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Bloating can be uncomfortable, frustrating, and hard to shift. It affects many of us to varying degrees – and often can be tricky to find out the root cause.
Often, people use the word bloating but mean different things. “To some, it’s a feeling or a sensation and to others, it’s a physical change in their shape,” says Peter Whorwell, a professor of medicine and gastroenterology at the University of Manchester who sees people who are struggling with bloating long-term.
So why is bloating hard to understand and treat? Well, it’s a multifactorial problem, says Peter. That means that a lot of different things, alone or in combination, may lead to bloating. Take this example: someone who is not stressed could eat, for instance, a tomato and feel fine, but if they’re stressed and eat a tomato, it could lead them to bloat.
[Read more: A Beginner's Guide to Bloating]
It’s also helpful to know that people bloat for different reasons. Without going too science-y on you, some people who bloat will physically change shape and see their stomach expand. “This cause is likely to be related to the diaphragm,” says Peter. “We all have an accommodation reflex, involving the diaphragm, that allows us to accommodate a certain volume of food when we have a meal. In some people, this reflex is reversed, so their diaphragm goes down instead of up and the front of their tummy relaxes instead, causing a bloating appearance.”
For others, they may bloat but not change shape – this is to do with the sensory system in the abdomen giving a feeling of “fullness” or “pressure” because their gut is oversensitive. “There will be signals going from the gut to your head saying, ‘I’m being stretched’,” says Peter.
And for some people, this “bloated” feeling may simply be because you’ve eaten a lot of food and have overloaded your gut lining. And that’s a normal reaction. In fact, in many people who suffer from bloating the problem is relatively mild and often comes and goes, says Peter.
However you experience bloating, what are the best and most common ways to manage it?
An average bloater – especially for women – is flat in the morning, and will gradually expand during the course of the day. So if your bloating goes up and down, it’s nothing to worry about.
“If your bloating is constant and doesn’t vary, it would be worth seeking professional help, to get it checked out” says Peter. “I always warn patients with bloating, that this is a very challenging condition to treat and it’s often a process of trial and error.”
An initial question Peter will ask patients he speaks to about bloating is if they’re constipated. “The more constipated someone is the more bloated they can become he says.
In fact, constipation is one of the more common causes of bloating, so if you treat that and relieve it, in some cases it can reduce bloating.
Avoiding dehydation, as well as eating fruit, vegetables and can help you avoid constipation.
Now this is a tricky one, says Peter, as you don’t want to completely eliminate a whole lot of foods.
However, some foods can produce gas when you eat them, so considering gas-producing foods is a good place to start. “Too much gas from foods will make your bloating worse,” says Peter.
This could be avoiding carbonated drinks, and avoiding foods that ferment more than others, such as green vegetables and brassicas. Reconsider broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, and kale. It might also be useful to eat less high fibre cereals and see if it makes a difference. These foods tend to be digested slowly and fermented by bacteria to produce gas as they pass through the gut.
“I’d suggest only trying it for a week or two, as you’re likely to get a signal about whether it is working almost straight away,” says Peter.
Stress will make bloating worse. That’s something Peter has seen with many of his patients. “A patient I saw recently said, ‘As soon as I get stressed, my tummy gets bigger in front of my eyes,” he tells us.
Relaxation techniques such as mindfulness and meditation could be very helpful here. Have you tried breathwork before?
“Any form of peppermint can often help to reduce bloating,” says Peter. “In your gut, you’ve got muscles that contract and move the contents through. That muscle can go into spasm, so you’re aiming to relax that smooth muscle, which peppermint can help with.”
There is no one-size-fits-all solution to bloating, but learning more about the causes and possible ways to manage it may help you with your own health.
If you want to read more about bloating and why it happens, read Dr Megan Rossi's beginner's guide to bloating.
This article was written by The Body Coach content team.