Abdominal bloating and gas can keep people from attending or feeling comfortable at social events and work as well as significantly decrease quality of life by reducing daily activity. Bloating is a very common issue, in fact, most patients who come to see me in the clinic with gastrointestinal complaints report some degree of bloating. It’s been reported that, for those with IBS, bloating is the second most common symptom following abdominal pain. In one study looking at 572 IBS patients, 76% reported abdominal bloating as a regular complaint.
According to a survey, 43% of those suffering from bloating reported taking medication to help relieve symptoms. This statistic reveals the severity of bloating and the need for more natural medicines solutions. Fortunately, natural medicine offers many simple and cost-effective treatment options, and if underlying causes can be found and addressed bloating is usually gone with the wind (pun intended).
What Causes Abdominal Bloating?
Although the physiology behind bloating is poorly understood, it’s generally believed to be caused by increased gas production in the GI tract. Bloating is truly a subjective measure meaning you don’t have to have a distended belly to be classified as having bloating. Below are some common causes of abdominal bloating that I look into when working with patients:
- Food intolerances/sensitivities: classic ones being lactose or gluten intolerance.
- Swallowing too much air (aerophagia): aerophagia can be caused by eating too quickly, drinking with straws, chewing gum, smoking, carbonated beverages, and even anxiety.
- Ineffective digestion of food and malabsorption of macronutrients such as carbohydrates: this can be caused by many factors such as pancreatic insufficiency, hypochlorhydria (low stomach acid), bacterial fermentation of carbohydrates (think about SIBO), or celiac disease.
- Delayed emptying of the stomach due to dyspepsia or gastroparesis
- Constipation (acute or chronic) leading to a buildup of waste and gas
- Intestinal infections such as giardia: usually GI infections are accompanied by diarrhea and abdominal pain, but not always.
- Visceral hypersensitivity, or in other words a heightened perception of sensations arising from the GI tract: this is common in IBS sufferers.
- Anatomical or structural abnormalities causing obstruction such as a previous surgery with scar tissue formation
- Chronic diseases like congestive heart failure, kidney failure, and liver failure where fluid builds up in different parts of the body
- Before or during menstruation leading to a fluctuation in hormones with bloating being a common symptom
Natural Bloating Relief: Long Term (Chronic)
These recommendations may take some time (days to weeks) to take effect, but they are preventative and more effective in the long run.
1. Removing common food intolerances like dairy, gluten, and sometimes eggs
Clinically, this is the number one treatment that yields the best results in my opinion. Many people are lactose and/or gluten intolerant and giving up all dairy and/or gluten containing foods can make a big difference in a relatively short amount of time (usually within a week).
2. Removing certain foods that are typically high in fiber, and/or high FODMAPs that cause bloating in many people
High fiber containing foods and/or high FODMAPs can be difficult to break down, and fermentation by bacteria can result in increased gas formation.
- Broccoli
- Cauliflower
- Cabbage
- Brussels sprouts
- Kale
- Beans
- Lentils
- Garlic
- Onion
- Sugar alcohols
- Apples
- Whole grains
3. Treating underlying infections (e.g. giardia, blastocystis hominis, etc.) and/or dysbiosis (SIBO, SIFO, yeast overgrowth)
In my practice, I treat a lot of dysbiosis which is an imbalance (usually an overgrowth) of pathogenic bacteria, protozoa, and yeast in the intestines. This can be achieved with herbal medicines or antibiotics/antifungals. Combine this with dietary changes and you can reduce bloating significantly. See my previous articles on SIBO and candida overgrowth for more information.
4. Taking probiotics to build a healthy microbiome
This large community of organisms in the gut can assist in the breakdown of foods particularly carbohydrates. There are many probiotic strains that may help with abdominal bloating and gas. Aim for a formula that contains at least 5 billion units and take daily or multiple times a day if bloating is a chronic issue. In addition to taking probiotics, I also suggest eating fermented foods, which will provide a natural supply of lactobacillus and other bacterial species.
5. For women experiencing bloating before and/or during their period, it’s important to balance hormones through use of dietary changes, herbal medicines, and lifestyle interventions
It is thought that fluctuating progesterone and estrogen levels before a period can lead to increased water retention. During this time, you’ll want to drink lots of water, exercise, reduce salt intake, eat more potassium rich foods, and reduce sugar intake. If there is a chronic underlying imbalance in your hormones where you suffer from other PMS like symptoms, you’ll want to work with your doctor to balance out the hormones.
Quick Abdominal Bloating Treatment (Acute)
These recommendations are for folks who are looking for immediate relief (minutes to hours) when bloating issues occur.
1. Prokinetic agents like Iberogast or Motilipro or ginger
These herbal formulas (Iberogast/Motilipro) help promote motility in the GI tract, and ginger has been shown to help calm down gas production.
2. “Bitter” herbs like gentian, dandelion root, burdock root, bitter orange, etc.
The best way to take these herbs is to buy a bitter herb formula in tincture from your local health food store or Whole Foods and add 1-2 dropperfuls (or more if you can tolerate the taste) to a cup of hot water. Slowly sip over a period of 10 minutes.
3. Carminative herbs like anise, chamomile, peppermint, caraway, fennel, etc.
These herbs are often found in bitter formulas (see above bullet point) or can be made into teas. For example, you can buy tea bags from most local markets like Gaia Gas and Bloating that contain most of these herbs. Just add boiling water, steep for 10 minutes, and drink slowly. If all you have is chamomile or mint tea in your cupboard at home, these will suffice as well.
4. Activated charcoal
Charcoal is used in Emergency Rooms for certain poisonings as it can help bind toxins to be removed from the GI tract. It is also thought to help with bloating by reducing gas formation. If all you have in your home is some activated charcoal, try taking 2-4 capsules (500-1000 mg).
5. Apple cider vinegar and lemon
You can add 1 tbsp apple cider vinegar and ½ squeezed lemon to a glass of cold or warm water. Apple cider vinegar helps to stimulate digestion, and lemon juice is alkaline forming in the body.
If you are suspicious that you have dysbiosis or an intestinal infection or some other underlying chronic health issue, please see your physician for further examination. I should mention that most causes of abdominal bloating and gas are benign. However, if you have been experiencing other systemic symptoms like weight loss, fever, malabsorption, or diarrhea, please see your physician as an organic cause like cancer may need to be ruled out.
Resources:
http://www.jnmjournal.org/journal/view.html?uid=327&vmd=Full
http://www.med.unc.edu/imsd/ibs/files/educational-gi-handouts/Abdominal%20Bloating.pdf
