Bloating.

Dr Joan Ransley

Most people know how it feels to be bloated. There is pressure in your abdomen, and you feel full. Your waistband starts to pinch and a sideways glimpse in the mirror shows a swollen belly. Loosening clothes doesn’t help much.

Feeling bloated is uncomfortable. So, what causes bloating? How can it be managed? And can bloating be a symptom of a serious illness?

What are the main causes of bloating? 

There are four main causes of bloating. Swallowed air, constipation, a depleted microbiome and finally the food we choose to eat.

Swallowed air

Air that is swallowed through the mouth can wiggle its way through the gut and cause unpleasant symptoms of bloating. Many people gulp air through their mouth without even realising it. Often a person who swallows a lot of air will also belch a lot.

Common causes of swallowed air are drinking carbonated drinks, sipping through straws, chewing gum, and sucking on hard sweets. 

Some people swallow air when they eat too quickly. They tend to be aggressive eaters, who eat fast, drink fast and gulp as they eat and drink.

Constipation

If food moves too slowly through the gut, it can cause constipation. This can lead to a build-up of intestinal gas as the food is fermented by microorganisms in the lower gut. Bloating, gas and abdominal discomfort are the main symptoms of constipation. 

If constipation is a problem, it is important to get into a rhythm with eating a diet rich in fruit, vegetables, wholegrains, and pulses. Drinking enough fluid is also important as this can soften food as it moves through the gut. When eating, drinking, sleeping, and getting regular exercise are accomplished constipation, gas and bloating often goes away. 

The gut microbiome

We have trillions of micro-organisms living in our gut. They play a vital role in digesting food, regulating our immune systems, and tweaking our brain chemistry through the chemicals they produce. The more varied our diet is the more varied and healthier the microbiome is.  

If the microbiome is depleted by eating a restricted, poor quality diet, food will not be processed properly by the bugs in your gut. This is when you can experience side effects like excess gas and bloating.  

The food you eat

One of the main causes of bloating is eating food that you have an intolerance to. For many people, this may be milk, up to 70% of the global population is intolerant to lactose. Symptoms of lactose intolerance can cause gastrointestinal upset including bloating. 

How to deal with bloating

• Look out for trigger foods, certain plant foods, such as broccoli, lentils, and oats, contain fibre and types of fermentable carbohydrates that are difficult for some people to digest. These otherwise healthy, nutritious foods should not be excluded from the diet completely but limited to the amount you can tolerate. 
• Keeping a food diary could help you to identify whether any foods cause bloating.
• Do not rush eating or drinking as it can lead to swallowing air.
• Eat a diet which contains a diverse range of plant based foods.
• Gentle exercise has been shown to help move trapped gas from your gut. A short 10–15-minute walk after a meal can be enough to relieve symptoms. Yoga has also been shown to help digestion in the long term.

Can bloating be a symptom of something serious?

In most cases, bloating is not a sign of a serious underlying illness. Medical conditions that can increase your likelihood of bloating include irritable bowel syndrome (IBS) and ovarian cancer. So, if you notice you feel bloated more often than usual, or if your bowel habits suddenly change, it’s important to see your doctor.