Why Am I So Bloated and Gassy? Common Causes of Bloating I See Everyday

If you’ve recently been asking ‘why am I so bloated and gassy?’, then this blog post is for you. While lots of us (yes, I’ve been there too) suffering from excessive bloating are quick to blame food or eating triggers, the real causes of bloating and gas are often hidden and can go undiagnosed for a long time. So if your goal is to identify and treat the underlying root causes of bloating, please read on!

Here is a summary of what we are going to cover:
>  What is bloating, what is normal and what isn’t?
>  Triggers for bloating and gas that get all the blame but probably shouldn’t
>  Functional reasons for bloating ang gas such as lack of digestive enzymes, stomach acid and microbial dysbiosis
>  Underlying root causes of bloating and gas we can test for
>  Things we can do in the short-term to manage bloating and gassy symptoms

What is behind constantly feeling bloated and gassy?

That bloated and gassy feeling after meals is often considered a normal part of eating, and in fact in some parts of the Middle East and India burping after meals is considered a compliment to the chef! But bloating, belching and gas can also indicate a range of other issues as well. So how do we figure out the difference between normal and not-so-normal bloating?

Bloating is a sensation or feeling of fullness in the belly. It often comes with distention, that is a physical belly-bulge that leads to tight skirts and pants around your belly by the end of the day. Bloating happens when there is a build up of gas that isn’t passed from the body via belching or wind. It can build throughout the day, or you may even wake in the morning with a bloated belly from gas building and not being cleared from the previous day.

There are many reasons for constantly bloated and gassy, that feeling of fullness, as well as the physical distention of your belly. Some can be sinister, so a trip to your doctor can confirm whether it is a serious medical condition or not. And by those I mean Coeliac Disease; cancers like ovarian, uterine and colon plus others; liver disease; congestive heart failure; kidney disease; Crohn’s Disease or diverticulitis; or a bowel obstruction. These really need a doctor’s diagnosis.

We’re not going to cover the medical conditions in this blog. We’re going to cover firstly triggers, such as food and mealtime practices, then the functional reasons for feeling constantly bloated and gassy and finally the root causes of bloating which we can test for and heal naturally.

Triggers for bloating

Sometimes there are certain things that you do or things you eat that may trigger the uncomfortable process of bloating and distension. Bloating triggers usually happen when we have underlying root causes. This is why many people confuse triggers, with being a root cause. For example, FODMAPs aren’t a root cause. They are just a trigger for people with an underlying root cause such as small intestinal bacterial overgrowth (SIBO).

So, if you struggle with any of the following triggers, make sure to read on about the root causes so you can understand why these foods or mealtime practices are consistently a source of bloating for you.

GROUP 1: FOODS THAT CAN TRIGGER BLOATING:

FODMAPs are a collection of short-chain carbohydrates (sugars) that aren’t absorbed easily in the gut, which can trigger symptoms like bloating and gas when the body is unable to digest them correctly. We’ll discuss why a bit further on (hint, hint, SIBO), but if you have issues with high-FODMAP foods then there is a root cause for this. FODMAPs are found naturally in many foods and food additives.
> Fermentable - Gut bacteria ferment undigested carbohydrates which causes gas to form
> Oligosaccharides - Fructans and Galacto-oligosaccharides (GOS) - found in foods such as wheat, rye, onions, garlic and legumes/pulses
> Disaccharides - Lactose found in dairy products like milk, soft cheeses and yogurts
> Monosaccharides - Fructose - high fructose fruits include apples, cherries and mangoes And
> Polyols - Sorbitol & Mannitol - Found in some fruit and vegetables and used as artificial sweeteners.

Raw Foods. Some foods are just difficult to digest. While raw vegetables are typically a healthy option, they also contain a lot of insoluble fiber. This can cause bloating and gas, even diarrhea and cramping as the undigested food particles pass through your gut.  If raw foods are a problem for you, then there is likely something going on with your body’s digestive fire, or you have some bad bugs in your gut, that you need to address.

Red meat is difficult to digest when it is in large chunks, not well chewed or fatty. It sits in the stomach longer, slowing down the transit of other foods. Then gas begins to build up in your gut leading to wind and bloating. Again, this is usually linked to your body’s digestive fire, or you have some bad bugs in your gut impacting things like stomach acidity.

Wheat, barley and rye are grains that contain gluten, and are also high-FODMAP foods. Gluten is the glue-proteins in some grains that holds breads and cakes together. The problem is that gluten proteins are very difficult to digest. Those with any type of gluten sensitivity can experience stomach pains and bloating, as well as other symptoms and, if you have a leaky gut, gluten can wreak havoc on your digestive system.

Lactose in dairy products causes bloating, gas and cramping in those who can’t produce lactase enzymes to break it down. In fact 75% of the world’s population loses their ability to digest lactose as they move into adulthood. Undigested lactose is then broken down by bacteria in the gut, causing gas to form, which leads to wind and bloating, pain and sometimes diarrhea.

GROUP 2: MEALTIME PRACTICES THAT CAN TRIGGER BLOATING:

Rushing meals. Then there are the things you might do, like gobbling your food and taking in too much air with your meal. Eating too fast can also lead to overeating, as your brain doesn’t have time to catch up with your stomach to know it’s full. All of which puts more pressure on your digestive system and for those lacking the necessary digestive fire to process meals properly, bloating is almost inevitable.

Not enough chewing. In addition to the mechanical breaking down of food, chewing also slowly releases your saliva, which contains digestive enzymes that start to break down the food, making digestion easier. If your food is undigested when it enters the gut it will place more pressure on your gut bacteria to break it down, resulting in fermentation. This will lead to the formation of gases, which results in bloating and wind, as well as other digestive issues.

So now we know some of the main triggers for bloating, but what we really want to know is why is this happening and how can I stop it without removing a whole tonne of foods from my diet?!?

Functional reasons for bloating and gas

‘Why am I so bloated and gassy?’ you ask yourself. There are lots of processes happening in your system during digestion. Any disruption can have uncomfortable consequences. You may have low levels of digestive enzymes, stomach acid or bile, or low levels of good bacteria and high numbers of the bad ones in your gut. And they may not be residing where they’re meant to reside! Let’s look at these in a bit more detail.

Insufficient Gastric Juices - enzymes, stomach acid and bile

There can be any number of reasons why your digestive enzymes may be low. The main digestive enzymes, Amylase, Protease and Lipase, are produced in the pancreas and small intestine, with small amounts from salivary glands and the stomach. As we age, our production of digestive enzymes gets lower. But conditions like the autoimmune disease Sjogren's Syndrome (that attack and dry out the salivary glands, and impair production of saliva), or pancreatic disease can affect the production of digestive enzymes and therefore impair the breakdown of your food and the formation of gas from undigested food particles will happen. Functional GI conditions like SIBO and Leaky Gut can also impact brush border enzyme production in the intestine through inflammation and damaged cells.

Your stomach acid - hydrochloric acid (HCL) - needs to be at the correct acidity level to digest your food. If your pH levels are too high (alkaline) or too low (too acidic) your digestion will suffer. Low levels of stomach acid can result in undigested food particles in your stools, belching and bloating, as well as overgrowths of opportunistic bacteria and yeast, like Candida albicans. So why might your HCL be low? Your age, over-use of antacids and PPI’s, or harmful bacteria like H. Pylori, which shuts down production of HCL in the stomach.

Bile has a similar impact on digestion to enzymes and stomach acid. If the gallbladder becomes clogged with stones or bile becomes too thick, you may experience extremely uncomfortable bloating.

Imbalanced gut microbiome

Within our gut is a diverse forest of different bacteria, fungi and viruses which form our microbiome. They form the majority of our immune system, acting as a line of defence to protect us from invading microbes - the bad kind like parasites. They are also fundamental to our digestion, breakdown of food and our absorption of nutrients. There are many reasons why your forest could be not as lush as you’d like.

It has been said that sometimes taking systemically absorbable broad-spectrum antibiotics is like letting off a bomb in a veggie patch to kill a few weeds. There is no doubt that they have saved many lives but taking them too often and too readily can wipe out the good bacteria in your gut, leaving you with few good bacteria. At the same time, it is often the pre-existing, naturally resistant microorganisms, such as yeasts and C.diff (i.e. the bad ones) that take over! These guys then impact digestion and absorption - cue bloating. Other ways to wipe out your gut microbes is through lifestyle/environmental factors such as smoking, stress and eating a highly processed western-style diet.

Bacterial overgrowth in the small intestine

The majority of our gut bacteria resides in the large intestine - the colon - while a small bacterial population lives in our small intestine. However, there are some people whose bacterial population in the small intestine has grown beyond what is considered normal. This condition is called SIBO or Small Intestinal Bacterial Overgrowth. You can read more about it in my blog here, but in a nutshell SIBO develops when bacteria from the large intestine travel into the small intestine or when the resident bacteria of the small intestine grow out of balance, or you get lots of bacteria coming in with the foods you eat. It is defined not only by the number of bacteria but the type as well.

There can be a few causes - a lack of stomach acid, motility disorders where the normal wave-like movement of the gut (MMC) to flush through food and waste is impaired, antibiotics, PPI’s and opioid medications, impaired immune function and post-surgical abdominal adhesions. The most common symptoms of SIBO include burping or reflux, and bloating within an hour after meals because of the high-FODMAP foods you ate; as well as chronic diarrhea or chronic constipation or an alternating of both; foul smelling gas; and stomach gurgling and discomfort or cramping. In my own journey, it was SIBO that resulted in people thinking I was 6 months pregnant after most meals - so much so that I was even offered a seat on a subway in Barcelona by a 90-year-old lady… It was some serious bloating which I'm sure you can resonate with if you're reading this blog.

Slow or impaired motility

The MMC - Migrating Motor Complex - is a series of contractions that occur during periods of fasting, and stop when we’re eating. It occurs roughly every 90-120 minutes and is like a wave that sweeps away the bacteria, waste and undigested food particles for excretion. It has been referred to as the “intestinal housekeeper”.

Sometimes though it stops doing its duty, resulting in a build-up of bacteria and food (specifically high-FODMAP foods) for the existing bacteria to feed on in the small intestine. Resulting effects are the development of SIBO (too much bacteria) and its associated symptoms, among which is bloating and gas. Slow transit of high-FODMAP food particles can cause them to putrefy and ferment, leading to gas formation, and of course wind and bloating. You can also stop your MMC yourself inadvertently by constantly snacking and grazing throughout the day. If you don’t allow a break from food for at least 90 minutes, then your MMC never kicks in. The results are the same though.

Constipation and issues with pelvic floor

The pelvic floor is a band of muscles that support the organs above the pelvis, that is the rectum, bladder and uterus. The pelvic floor muscle should relax during a bowel motion, while the abdominal muscles contract to push out the stool. For some reason, some of us have dysfunction in our pelvic floor confusing the muscles which then contract rather than relax leading to bloating and constipation.

Mechanical obstruction and structural issues

As we’ve mentioned, more serious conditions that may cause bloating include Coeliac Disease and gluten sensitivity; cancers like ovarian, uterine and colon plus others; liver disease; congestive heart disease; kidney disease; diverticulitis and Crohn’s Disease; or a bowel obstruction. Your doctor is best placed to diagnose these conditions.

Testing for the underlying root causes of bloating and gas using Functional Labs

My mantra when it comes to identifying the root cause of IBS symptoms like bloating has always been to test, don’t guess. The reason you are so bloated and gassy could be one of many common ones I see every day. But there are a couple of tests we can use to find out the root cause of why you’re experiencing these frustrating symptoms.

GI Map / CDSA stool test

One of the first tests I like to do is a stool test. There are a whole range of markers on a comprehensive stool test that help us get a really clear idea about what is going on inside your large intestine that may be contributing to your bloating and other symptoms. But a stool test also gives us clues about other parts of the digestive system, like the stomach, small intestine and pancreas. This is why I like my clients to start with a simple one-day sample stool DNA test, that they can do at home. But most importantly, a stool test gives us information about whether you have a dysbiosis – an imbalance of good, bad and commensal bacteria in the large intestine, and/or a gut infection such as those caused by parasites, bacteria and yeast/fungus.

Lactulose and/or glucose breath test

The current gold standard test we use to detect SIBO is the lactulose and/or glucose breath test. For both, you take a baseline breath sample, drink a lactulose or glucose solution, then take further breath samples every 15-20 minutes for up to three hours. It’s very easy and can be done at home. If overgrown bacteria or archaea are present, they will ferment the lactulose or glucose and produce hydrogen or methane gas, which we can detect and measure in your breath to work out whether you have SIBO as a root cause for your bloating. We can also work out where in the small intestine and how large the overgrowth is.

What other measures can we take in the short-term?

While we’re getting to the root cause of why you are so bloated and gassy, there are a few things to try that may provide relief.

> Take digestive enzyme supplements to help with breaking down your food. Readily available in chemists or online, my favourite is Enzymedica Digest and is available on iHerb and Amazon. You can take 1 capsule with each of your mean meals.

> Probiotics really need to be tailored to you and your microbiome, so I generally don’t make broad recommendations in blogs, other than to mention a few key strains which have been shown to help reduce bloating: Lactobacillus rhamnosus GG, Lactobacillus plantarum 299v, Bifidobacterium lactis HN019, Saccharomyces cerevisiae var boulardii.

> Eat foods that aid digestion such as bananas and mangoes which contain amylase; pineapples that contain bromelain, and papaya that contains papain both of which are proteases; avocados that contain lipase; honey and kefir also contain a number of different enzymes. That said, if you have SIBO many of these foods are high-FODMAP and will contribute to your bloating.

> If you do experience excessive bloating and gas production after a meal you can use activated charcoal to help with binding up the gasses and relieve the bloating naturally as a short-term solution. Take 2 capsules with a full glass of water at least 1 hour away from food, medications and other supplements otherwise charcoal can bind up and impact these too. If you're looking for an IBS-friendly product, you can source an Activated Charcoal from coconut shells iHerb and Amazon.

> And remember to eat slowly, chew your food well, and be mindful of your portions if you find you commonly overeat.

> Stop focusing on triggers and start thinking about identifying and treating the underlying root cause.

Why am I so bloated and gassy - what next?

So, if you’ve been constantly asking why am I so bloated and gassy?, hopefully you found some answers and an understanding of the importance of root causes. If you’d like to work together on your gut healing journey, you can learn more on the ‘work with us’ page of the website. I truly hope you can find and heal the root causes of your bloating so you can get back to your vibrant life without being offered seats on public transport by lovely ladies who are much older than you!

Note: Affiliate links for iHerb and Amazon have been included in this blog post. These do not adversely affect the price you pay.