1. Drink Enough Water
When it comes to improving your digestive health, there is nothing more important than drinking enough water. The more dehydrated you are, the more your body tends to hold onto fluids to try to correct the situation. This is especially problematic if you are eating a lot of fiber powders or bars that cause gas without adequate fluids (think about all of the food products out there that add synthetic fibers to their products). Dehydration can also exacerbate constipation, worsening any bloating. Aim for half of your body weight in fluid ounces to stay adequately hydrated.
2. Make Sure You’re Having a Daily Bowel Movement
Research shows that constipation is a major source of bloating and distention. As the stool builds up in your large intestine, it causes fecal impaction and colonic loading which can resemble feelings of bloating. The second problem is the fermentation of the stool in your colon by the bacteria in the large intestine, creating excess gas. If you are already consuming adequate fiber and water while getting enough movement and are still constipated, try supplementing with magnesium citrate before bed.
3. Cook 50-75% of Your Vegetables
While raw vegetables can be nutritional powerhouses, they can also be very tough on your digestive system. The fiber that makes up the plant cell walls is very hard for your system to break down, causing excess gas and pain. This is especially true for vegetables like broccoli, cabbage, kale, onions and garlic. Cooking your vegetables helps to break down these fibers and make digestion a little bit easier.
4. Consider Cutting Back on Fermentable Foods
Fermentable foods are those that are classified as FODMAPs. This is an acronym for fermentable oligosacchardies, disaccharides, monosaccharides, and polyols. They are short chain carbohydrates that are poorly absorbed in the small intestine. This includes fructose (apples, pears, watermelon, asparagus, honey, wine), lactose (cheese, milk, yogurt, ice cream), fructans and galacto oligo-saccharides (beans, wheat, barley, rye, cashews, garlic, leeks) and polyols (sugar alcohols, prunes, cauliflower, and more).
There is good research to show that low FODMAP diets can help resolve bloating because high FODMAP foods increase intestinal water and and feeds colonic bacteria that produce hydrogen and methane-causing gas. It’s best to work with a dietitian on incorporating a low FODMAP diet to ensure you are meeting your nutritional and microbiome needs. It’s also not recommended long-term because decreasing FODMAP intake can lower short chain fatty acid production in the gut (which is the opposite of what you want for gut health).
5. Eat Soaked Nuts and Seeds
Nuts and seeds are an amazing way to get healthy fats into your diet, but they can be hard on digestion for people who are more sensitive. The phytates naturally found in nuts and seeds have been shown to decrease absorption of nutrients like zinc, iron, and magnesium but also inhibit production of digestive enzymes like amylase, pepsin, and trypsin. This does not lead to digestive issues for everyone, but for those who are trying to reducing the bloat, try soaking your nuts and seeds. To soak your nuts, mix 3-4 cups of warm filtered water with 1 tablespoon of salt and add 2 cups of raw nuts, making sure they are covered with water. Let these sit for 7-24 hours and then dehydrate in a dehydrator or in the oven at 150F until completely dry. This drying process can take up to 24 hours.
6. Choose Sprouted Grains
Similar to soaking nuts, sprouting grains removes the phytates that can cause digestive upset. Sprouted grains are simply grains that are going through the germination process of a seed becoming a plant. This process breaks down some of the starch in the grain and activates enzymes within the grains that make them easier to digest. Bonus: some of the vitamins in sprouted grains tend to be more bioavailable than those in unsprouted grains. Look for TruRoots sprouted quinoa and even Trader Joe’s who sells a blend of sprouted brown/black/red rice.
7. Avoid Sugar Alcohols
Sugar alcohols are anything that ends in ‘ol’ on your ingredient list. Examples include xylitol and mannitol which are found in a variety of low-sugar foods. Since they are only partially digested by the bacteria in your large intestine, they draw lots of water into your colon, causing gas and even sometimes major stomach upset like diarrhea. Watch out for sugar alcohols in your gum, low-calorie ice cream, and products advertised as low sugar or keto, and learn more about these alternative sweeteners.
8. Limit Carbonated Beverages
The carbon dioxide that is required for making carbonated beverages like soda water can cause gas and bloating. Drinking carbonated beverages can trap gas in your digestive system. Swallowing these large amounts of air is a common cause of the puffy bloating, so try to switch to still water. You can also swallow too much air by simply eating too quickly so be sure to chew your food slowly and be present with the eating process.
9. Keep a Symptom Diary
It can be incredibly hard to determine which foods cause bloating. Especially because sometimes it seems to appear out of thin air. The best way to track patterns is to keep a detailed journal, tracking what you ate, how much, when, and your symptoms. Common culprits to watch out for are high fiber foods, starchy foods like potatoes or beans, or common allergens/sensitivities like dairy and gluten. My favorite app for tracking symptoms is MySymptoms App which you can download from the app store.
10. Add Digestive Enzymes with Meals
Digestive enzymes like amylase, protease, and lipase are naturally secreted in areas of the body like the pancreas and small intestine. Probably the most commonly known enzyme is lactase, an enzyme that helps break down the milk sugar in dairy called lactose.
The job of these digestive enzymes is to help break down your food. Sometimes the body does not produce enough and other times it just needs a little extra. Certain conditions like cystic fibrosis, chronic pancreatitis, and pancreatic cancer can lead to lower levels of digestive enzymes and it’s thought that factors like inflammation or chronic stress can also decrease enzyme production. This is where digestive enzyme supplements can come in, which can assist the body in breaking down food. There is not much research to demonstrate the effectiveness of them but from a clinical standpoint, they do seem to help a number of people relieve their bloating.
11. Add Digestive Bitters (or Herbal Teas)
Digestive bitters work to stimulate your natural digestives juices such as hydrochloric acid in your stomach, bile, and pancreatic enzymes. By increasing the amount of these digestive juices, bitters help break down food to relieve gas and bloating. Like the enzymes, certain teas are formulated to help ease gas and bloating. These teas are typically marketed as gas relieving such as this Gaia Herbs tea, and contain ingredients such as peppermint, fennel, ginger, or licorice that are known to calm your stomach and relieve gas.
12. Try a Probiotic
Probiotics can help ease bloating by increasing the population of good bacteria and reducing the bad guys that cause digestive upset. There are certain probiotics like bifidobacteria infantis (1 × 108 CFU/mL) that have been associated with improvements in bloating and abdominal pain/discomfort, when compared to the placebo. Other probiotics such as Visbiome have also been shown to improve bloating and gas. In certain cases, specifically if you have bacterial overgrowth, probiotics can make bloating worse. If this is the case then you would want to work with a functional medicine doctor.
13. Space Out Your Meals
While you may have heard that that grazing all day is best for your metabolism and blood sugar levels, eating too often does not give your digestive system the chance to clear out after each meal. Your migrating motor complex (or MMC) is responsible for doing a clean sweep after each of your meals, clearing food out and pushing it towards your colon. The MMC process is initiated 90 minutes or so, meaning you need to give your digestive system ample time to initiate and complete this process between meals. I recommend leaving four hours between meals to make sure the MMC is doing its job.
14. Incorporate Yoga
Yoga is great for combatting bloating in many ways. First, many poses are “wind-relieving” poses and can help dispel some of your trapped gas. Sequences like this may help. Yoga is also a phenomenal anti-stress tool. As I discussed previously, stress is the antithesis to healthy digestion. When you have chronic low grade stress, your digestive system shuts down, leaving your food to sit too long and create excess gas.
Finally, yoga is a great form of movement, and movement is key for proper digestion. Movement, like yoga or walking, helps move food more quickly through your system, giving the bacteria less time to produce gasses from your food. Incorporate activity, but be sure not to overexert yourself.
15. Consider Working with a Dietitian
There are so many reasons for why you may be feeling bloated and it can be difficult to figure it out on your own. Some doctors will recommend low FODMAP diets, gluten-free diets, the autoimmune protocol, paleo, etc. It’s important to work with a registered dietitian that is trained in integrative and functional medicine who can better assess the underlying cause and the best nutrition plan for you. You may also want to seek out a medical professional to rule out other possibilities such as ovarian cysts, low thyroid function, celiac disease, hormonal imbalance, SIBO and candida.
Jamie Foti Contributed to this Article.