Six ways to overcome bloating
In light of World Digestive Health Day on the 29th May, Consultant Dietitian, Ms Carin Hume, explores common reasons for bloating and gives her top tips in trying to overcome it.
Many people will experience a bloated feeling at some point in their life, but for some, it’s an uncomfortable, often painful reoccurrence. Research has shown that people who suffer from Irritable Bowel Syndrome (IBS) who experience bloating can distend by up to 20cm. While others don’t physically distend, they likely have a feeling of pressure building up in their stomach. Most people find that bloating is worse after eating and gets progressively worse as the day goes on.
It is important to note that if you’re bloating does not worsen throughout the day, or there is no variation in your bloating, you should see your doctor as it could indicate something more serious.
There are a few things you can try to help reduce your symptoms. Here are my top tips:
While certain foods can trigger bloating, it can be helpful to take a more holistic approach to managing symptoms, rather than just reducing or removing the offending food from your diet. Many of us tend to eat at least one meal on the go, increasing the likelihood of eating too fast. As a result the food we’ve eaten may not be well digested which can then cause bloating. It may not seem important, but taking time to eat and chew your food thoroughly can make a positive difference. Try to chew your food at least 20 times if possible, although what you’re eating will determine how easy that is. Some studies have shown that practicing mindfulness whilst eating can improve IBS symptoms, including bloating.
The low FODMAP diet is becoming increasingly popular for those suffering with bloating and IBS. It’s an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Essentially these are types of carbohydrates which do not digest well; they make their way down to the large intestine where they feed on bacteria. Without the right balance of bacteria in the large intestine the fermentation of these fibres causes symptoms such as bloating and diarrhoea. Examples of high FODMAP foods include garlic, avocados, broccoli and leeks, to name just a few.
However, these high FODMAP foods are very healthy, so you’re generally encouraged to eat them. The FODMAP diet is therefore a short term plan to temporarily remove such foods, with the long term goal of reintroducing them back in. For example, for breakfast you could try oats such as porridge instead of wheat cereal. For lunch, instead of a sandwich, you could try a quinoa salad or a baked potato. Then for dinner, incorporating foods like fish or meat, rice and spinach could help too. It is a good idea to work with an expert, such as a dietitian trained in this approach, should you want to try the diet.
Relatively few bacteria live in the small intestine, when compared to the large intestine or colon. A common condition I see in patients is that they have too much bacteria in the wrong place. Small Intestinal Bacterial Overgrowth (SIBO) is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel. This can sometimes damage the lining and functionality of your gut, affecting the digestion and absorption of nutrients. While there are various causes of SIBO it’s not uncommon to develop SIBO after a bout of food poisoning. Many of my patients link their IBS to being ill on holiday or as a result of a stomach bug.
If you have bloating as well as loose, frequent bowel motions, a slightly lower fibre diet may actually make a real difference to your symptoms. Some people find their symptoms get worse after adopting a vegetarian or raw foods vegan diet, where they are consuming lots of raw vegetables, smoothies and pulses. To be clear, we are encouraged to increase our fibre intake and eat ‘5 a day’ for good reason, but this illustrates the important point that there is no one diet that ‘fits all’. It’s still important to focus on having a variety of plant foods, but go easy on raw foods, whole grains, bran cereals and pulses.
Probiotics are present in food and supplement form, and contain live microorganisms which can prove beneficial when consumed. Foods rich in probiotics include kefir, yoghurt and fermented vegetables. Probiotics in supplement form are actually a highly specialised field, making it difficult for the general public to know which product to purchase. As with diets, there is not one probiotic that suits everyone. Ideally you want to take a product, or at least start with a product, that contains a strain or strains of bacteria which have been tested in a clinical trial. Therefore it’s best to get advice from a healthcare professional working in this field to determine which product is best to take, based on your individual needs and symptoms.
If you are not convinced that a probiotic is making a positive difference to your symptoms, stop taking it and switch to a different probiotic supplement. I like to give a probiotic at least a month before considering switching to a different product. Probiotics can be hugely beneficial for some and have been shown to modulate the immune system. However, there are also products on the market that will do absolutely nothing other than cost you money.
Reducing sugar intake in general is also a good idea, as a high sugar diet will alter the microbial community in your gut, disrupting the balance in bacteria.
We are seeing an increasing amount of different forms of sweeteners used in foods, providing low calorie alternatives. However, these sweeteners are not always easily digestible and can sometimes contribute to bloating. For instance, “sugar alcohols” are used as an alternative in sugar free gums and low sugar chocolates. While they don’t actually contain ethanol, they are a type of FODMAP which could lead to bloating. Also agave nectar, often promoted as a lower glycaemic (GI) sweetener is in fact mostly fructose, which may trigger your symptoms if you are sensitive to fructose. A simple swap in this case would be to have maple syrup instead of agave nectar.