Understand why you’re bloated and the first 5 steps you must take to alleviate it
Why you’re bloated and what steps you must take to alleviate it
April is IBS Awareness Month (Irritable Bowel Syndrome). It is also Stress Awareness Month and the two go hand in hand since stress exacerbates IBS and having IBS is very stressful.
It’s estimated that 1 in 5 of the UK population suffers from IBS, but you would not realise how many people are affected as there is embarrassment around the disorder.
One of the common symptoms of IBS is bloating. Bloating is a sign that something is most definitely wrong in the gastrointestinal tract. It’s a common symptom of IBS alongside other digestive symptoms like constipation, diarrhoea, wind and cramping.
Some of my clients describe looking 7 months pregnant by the end of the day- and this includes the men! Some days may be OK (but there is always a degree of bloating) yet other days there can be huge discomfort and clothes don’t fit. This is immensely frustrating to the sufferer.
Do you know where your bloating is?
Your digestive system is complex and very long – about 9 metres (30 feet) from top to bottom! It’s in several distinct sections, so before you can even think about solutions, you need to get to know your body better.
Check in with where you’re feeling the bloating in your body (it may or may not be visible) to start to identify where the problem is.
Is it felt in the Stomach Area?
The stomach is high up under your rib cage on the left-hand side. It extends across to the middle and down towards your naval. Bloating under the rib cage, in the sternum area and above the naval is most likely to be in the stomach.
Food arrives here very quickly after swallowing and stays here for up to 3 hours. The more dense the protein food (like red meat), the longer it stays here to be digested.
This is a major site of protein digestion, requiring an extremely acidic environment. If there is less gastric (stomach) secretion needed to digest your food, the stomach can feel bloated and heavy. Food may sit here for longer than ideal, food may start to ferment creating gas leading to more bloating.
Is it felt – or seen – in the Small Intestines?
This area is a very long coiled tube of about 7M in length that extends from slightly above the naval area to the bottom right-hand area of your pelvis. It fills the entire abdomen area across the front of the body. Let’s call this whole area the mid to lower abdomen.
This is a major area for digestion of all food and absorption of nutrients. Digestive enzymes and bile are secreted into the small intestines to break down the food ready to be absorbed as simple nutrients to be used by the body.
We now understand that one of the major causes of IBS – and bloating – is an overgrowth of bacteria in this area. SIBO stands for Small Intestinal Bacterial Overgrowth. Bacteria should not live in large quantities in this area. As it is a major site of digestion, before food can be fully digested, the bacteria are able to feed off the partially digested food. This creates gas and the associated bloating (often accompanied by pain or discomfort).
Is bloating felt in the Large Intestine (Colon)
The colon starts in the lower right-hand corner of your pelvis by your hip bone. It sweeps directly up the right-hand side; then extends horizontally across the abdomen above the naval in most people; then it extends directly down the left-hand side of the body to the pelvis region (hip bone) finishing in the centre in the pubic bone area. You can think about this as the shape of an arch.
If bloating occurs in these areas, it is most likely to be the large intestines. This is the major site of the microbiome. The trillions of bacteria, both beneficial and pathogenic, that live in us.
Bloating here can be linked to poor digestion coupled with an imbalance in the microbiome population. Undigested food can feed pathogenic bacteria, creating gas and bloating. It may also be due to very sluggish bowel movements causing constipation and residual waste coating the colon walls.
The first steps you should follow to help alleviate your bloating
1. Are you consciously eating your meals?
We take digestion for granted. We don’t know what or how digestion happens but we eat food, it keeps us alive and we excrete the waste matter. But this complex process can only work effectively if we give it all the help it needs.
Digestion starts before you eat a single piece of food. The sight, smell and chewing of food triggers messages via the brain to communicate with the stomach to release gastric acid. This creates the highly acidic environment in the stomach required to digest protein foods. This all happens in a split second before food arrives. If this action is hindered by not paying attention to eating your food, less gastric acid may be available.
Pause before you start eating, don’t rush, enjoy the smells and take small mouthfuls, chewing well before you swallow. Avoid distractions like your phone, TV or laptop and consciously focus on your meal.
2. Are you feeling uptight and stressed when trying to eat?
It’s no coincidence that the opposite of the stress response is known as “rest and digest”. This parasympathetic arm of our nervous system should be activated when we’re eating. It is only in this state that we can properly digest food, as the body is able to proactively secrete digestive secretions.
I understand that it is impossible to avoid all the stress in our lives just when we want to eat, but we can choose to try and activate the parasympathetic nervous system. One of the best ways to do this before eating is to focus on deep breathing. I wrote about this in last week’s blog on naturopathic approaches to calm the stress response.
Slow deep abdominal breathing that enables the abdomen to rise and fall as we breathe will calm the mind and help to switch off the stress response.
3. Are you a snacker?
We have become a nation of snackers – food is available to buy wherever we go. But the body is not designed to be constantly digesting food.
Between meals there is a distinct sweeping action that cleanses the walls of the small intestines of debris, food and bacteria. This is called the Migrating Motor Complex (MMC). This prevents bacteria accumulating in this area that can lead to SIBO. This action only happens 90 minutes after a meal has been finished.
Allow at least 4-5 hours between meals and at least a 12-hour fast over-night. This enables this sweeping action to occur at least once between meals and several times overnight.
4. Are you consuming the right fluids at the right time?
It is important to be well hydrated – typically 2L of fluid a day. Most of these fluids should be hydrating from water, herbal and fruit teas or well diluted cordials. Hydration helps keep stools soft (since a dehydrated will draw water from the colon for the body, drying out the stools).
Fizzy drinks can cause bloating. Tea and coffee can interfere with digestive secretions.
Too much fluid at mealtimes (more than a 250ml glass of water) may dilute digestive secretions and this will interfere with digestion. Remember, the stomach needs to be really acidic.
Aim for 2L fluid a day, mostly from hydrating sources. Limit tea and coffee to a maximum of 4 cups a day, and avoid fizzy drinks. Other than one glass of water, avoid fluids an hour either side of your meals.
5. Have you identified your food triggers?
As human adults, we lack the secretions to digest dairy. And modern wheat with its protein gluten can be hugely problematic. These should be the first two food types to be eliminated entirely for a month to monitor symptom changes. It is important to check every food brought as wheat, gluten and dairy can be hidden where you least expect them to be.
If bloating improves, then very slowly – every 4 days, eat a small portion of a food (a cracker, piece of pasta, small piece of cheese) and monitor reactions.
It is very time-consuming and if you don’t get relief, it could be other foods like eggs, lentils, nightshade (tomatoes, potatoes), histamine rich foods (mushrooms, fish).
If you have been suffering with bloating for some time and are struggling to get relief, then working with a gut health expert can help you navigate your way through this complex disorder; look at the symptoms objectively and help you on your journey to recovery using specialist testing and digestive support protocols and supplements.
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