Episode 007: Today’s episode is all about bloating. It is probably the most common symptom that clients suffer with so I think there will be a lot of people who can benefit from this information.
While bloating is normally thought about as a simple problem that relates to eating the wrong kind of food, it’s actually more complicated than this. As you’ll hear, bloating can be happening for a wide range of reasons. And depending on where it is coming from will determine what is the best course of action for dealing with it.
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Chris Sandel: Welcome to Episode 7 of Real Health Radio.
Welcome to Real Health Radio: Health advice that’s more than just about how you look. Here’s your host, Chris Sandel.
Hi, and welcome to Real Health Radio. Before we get started, I just want to mention a promotion I’m doing at the moment. From now until the 2nd of October, I’m offering people the option to have a free consult with me to create a health plan. We’ll look at what’s going on with you, what you want to achieve, and work out how to get there. To find out all the details for this, you can head over to www.seven-health.com/freeplan. That’s my normal website /freeplan. I’ll put the link in the show notes.
Today’s show is all about bloating, and if I’m to think about the most common symptom clients suffer with, bloating is probably that one. While for some it’s an every-now-and-again thing; for a lot of people that I’m seeing, it’s an everyday ordeal. What I want to do with today’s show is run through the different problems that can be causing bloating. As you’ll see, there’s lots of different reasons why this can be happening. it’s not just one thing.
As I go through it, maybe start to think about your own experience, and if you are suffering with bloating, thinking about where it could be coming from for you.
Before I dive into the causes, let’s just start with what is bloating? To be honest, it’s kind of a gray area, because lots of people use the term of bloating to describe different things. When someone has a heaviness in their stomach after a meal, they can say that they feel bloated. When someone has distension in their abdomen region, they can describe it as bloating. When someone has water retention around the abdominal region, even if it doesn’t feel like it’s coming from the digestive system but is more in the flesh above it, they describe it as bloating.
Basically anywhere in the front portion of the body, if someone has a sense of fullness or swelling or distension, they describe it as bloating. On today’s show, I’m going to take all of these ideas and deal with them under the umbrella of bloating. Even though sometimes what people refer to as bloating wouldn’t from a medical perspective be bloating, because this is so common, I’m still going to discuss it under this umbrella term.
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With that said, let’s get started. The first reason for bloating is stress. Stress really shuts down the digestive system. Stress has a primary function of keeping you alive and getting you out of harm’s way, and it does this in a number of ways. One is to bring energy to your cells so you can run or fight or do whatever you need to do to get yourself out of that situation.
The other way is to manage what your body is spending that energy on. During stress, the body really shuts down or minimizes the functions that it thinks of as long-term health, and instead focuses on short-term survival. While digesting your food is important or long-term health, it’s not so important at the time of running from a lion, so your body brings that stuff to a halt or really minimizes it.
If you look at the pioneering work of the studies done by Hans Selye, he noticed a number of things. Hans Selye was the person who coined the term “stress.” Much of his early experiments were done on rats, and when he would put rats under stress – and this could be whether he was starving them, whether he was putting them in cold rooms, whether he was putting them on the tops of rooves in the middle of summer, getting them to do lots of different exercise – they would all end up with the same triad of issues.
These were stomach ulcers or peptic ulcers, enlarged adrenal glands, and shrunken thymuses. For those who don’t know, the adrenal glands are the glands that sit on top of your kidneys and produce the majority of your stress hormones, and your thymus is like the epicenter of your immune system. It’s where your immune system goes to school and learns how it should act within the body.
When you stress an animal, like us humans, it has a negative impact on our digestive system and on our immune system. You can basically add all the other systems to that list, but these are the ones that Selye would see when he was doing the autopsy on the rats.
While he would notice the peptic ulcers or the stomach ulcers being common, stress really shuts down, or at least impairs, the whole digestive system and the whole way along the digestive tract – and when you’re not digesting your food properly, bloating is likely to occur.
Stress is such a general term. Really, stress can refer to a whole range of factors – lots of which I’m going to go through today – but just know that stress, really in all its guises, is typically having a negative impact on digestion and is often what leads to bloating.
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I now want to cover the digestive system for a little bit and some of the parts of the digestive system, just to explain how bloating can be occurring.
In a general sense, the GI system is pH driven. The pH scale ranges from 0 to 14; 7 is in the middle and is neutral. Everything that is above 7 is alkaline, and as you go higher up, it becomes more alkaline, and anything below 7 is acidic, and as you go lower down, it becomes more acidic.
The pH of different regions in the digestive system is dictated by the job that needs to be done within that region. For example, the stomach is very acidic because it needs to be digesting protein. When you then move on to the duodenum, which is the first part of the small intestine, it’s more alkaline because it needs to neutralize the acidity of the food that’s just come out of the stomach. In the next part of the small intestine, the pH has to be within a certain range so that different enzymes can work in terms of digesting food. So the pH of different regions largely than dictates how effective that region is because it has a job to do, and the pH affects that job.
But the pH also has a knock-on effect, because it impacts on the region below it as well. What I mean by that is, for example, when the food comes out of the stomach, it then hits the duodenum. It needs to be acidic enough to then activate certain hormones in the duodenum, and these hormones then activate the enzymes that are then needed for the digestion in the small intestine. If the stomach isn’t acidic enough, this then messes up the ability of the small intestine to work properly and so forth.
I always say to clients that digestion is like dominoes because if the area above is not working properly, and therefore the domino doesn’t fall as it should, it’s going to affect everything going further down from there. This often means that when someone’s getting an issue within the digestive system, it makes sense to look at the section above it to work out is that the source or the contributor, because normally it’s having an impact.
Starting with the stomach, it should be pretty acidic and have a very low pH. The stomach is acidic for three main reasons: to break down protein, to break away minerals, and to kill bacteria, viruses, fungi, etc., because it’s actually part of your immune system as well.
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If I’m thinking about bloating with the stomach, it’s typically because it’s not acidic enough. Food is, therefore, sitting in the stomach for longer, which can give people that heavy feeling. It can also be fermenting in this state, creating lots of gas and gurgling and burping and even heartburn. Despite what most people think, it’s typically because of too little stomach acid, and not too much, that’s actually creating heartburn. This sensation of the fermenting in the stomach and the food sitting there and going nowhere is often what people describe as bloating.
If we go then from the stomach to the small intestine, while the stomach is where protein is largely being broken down, the small intestine is where most digestion and absorption takes place. In the small intestine, you have the villi and microvilli, and these are little finger-like projections that increase the surface area of the small intestine to an enormous amount. The way that this works is as the food then brushes against these villi and microvilli, they release different enzymes that help to break down carbohydrates, protein, and fat.
The food gets broken down further and further and further until it’s in small enough pieces. When it’s small enough, it then makes its way through the villi and then into your bloodstream so it can then be taken around the body where it’s needed.
With bloating with the small intestine, it can be because the food that came out of the stomach wasn’t acidic enough, and this means that the hormones then aren’t turned on and the different enzymes aren’t activated, so the villi and microvilli aren’t able to do their job properly. Food is then staying in the small intestine for longer, but it isn’t being broken down as it should. Again, this can start to ferment and it can cause bloating.
The next issue is to do with the villi or the microvilli if they start to atrophy. Those finger-like projections start to shrink and fold down and they don’t work so effectively, so again, you’re not able to break down your food properly. It prevents you from being able to absorb your food properly. Again, this can then lead to bloating.
You can have an issue known as leaky gut or cell permeability. The cells that line the small intestine should be pretty tight next to one another, so there’s no real gap between them. This means that food needs to be broken down into really small pieces before it can move out of the digestive system and into the bloodstream. It really means that the only way that this food can move out is by being broken down into tiny pieces and then going through the villi and then into the bloodstream.
But what happens if the cells start to be not so tight next to one another is there begins to be gaps. You get to a situation where bigger particles of food that haven’t been broken down properly can start to make their way into the bloodstream, and it’s doing this between cells rather than through the villi. It’s not the fact that these bigger pieces of food making their way into the bloodstream is actually causing bloating, but it’s the repercussions that this situation then creates that then could cause it.
So those gaps between the cells then can be a two-way system. It’s not only that food can make its way out of the digestive system into the blood between those cells, but stuff that is in the blood can then make its way back into the digestive system. This can be things like bacteria or fungi or viruses, and this can start to cause bloating.
Or it could be the fact that these food particles that make their way into the blood, when they’re seen by the immune system, they’re not seen as food. They’re seen as a foreign invader, so the immune system can start to respond and attack this. Depending on the state of the immune system, it can lead to having a really huge response to something that’s pretty mundane. This can lead to lots of inflammation, and oftentimes this can be around the abdomen, and this can lead to bloating.
Another issue that I’ve alluded to with cell permeability is to do with the wrong kinds of bacteria or fungi making its way into the small intestine. Honestly, this can happen regardless of small intestine permeability. You can still get the wrong kind of bacteria and viruses, etc., within the digestive tract.
The small intestine should have some bacteria in it. These bacteria, when working in the right way, help with digestion and they help support health. But truthfully, the small intestine should be a pretty sterile place. The vast majority of bacteria should be in the large intestine. This isn’t to say that bacteria shouldn’t be there, but the large intestine should be the major site of your probiotics and healthy gut bacteria.
What can happen in the small intestine is you get bacteria that is straight up pathogenic. This means that it’s not serving a role. In small quantities, it’s possibly fine, but as it gets to too high amounts, it starts to really cause an issue. Or you can get bacteria in the small intestine that is actually really helpful, but it’s help when it’s in the large intestine. The large intestine is where you do a lot of fermenting with bacteria, and this is a good thing. This fermenting is how you create certain vitamins and they’re part of creating healthy digestion. So it’s not that you don’t want that fermenting; you just want it to be taking place in the large intestine, and when it’s taking place in the small intestine, it’s then starting to cause a problem.
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I know everyone talks about the benefits of probiotics and how amazing they are and how bad antibiotics are, and that people’s digestive issues are because of overuse of antibiotics. Personally, I don’t think it’s so black and white. Probiotics – and this can be whether we’re talking about food or supplement sources of probiotics – are only going to be successful if you’re creating the right environment.
What I mean by this is that the type of bacteria that you have in your small intestine or in your large intestine is a product of the environment, and this environment links in to the pH in that region, how well the region is functioning, the transit time of food moving through it, etc. The environment dictates what type of bacteria want to take up residence and live there.
The environment isn’t just about the food that you eat, but your sleep and exercise and stress levels, medication used, hormone levels, etc. Certain bacteria prefer certain environments, so this is then going to be reflected upon based on the environment you have in your body.
If someone’s having issues with bacteria and it’s because they’re super stressed, they’re having long gaps between their meals, they’re on the pill, they’re over-exercising, they have endometriosis, they’re doing a job that they hate, they can be taking as many probiotic capsules as they want, they can eat a ton of sauerkraut, they can be necking pints of Kefir – it’s going to do very little unless they address these other problems. Otherwise, these friendly bacteria come in, there’s not enough of them to change the environment because they’re up against all the other lifestyle factors that someone’s keeping up that’s creating that environment, and fairly shortly they move on or they die because it’s just not a hospitable place for them to stay in.
So probiotics can be helpful, but it has to be done in conjunction with everything else and understanding what are the real factors that are affecting that environment.
On the antibiotic front, yes, frequent use of antibiotics can cause a problem, but in the right circumstances, they can actually be really helpful. Sometimes the bacterial makeup of the gut has gotten to a stage where it’s very difficult, if not impossible, to clear up with just nutrition and lifestyle habits. In these instances, the right antibiotic can in a sense clear things out so that someone can have a clean slate, or a cleaner slate. While antibiotics are just the start and you then need to make diet and lifestyle changes, the antibiotics can be the thing that allow this to happen. While antibiotics used excessively can cause a problem, in the right circumstances they can actually help.
Let me just say, I’m not a doctor. I’m not making prescriptions for antibiotics. I have on occasions, when some tests have been done, made some suggestions to clients about types of antibiotics or drug combination therapies that are useful for what they’re dealing with, but it’s not up to me to prescribe this stuff. I’m very adamant when I’m talking to them to say that I’m not an expert in this area. This is not my expertise. This is what I’ve gleaned from reading some research, but they need to be then discussing this stuff with a doctor, and the doctor is the one who is then going to make the call.
If we now move on from the small intestine to the large intestine, a lot of the same issues I just went through with bacteria can be applied to both the large and small intestine.
One issue I find happening with bloating and the large intestine relates to swelling. This often goes hand in hand with water retention or swelling happening throughout the body. It can be swelling someone’s noticing in the abdominal region; it could be swelling that people notice with legs and ankles or hands or wrists or just general puffiness.
I want you to imagine the colon as like a tube, and when cells start to swell and take up water, they swell inwards. This makes the passage that your digested food should be passing through much, much smaller. This can lead to a slower transit time, to constipation and a backload of stuff that really needs to get out. This can therefore lead to bloating.
These are the issues that I link to the different sections of the digestive system that all link in to bloating. I now want to look at some of the other causes. Some of these will relate to other systems in the body and how they knock on to the digestive system, so we may touch on stuff I’ve already gone through, but it will give you a bigger picture and perspective of where that’s coming from – and others are to do with lifestyle factors.
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I just want to make this point now that I remember when I was at college and we were told, “You’ve always got to treat your gut. Digestion is the centerpiece of health, and without it working properly, good health is going to be impossible, so treat the gut, treat your gut, treat your gut.” While I agree with the sentiment about how important digestion is, it misses out on the fact that digestion is impacted on by all systems of the body as well as a multitude of lifestyle factors.
To me, it seems that too much of the focus is on digestion, like it’s some independent system – that if you’ve got some issues with your digestion, take some HCl for your stomach or digestive enzymes or probiotics, and these things will balance out your digestion and everything’s going to start working properly.
Or the beliefs behind the GAPS diet. For anyone who isn’t in the know, GAPS is a protocol where you strip your whole diet back to basically nothing. You’re removing all these foods that could be causing digestive upset. In reality, it means living off a diet of just broth to start with, and after a while, you can slowly introduce certain carbohydrates in very small amounts, in a very piecemeal fashion. It’s basically a very, very low carb diet consisting of lots of fats, and it’s mostly liquids. The pretense is that if you do this and remove all of these things, you allow your digestive system to heal. Often people end up doing this stuff for years in an attempt to heal themselves.
While there’s definitely been some success stories on GAPS, for me it really misses the point. It sees digestive issues as solely being due to issues with the digestive system, and not realizing that there are a whole host of other things impacting on it. Putting someone on a really low carbohydrate diet that’s very high in liquids is just going to turn on the stress response – which from my perspective is going to further impact on digestion in a negative way.
Not to mention then the endless number of people who contact me and say that all their food phobias and their eating disorder started after following GAPS and all the imposed restrictions that it recommends.
So digestion is clearly at the center of health, but understanding how it fits into everything else is the way you fix it. It’s not by myopically focusing just on digestion.
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The next area I want to look at is bloating in relation to liver function. Every drop of blood that you have makes its way through your liver every 4 minutes or something along those lines. As food makes its way out of your digestive system, it goes into your bloodstream, and this bloodstream then shuttles it straight to your liver to be inspected. This bloodstream heading towards the liver is called the portal venous system.
With the liver, it has two valves. You have one valve going from the portal venous system into the liver, and then you have one going from the liver out the other side once it’s been dealt with, which is through the hepatic veins. If the liver is not able to keep up with what’s being thrown at it, it can then start to close the valves both going in or going out, and this really slows everything down.
This can lead to things getting out of the digestive system much slower than they should. This could be innocuous stuff like food, or it could be more harmful substances that are now staying in the digestive system much longer than they should be. In both instances, this can then lead to bloating.
When the liver breaks down substances, these need to be excreted from the body, and some of the roots of doing this and getting this stuff out is by putting it into your digestion, by putting it into your urination, by pushing it out through your skin. Stuff that’s going to be going out through your digestion is detoxified and it’s then put into bile. Bile, rather than just being the breakdown substance from your liver, is also integral to digestion. It’s used to break down fats.
What can happen if your liver’s not doing its job properly is the substances that are making it into the bile haven’t been broken down as well as they should be, and this then means that that bile can be quite irritating, and it can irritate the digestive tract, and this can then lead to bloating.
You could have a situation where the bile isn’t actually irritating, but the length of transit time is causing issues. One of the ways detoxification works is you bind substances together. You have something that is harmful, and it gets bound to something that is safe, and this safe substance then helps you shuttle this substance out through the digestive system. I’m massively simplifying things here and using childlike language, “harmful” and “safe,” but it’s not far off what’s actually happening.
When these substances are then sitting in the intestines for longer. It’s been broken down by the liver; it’s then been put into your digestive system, but it’s then sitting there in the intestines for a long time because of slow transit. Certain bacteria can come out, and it can eat the safe substance that’s been bound to the harmful one. So the harmful one is now free again, and it makes its way back into the bloodstream. It then has to be dealt with again by the liver for it to be removed.
This process can sometimes go on a number of times before it’s actually excreted from the body. It’s known as intrahepatic recirculation, and it can be a really massive burden on the liver. Rather than dealing with a substance once, it’s having to deal with it two, three, four times, which is a whole use of energy and a whole time when it should be just dealing with this thing once. Over time, this can then lead to bloating because the liver is having to deal with so many of these things, and things start to fall behind.
The next system I think about with bloating is hormones. I’ve already talked about stress at the beginning, and obviously, stress hormones can impact digestion and lead to bloating, but reproductive hormones can also be an issue. It really is a misnomer to be calling hormones like estrogen and progesterone “reproductive hormones,” because they have such a wide-ranging impact on all systems within the body. But as most people know and refer to them as reproductive hormones, I’ll stick with it.
Bloating for a lot of women is linked to their cycle. Often this is happening just before their period or during their period. Estrogen typically makes cells swell and take up water, and this can lead to puffiness, to water retention. It can lead to the swelling inwards of the colon that I talked about, which really slows down transit time, which leads to constipation, which can lead to bloating.
The liver is also crucial when it comes to regulating reproductive hormones. The liver’s role is to break down these hormones, so it therefore directly impacts on when hormones are high and low throughout a woman’s cycle. When the liver is working well, then there’s not a problem. When it’s not working so well, then hormones are going to be in the wrong ranges from where they should be at certain times. This can often lead to a whole host of issues and digestive upset, bloating being one of them.
It’s why when I’m thinking about reproductive hormones and issues in this area, I think about detoxification and liver function at the same time.
Reproductive hormones can also be having an impact on the digestibility of certain foods. For example, I see lots of women who have issues digesting dairy. Poor digestion of dairy can link in to low amounts of progesterone and another hormone called pregnenolone. Initially, when a client eats dairy, they get lots of symptoms, and one of them could be bloating. But once they start to regulate their hormones and reproductive health and liver function improves, they’re then able to start tolerating dairy.
This isn’t always the case. Some still don’t do well on it after hormones improve. But it’s amazing how often it changes so that these people can now start to eat dairy again.
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This really segues nicely into the next area that can cause bloating, which is looking at the food side of things. Often, I see people eating foods that they can’t tolerate, which is causing their bloating. I know this sounds very obvious because food of some sort is typically the trigger for bloating, so let me break this down further.
I often see people eating foods that are difficult to digest for everyone. This can become a problem, or much more of an issue, when people choose to make these foods the mainstays of their diets. If you’ve been following my stuff for a while or read my book, this shouldn’t really be anything new. Foods like lightly steamed vegetables, salads, greens, nuts and seeds, these are all pretty difficult to digest for everyone. Some people can get away with eating more of them than others, but they are difficult-to-digest foods. Apart from the nuts and seeds, they’re all pretty low in calories, so you’re using a lot of energy to digest this stuff and getting very little back.
When these are the feature of someone’s diet and they’re eating them in large amounts or basing their whole diet around it, this is going to cause an issue, and bloating is normally one of those symptoms.
I’ve lost count of how many clients I’ve told to take it easy on these kinds of foods, and they’ve noticed a dramatic turnaround in their bloating. I’m not one to be dogmatic or create fears with foods, but most people just can’t eat this stuff in the quantities that they’re choosing to.
Same thing with apples and pears, which is one thing people rarely think about. So often I speak to clients and they’re getting bloating, and I have a look at their food log and they’re having an apple every mid-morning or mid-afternoon. Apples and pears are high in pectin, which is a substance that’s difficult to digest and can cause bloating. So I recommend that if people are going to be eating these, that they cook them, as this helps to break down the pectin.
For me, when I want to eat these things, I make stewed fruit or I make an apple and pear crumble. This is the way I eat them, and I don’t have any issues. It is amazing how often, when people switch having raw apples and pears from their diet, how much of a difference it makes.
These are by no means the only things that people can eat that cause a problem. Bread and grains are common. Quinoa is an issue. Beans, pulses, legumes can all cause problems. Like I mentioned earlier with dairy, often these foods are only an issue because of the state that the body’s in. It’s not that these foods are inherently bad for you, but at this stage where your health is at, you’re not able to digest them. But once things improve, this will change.
And this isn’t always; again, sometimes people change their health, but they still can’t eat certain foods. But I’m amazed at how often it changes that as health improves, people are able to tolerate a much wider selection of foods.
I’d also add to this the idea of tolerance levels. For a lot of people, it’s not the introduction of a food, but it’s the amount that they’re eating. Once they start consuming more of it or they reach some threshold, it’s then that that becomes the issue. For example, having bread a couple of times a week is fine, but having it every day or sometimes having it multiple times a day, now someone starts to get an issue with bloating.
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Issues with food can also link in to our beliefs about that food. It’s amazing how many people have reactions to bread or gluten because they’ve read how bad it is for them. It’s not just this food, but I’d say this is one of the ones that people fear the most.
There was a really great article that I read this week that looked at some research on this. There are lots of people who feel that they’re gluten sensitive even though when they do testing of them, they don’t have Celiac disease. It’s a condition known as non-Celiac gluten sensitivity, and if you read all the fearmongering around gluten, we’re told that huge chunks of the population suffer with it. I’m going to use the information directly from the article about this study, and I’ll put a link to it in the show notes.
They did a study, and they had 35 people who suffer with non-Celiac gluten sensitivity. The participants were randomized to receive either gluten-containing flour or gluten-free flour for 10 days. This was then followed by a 2 week washout period, and then they were crossed over, so they had another 10 days of gluten-containing flour or gluten-free flour. If you got the gluten products for the first 10 days, you didn’t get it for the second, and vice versa.
The results: only 12 of the individuals, so 34% of the allegedly highly gluten intolerant individuals, were able to tell when they were actually fed gluten-containing flour. This was based on increases in pain, in reflux, indigestion, diarrhea, and constipation. 17 of the participants, or 49%, swore that they had been fed gluten-containing flour when they were on the gluten-free diet. These people were then experiencing real increases in pain and reflux and indigestion and constipation, even though there was no gluten in what they ate; it was just that they believed there was.
For all the good that nutritionists do in helping people, I often think that the harm that they cause outweighs this good – all the fears that we now have created around food and about healthy eating and the knock-on effect that this stress and worry causes.
And it’s not just in the mind in terms of this stress, but in physical symptoms, like the study shows. Stress is intimately linked with inflammation, and too often, people’s experiences with eating a bad food is a self-fulfilling prophecy. Because they worry and have anxiety about it, that worry and anxiety causes stress, which means they don’t digest their food properly, which means that they then get symptoms like bloating and gas and pain, and then they’re like “See? I know I shouldn’t eat that food.”
If I continue to then look at the causes related to bloating with food, often it isn’t the food per se, but the diet in general. This can happen from a couple of different angles.
First is someone who is undereating. If someone isn’t eating enough food, the body is having to turn on the stress response to deal with this, so this can cause bloating. It’s also like the body tries to slow the transit time right down in an attempt to get every last drop of stuff out of that food. This can lead to bloating for some of the other reasons that I mentioned in this, because food is sitting in the small intestine and the large intestine for longer. It’s not uncommon for me to speak to women who are passing a stool twice a week and suffering with lots of bloating, all because they’re undereating.
Some issues from bloating are from consistently eating lots of processed food. In this case, it may not be a particular food, but the diet in general. Why this is causing bloating can link into a host of reasons. It could be due to lack of vitamins and minerals in the diet. It could be reacting to some additive or preservative or gum or filler. It could be that they’ve eaten too much food or that they’ve eaten too quickly or that they haven’t chewed properly. All of these, in terms of eating too quickly or not having chewed properly, etc., can be causes for bloating also outside of processed food. It can be happening with all foods.
Another cause can be due to lack of sleep. If someone is under-sleeping, this is a stress. I’ve mentioned numerous times that stress can affect digestion and bloating. But lack of sleep can also work in a less direct way. People who are having inappropriate amounts of sleep are more likely to crave processed foods. They’re more likely to overeat. They’re more likely to comfort eat and to eat to support their emotions. All of these can then be leading to bloating.
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Another very common one is people who don’t want to use public toilets. I’m amazed at how many women I speak to who are afraid of passing stool unless it’s at home. If they need to go at work, they’ll hold on all day. If they’re out in public, they’ll suppress the urge. This inability to go in public can be a real issue and a real cause for why someone’s getting bloating. I know a number of clients who’ve been helped greatly with their bloating just by getting over this and being okay with using a public toilet.
You also have the issue with prolonged sitting and bloating. Prolonged sitting is linked to a whole range of digestive issues as well as other health conditions, but bloating is one of them. Getting someone to spend more of their day standing while they’re working or walking while they’re working, or at the very least having much more mini-breaks where they get up for a couple of minutes and then come back to their desk throughout the day.
Medication can be causing bloating, and this can be medications that have a direct impact on the digestive system, or it could be because of how that medication impacts on the liver or on hormones or other systems that then knock on to the digestive system. If you’re suffering with bloating and you’re on medication, it might be worth checking the common side effects of that medication. This is by no means suggesting to come off medication; it’s just letting you know that this could be part of the cause.
Finally, you have certain medical conditions that can be causing bloating. This could be obvious ones – things like Celiac disease or diverticulitis or cystic fibrosis, which are all conditions that are directly affecting the tissues of the digestive system. But you can then have other issues, like hypothyroidism or polycystic ovary syndrome, where they’re causing bloating but people don’t think of them as being a digestive disease.
So if you are getting bloating as well as other symptoms, it may be worth getting checked up by a doctor to see that there isn’t a medical condition that’s actually causing the symptoms.
That’s it. I know I’ve probably missed some things, but hopefully, I’ve covered most of it. My reason for going through all this is not just to get you to understand bloating, but obviously to increase your understanding of digestion and how digestion works. But I also want you to understand that something as simple as bloating can be happening for a whole host of reasons, and it isn’t just bloating that’s happening like this, but there’s a whole range of health issues that can be happening for lots of different issues.
Too much of what I see prescribed these days is a “this for that” mentality. “If you’re getting bloating, just take this” or “If you’re getting cramps, just take this.” But it’s really never that simple, and can be coming from multiple sources. It’s more important to work out where something’s coming from to decide what the appropriate course of action should be versus just assuming that if you’re getting this one thing, this is the only solution for it.
I hope you found this podcast useful, and I’ll catch you next week when I have another guest joining me on the show.
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What would cause someone to wake up in the morning super bloated? I’ve been waking up this way for YEARS now and no doctor or naturopath can tell me why 🙁
Hi Emily,
There could be a couple of different things causing this. It could be do to food intolerances, for example issues with gluten or dairy. I’m not demonising these foods and think if people can tolerate them they should eat them, but just used them as examples. It could be something like SIBO (which I cover here http://www.seven-health.com/2015/12/018-interview-with-kelsey-marksteiner/), parasites or issues with gut flora.
Those would be the first two things I would think of.
Chris
Thanks Chris!
I probably should have mentioned that I have done almost every elimination diet out there with no change! – I have also been tested for SIBO, parasites, yeast etc. Nothing has showed up! I even went as far as doing FMT’s to rebalance my gut flora.
Is there any thing else you would think of? …
Hi Emily,
Have you done a stool test? Even if it is not coming from parasites, yeast, etc, it could give an indication of other areas of weakness (i.e. low pancreatic enzymes, poor fat digestion, etc). I’d also think about certain foods being a problem but don’t know what you’ve tried with elimination diets or what the usual eating patterns are. Seeing someone like a osteopath who can look at things from a structural perspective to see if because of alignment issues this is affecting your digestion. Doing a test to check the HCL levels in your stomach like the Heidelberg Stomach Acid Test as this could link into the bloating (although I would imagine there would also be other symptoms other than just bloating if this is the case).
Hopefully this gives you some ideas of things that you haven’t looked into yet.
Cheers,
Chris
I just found you from Summer and I love your eating and body functions philosophy and really appreciate your podcasts! Thank you!
[…] top-13 breakdown of the causes of ‘bloating’ adapted from Chris Sandel‘s Real Health Radio podcast episode 7: ‘Understanding Bloating.’ In this expert podcast Chris describes some of the possible causes of bloating in simple […]