A beginner's guide to bloating

In this guest blog post, Dr Megan Rossi, an award-winning gut health scientist, dietitian and founder of The Gut Health Doctor explores the fundamentals of bloating and how to cut through the many myths and misconceptions to effectively manage.

Does bloating regularly impact you? If so, you're not alone: this gut bugbear is extremely common. That doesn't mean that it's not distressing though - especially when it impacts how you feel and you have no idea what the root cause is. And, to make matters worse, there is a lot of misinformation on the internet about how to deal with bloating. Take it up and you may find this not only makes your bloating worse in the long run but also keeps you from discovering the science-backed solutions that could help you master your bloating once and for all.

The truth is, when it comes to bloating, there is no silver bullet. It would be great to find the one supplement/tea/food to eliminate, which also functions as a cure-all. However, the reality is that the causes of bloating are often complex. But the good news is that there are a series of simple diet and lifestyle changes backed by science that can put an end to the suffering.

If you want to be smart about dealing with the problem, here are 7 things you should know.

What actually is bloating?

In simple terms, bloating is a feeling of increased pressure in your intestine, sometimes accompanied by a visible protrusion (what you might call a 'food baby'). It can happen a) as a result of built-up pressure from the sheer volume of food or fluid you've eaten; and b) thanks to gas produced by those trillions of bacteria in your gut (aka your gut microbiota, or GM as I call it) when you eat large amounts of certain types of high fibre foods. This might include legumes (such as chickpeas), veggies (such as cauliflower) and fruit (such as cherries).

This increase in gut content essentially stretches the intestine, giving you the sensation of bloating. Now, a little bloating after a high-fibre meal is actually a good thing - it's a sign of a well-fed GM doing its job. It's also worth understanding that everyone's gut is different. You can have the same food and drink intake as someone else at the table but have a different physiological reaction. This is something our research team at King's College London has been investigating. It also explains why everyone has their own unique set of bloating triggers, which I address below.

And when should I be worried about it?

Deciding on if you should look into your bloating, and seeing how you might reduce it, comes down to how much bloating is impacting you physically and emotionally. Is it getting in the way of your quality of life? If the answer is yes (or you have any of the 'red flags' below), then it's certainly worth a visit to your GP or physician to rule out more troublesome causes like coeliac disease. Once you have the all-clear, the empowering news is that the science has progressed a lot in the last few years, and we now know that the vast majority of bloating can be mastered with diet and lifestyle strategies. Gone are the days of suffering in silence.

Know your triggers

From my gut health research at King's College London and 14 years working as a clinician, I've found that most people's bloating is triggered by a combination of 22 food and lifestyle factors. Now, outside of those who have specific food intolerances to things like lactose (aka milk sugar), I find it's rarely the case that specific foods alone cause bloating. The truth is, it's more likely you're sensitive to a blend of foods. But the good news is that you can train your gut to enjoy many of them.

Within the 22 triggers, there are also ones that can actually increase your propensity to bloat when you eat other foods. Take salt for example. New research has identified that a higher intake of salt can change your gut microbiome. Over time, the accumulative effect of a high salt diet is also thought to change how your body metabolises different types of food. This means that a higher salt diet (even for a month) may be increasing your gut's vulnerability to bloating - while also making it harder for you to identify it as a contributing factor to your bloating.

It's these types of complexities that I saw trip up people time and time again in the clinic, and what drove me to develop my results driven Bloating Masterclass (but more on that below).

Restrictive eating is not a solid long-term strategy

You may have been led to believe that foods like lentils, or components like gluten, are the biggest culprits for burdensome bloating and that you should restrict them where possible. But, not only can cutting out wholesome foods impact your gut health (and therefore propensity to bloat), it can actually make you more sensitive to foods. In fact, this is why many people find extended fasts tend to make their gut more sensitive the next time they eat.

Prebiotics might do more harm than good

Not only are prebiotics not proven to help bloating, but they can be a bloating trigger. Why? Well, prebiotics are like fertiliser for your 'good' gut bacteria. But this means that, in your intestine, they tend to ferment very quickly, creating pockets of gas. While for some this is fine, if you have a sensitive gut and can't effectively move the gas along your gut lining, it gets trapped in your gut and triggers bloating.

Where your bloating is located tells you a lot

Did you know that the location and type of bloating you experience offers important insights into your triggers? If you mostly experience bloating in your mid-abdomen, for example, then it's likely connected to what, rather than how you eat. It means that the most effective strategies to manage bloating in the middle of your stomach tend to be different to those for upper-abdominal bloating.

Okay, so how do I manage my bloating?

Again, if your bloating sporadically arises after you've eaten a high-fibre meal then it's nothing to be concerned about. If it's bothering you, though, then start a food and symptom diary to help you identify your triggers. But if you suspect certain nourishing foods, make sure you don't cut them out for any longer than a few weeks.

What are the red flags to be aware of?

  • Unintended weight loss (more than 5% of your body weight in six months)
  • Blood in your poop
  • Low blood iron levels
  • Fever
  • Family history of cervical or colon cancer, inflammatory bowel disease (IBD) or coeliac disease
  • New onset of symptoms after 50 years of age

If you need support to get on top of your bloating, my Bloating Masterclass commences on the 19th February 2024 which helps you train your gut, like you would your muscles at the gym. Or if you feel you need more personalised support, speak to your GP or physician and my team of gut-specialist dietitians at The Gut Health Clinic are there to help too.

Are you looking to make your gut health a priority in 2024? If so, follow @theguthealthdoctor on Instagram or Facebook for lots of free gut-loving education and recipes

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