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Gut Feelings: Understanding Abdominal Bloating and Finding Relief

7/19/2023

 
Authored by Dr. Barrett
PictureFrom Marta Wave on Pexels


Abdominal bloating and distention are two of the most commonly reported gastrointestinal concerns. Bloating is a feeling of tightness, pressure or fullness in your abdomen. You may even notice a visibly distended abdomen and clothing can feel tight. While it is not usually a serious medical concern, chronic or severe bloating can significantly impact one's quality of life. In this article, we will explore the various causes of abdominal bloating.






Causes of bloating:


Gas Production:
  • Gas production occurs naturally as a part of digestion. Bacteria live in our intestines and fermented leftover carbohydrates. If there is too much fermentation happening excessive gas can be produced. This gas is eventually passed as flatulence. 
  • SIBO (small intestine bacterial overgrowth) is just what it sounds like, an overgrowth of bacterial in the small intestines. This causes excessive bloating and discomfort with most meals. This gas can become trapped for long periods of time before being passed. 
Swallowing Air:
  • Swallowing air unintentionally is a common cause of abdominal bloating. This can happen when talking while eating, chewing gum, drinking through a straw, or consuming carbonated beverages. Individuals who are anxious or nervous may also swallow air more frequently, exacerbating bloating symptoms.
Stress:
  • Stress can impact the movement and contractions of your gastrointestinal tract. It can either speed up or slow down the movement of food through your intestines, leading to changes in bowel habits and potential bloating.
  • Stress can lead to the redirection of blood flow away from the digestive system to support other parts of the body preparing for the sympathetic or "fight or flight" response. This reduced blood flow can hinder the optimal functioning of the GI tract and cause bloating.
Food Sensitivities/Intolerances:
  • Food intolerances and sensitivities occur when the body has difficulty digesting certain substances, such as lactose, fructose, or gluten. In these cases, the undigested components can ferment in the intestines, leading to gas production and bloating. Common culprits include dairy products, wheat-based products, beans, and certain fruits.
Menstruation:
  • Bloating and water retention can occur during the menstrual cycles due to hormonal fluctuations. This monthly occurrence can lead to abdominal discomfort and swelling.
Bowel Obstruction or Serious Conditions:
  • In rare cases, abdominal bloating can be a symptom of more serious conditions, such as bowel obstruction, ovarian cysts, uterine fibroids, or even certain cancers. If bloating is accompanied by severe pain, sudden weight loss, or persistent changes in bowel habits, medical attention should be sought immediately.

Therapeutic options:

Dietary Modifications:
  • Identify and avoid trigger foods that can cause bloating, such as carbonated drinks and certain artificial sweeteners.
  • Avoid food intolerances. These are often identified by using an elimination diet. 
  • Consider trying a low-FODMAP diet, which restricts fermentable carbohydrates that may cause gas and bloating in some individuals. Note: this diet is for temporary relief and should not be followed longer than 6 weeks. 
Chew Slowly and Avoid Swallowing Air:
  • Eat meals at a slower pace to reduce the amount of air swallowed during eating.
  • Avoid using straws and chewing gum, as they can lead to swallowing excess air.
Microbiome Support:
  • Consuming probiotic-rich foods or taking probiotic supplements can promote a healthy balance of gut bacteria and improve digestion, potentially reducing bloating.
  • Eating prebiotic fibers can help support a healthy microbiome. Foods high in prebiotic fibers include garlic, onions, bananas, apples, and oats. 
Deep Belly Breathing:
  • Deep breathing activates the parasympathetic nervous system, which is responsible for promoting a "rest and digest" response in the body. This helps relax the muscles in the gastrointestinal tract, facilitating better digestion and reducing bloating.
  • Deep breathing can aid in the release of trapped gas from the digestive system. When you take slow, deep breaths, you stimulate movement in the intestines, which may help relieve gas and bloating.
Herbal teas:
  • Certain herbal teas such as peppermint, ginger, fennel and chamomile can aid in digestion and help to reduce bloating. 
Apple Cider Vinegar (ACV) and Bitter Herbs:
  • ACV contains acetic acid, which is thought to stimulate the production of digestive enzymes, potentially aiding in the breakdown of food and improving digestion.
  • Bitter herbs such as dandelion, gentian, chamomile, and artichoke can help stimulate the production of digestive enzymes and the release of bile to improve digestion. These herbs may also have carminative properties, meaning they help reduce gas and gloating in the digestive system. 
    • These herbs can be consumed as a tea or tincture or incorporated into dishes.
Regular physical activity:
  •  Regular exercise can help improve bowel motility and prevent constipation, both of which can reduce bloating.
Manage Stress:
  • Stress and anxiety can worsen bloating symptoms. Practicing relaxation techniques, such as deep breathing, meditation, yoga, or mindfulness, can help reduce stress and its effects on digestion.

Resources:
  • Lacy BE, Cangemi D, Vazquez-Roque M. Management of Chronic Abdominal Distension and Bloating. Clin Gastroenterol Hepatol. 2021 Feb;19(2):219-231.e1. doi: 10.1016/j.cgh.2020.03.056. Epub 2020 Apr 1. PMID: 32246999.

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