Bloating

Cause for concern or normal?

The number one digestive issue I hear from clients is bloating. It’s no surprise, considering it is the most common gastrointestinal complaint reported by people with functional gut disorders, as well as the general population. But do we really understand what bloating is and when it’s normal or a sign or a bigger problem? Considering it’s prevalence, there seems to be a lack of data targeting bloating in particular, with it often being researched in conjunction with other symptoms and conditions.

What is bloating?

Bloating is described as the subjective sensation of increase abdominal pressure without an increase in abdominal size, whilst distension describes the same sensation but with an increase in abdominal size. In other words, you may feel like you have a ‘food baby’. Bloating is a common symptom of Irritable Bowel Syndrome (IBS) with up to 96% of patients reporting it, and 20-30% of the general popualtion reporting issues with bloating. The difficulty in diagnosing bloating is that it is largely a subjective condition, in that every person perceives the severity differently. This creates the issue of understanding whether your bloating is part of the regular food digestion process, or is a reaction to possible food intolerances. As a dietitian, this guide will help you to understand what is conderiderd normal and what might be cause for concern.

So.. is it normal?

It's crucial to distinguish between short-term, mild bloating that results from overeating or consuming gas-producing foods and persistent, severe bloating that may signal an underlying health issue. After eating a meal it is common to experience some bloating. The stomach naturally is able to expand to make room for the increase in volume from food and drink. If you notice that your jeans are a little tighter after dinner or your stomach isnt sitting quiet as flat, it’s normal!! Futhermore, if we eat specific foods that contain a high amount of fibre or FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols), our body will produce gas during the digestion process. These foods are not able to be easily digested by the small intestine like other carbohydrates and instead are fermented. If you’ve ever had a bottle of kombucha you’ll notice lots of bubbles and gas because it too has also been fermented. Gas production is a natural part of the fermentation process. However, some people experience this more so than others, which is where trialling a low FODMAP diet might be the answer.

Causes of bloating

High fibre/high FODMAP diets

Eating or chewing quickly

Overeating

Dramatic increase in fibre intake

Not drinking enough water

Bubbly drinks

Hormonal changes (e.g. period)

Stress

Medications

When is bloating a problem?

If you experience bloating that is persistent or impacts your quality of life then it might be a sign of a more serious health condition. Conditions such as IBS, IBD, coeliac disease, food intolerances and others can all cause bloating. It is possible to relieve bloating, however it’s important to find the root cause. Since bloating can be a symptom of many different conditions, treatment often involves working closely with a dietitian in a process of trial and error to eliminate potential causes.

Let’s get to the point

Bloating IS normal and a food baby after a big meal might just be part of life. Everyone experiences it and it is completely regular for your stomach and body to change shape throughout the day. However, bloating should not be persistant, cause pain or associated with other symptoms such as diarrhoea or constipation.

References

Foley A, Burgell R, Barrett JS, Gibson PR. Management Strategies for Abdominal Bloating and Distension. Gastroenterol Hepatol (N Y). 2014 Sep;10(9):561-71. PMID: 27551250; PMCID: PMC4991532.

Nanayakkara WS, Skidmore PM, O'Brien L, Wilkinson TJ, Gearry RB. Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date. Clin Exp Gastroenterol. 2016 Jun 17;9:131-42. doi: 10.2147/CEG.S86798. PMID: 27382323; PMCID: PMC4918736.