Addressing The Route of Bloating.
Among all of the different digestive symptoms we can experience bloating can be the most annoying. Often it appears with other IBS type symptoms such as constipation, diarrhoea and cramping or sometimes just on its own. Most annoyingly it can happen without rhyme or reason.
We may use the word bloating to describe different sensations. Some use the term bloating to refer to the sensation of a swollen/distended abdomen, and others use it to refer to the sensation of a full belly.
When I’m working with individuals with IBS in my clinic, I like to make this definition clear. It’s important to know if there is the feeling of bloating as well as any visible distention.
Around 25% of those with bloating sensations have no signs of distention.
So, what causes it?
The precise cause of bloating is not exactly well understood by science. However, it appears to be a combination of the following 4 factors
- The feeling of bloating (this is independent from the visible distention)
- The visible abdominal distention
- The volume of the contents of the abdomen
- Abnormal activity of the muscles in the abdominal wall.
The Feeling of bloating
The feeling of bloating can be present without the visible swelling and inflation of the abdomen. The reason for this can be that those with gut issues and IBS can often have a very sensitive gut lining.
This is known and visceral hypersensitivity.
This means that the volume of any gas that is produced (more on this soon) feels a lot greater than is actually present due to an overly sensitive gut wall.
Bloating and IBS
I am not a great fan of the term IBS. It simply describes a set of symptoms but doesn’t give us a clear idea of their cause. It’s the same with bloating.
Bloating isn’t a disease as such. It’s an indicator that there is something out of balance in the digestive tract.
The bacteria along the digestive tract produce various gases as by-products of fermentation. Some of these bacteria produce gases such as hydrogen and methane, while other have the role of consuming this gas. It’s all about balance.
If the balance between creating the gas and breaking down the gas is disrupted we may start seeing issues. If the gas creating bacteria and in greater numbers this will certainly put a strain on the system, create more gas with bloating resulting.
What can cause this bacterial imbalance?
A variety of factors can predispose individuals to a disrupted microbiome.
- Anti-biotic use – this can greatly reduce the number of many of the bacteria in the gut. Once they repopulate, they can do so in an imbalanced manner.
- Prolonged stress – stress can lower the immune system which can then allow more opportunistic bacteria to make their home in our gut.
- Low fibre diet – eating a western style diet which is high in refined carbohydrates may be starving the beneficial bacteria. This can lead to imbalances and a low diversity of bacteria in the gut.
- A high fibre diet – a diet higher in fermentable fibres can be troublesome for some people and can be a real trigger. It’s not uncommon for me to hear the words ‘the healthier I eat, the worse I feel’
More fibre of less?
Often, we see a list of high fibre, gut-healthy foods and we try and fill up on them. The truth is that fibre is a very individual requirement. Following these high fibre guidelines can make things worse and when there’s bloating it only adds more fuel to the fire.
In most cases, there’s a 4-pronged approach to resolving bloating to get your digestion back on track.
- Rebalancing the gut microbiome
- Finding right amount of fibre for you
- Encouraging regular bowel movements with non-fermentable fibres
- Managing stress levels