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We’ve all been there – squeezing into your favorite pair of jeans or trying on bathing suits and all you see is a bloated stomach. I completely understand how uncomfortable and frustrating it is. Some people suffer from bloating more than others; and personally, I am one of them. So, I decided to dive in and do some research on normal versus abnormal bloating, the most common causes of bloating, and how to fight it.
What is bloating?
There is a difference between bloating and distension. Bloating is when your belly feels full and tight, which is caused by gas or air trapped in your abdomen. The feelings associated with bloating include an overly full and tight stomach, and there may be some pressure in the belly. Distension is when the belly physically looks larger than it usually is. It is normal for your belly to stick out a little bit when your gut is full of food or stool – food baby anyone – but what is actually causing this issue?
What are the major causes of bloating?
Throughout the day, gas builds up in both the lower and upper digestive tracts; and there are several causes for both. In the upper digestive tract (which includes the oral cavity, pharynx, esophagus, stomach, and duodenum) the main culprit for gas is swallowing air; which we do all day long. In fact, we consume a few milliliters of air every time we swallow. Bad news for gum chewers and smokers – this increases the amount of air you swallow. Other causes of excess air being swallowed include eating too fast, talking while eating, and drinking through a straw. In the lower digestive tract (anus, rectum, colon, and cecum) the gas that is produced is caused more by the foods that we eat. In humans, the large intestine is quantitively the most important site of fermentation, or the breakdown of undigested foodstuffs, like cellulose and residual starch. The large intestine is made up of an enormous number of bacteria, which contain the enzymes that breakdown and digest the food not digested in the small intestine. The major end products of microbial digestion of cellulose and other carbohydrates are volatile fatty acids, lactic acid, methane, hydrogen and carbon dioxide. Thus, this fermentation process is the major source of intestinal gas.
Which foods cause the most bloating?
Foods like whole grains, beans, brussel sprouts, cabbage, and asparagus contain a complex sugar called raffinose. Raffinose is broken down by a specific enzyme that is not present in the human digestive tract but is found in the gas-producing bacteria that are part of the fermentation process. The end products of the breakdown of raffinose are carbon dioxide, methane, and hydrogen – hence flatulence when eating these types of foods.
Some fruits like apples, pears, peaches, prunes, and some berries may also cause bloating and gas because they contain a small amount of sorbitol. Sorbitol is a sugar-based alcohol that is metabolized very slowly in the body and is eventually converted to fructose by a couple of gas-producing enzymes in the large intestine. Sorbitol and other sugar alcohols are known to display laxative properties and can cause bloating from the bacteria used to metabolize them. Sorbitol is also commonly found in sugar-free products such as chewing gum, candies, ice cream and cough syrups. Many people are very sensitive to sugar alcohols, like sorbitol – ever read the reviews for the Haribo sugar-free gummy bears?
Foods like milk, cheese, and yogurt can also cause bloating and gas when someone has lactose intolerance. Lactose is the main sugar in milk and dairy products. When someone suffers from lactose intolerance, their body can't digest lactose because their small intestine doesn't make enough lactase, the enzyme that digests lactose. The lactose that isn't digested makes gas in the colon, which causes symptoms like bloating and stomach discomfort.
When is bloating abnormal?
Excessive gas in the lower digestive tract can occur in people with malabsorption disorders, such as celiac disease, Crohn’s disease, or chronic pancreatitis, where difficulty with absorbing certain nutrients occurs. Bloating is also a particularly common symptom in people with functional gastrointestinal disorders, such as irritable bowel syndrome, inflammatory bowel disease, and diverticulosis. Some warning signs that your bloating is not normal include weight loss, jaundice skin, severe abdominal pain, blood in your stool, constipation, diarrhea, and fever. If you experience any of these symptoms along with serious bloating, it is best to seek medical attention.
What are some ways to alleviate bloating?
If you find that you’re experiencing bloating and gas on a regular basis or more than normal, consider implementing some of these strategies:
• Limit your intake of gas-causing foods, particularly cabbage, onions, broccoli, Brussels sprouts, and whole grains.
• Avoid sodas and other carbonated beverages.
• Skip foods that contain sorbitol, such as artificially sweetened foods and sugar-free chewing gum and candy.
• Talk to your doctor about any possible food intolerances if you find that lactose or fructose trigger discomfort.
• Be mindful during meals to promote slowing down and avoid distractions while eating.
• Quit or decrease smoking.
• Get moving – walk, jog, or stretch to get gas moving and decrease bloating.
Understand that some bloating is very common and normal; however, if it is bothering you, the best thing to do is make some of these small lifestyle changes or seek medical advice.
Hi there readers! It has been way too long!
The reason for my lengthy absence is that I was in Florida for 2 months at the Toronto Blue Jays Spring Training camp. In November, I was hired part time with the Toronto Blue Jays as an affiliate dietitian. I spent February and March in Florida at Spring Training and am now back in Lansing working with the Jays’ single A team, the Lansing Lugnuts. And I am having a blast!
I am also putting tons of time into my Lansing-based private practice and am taking new clients every day! In addition, I have been busy working on materials for several speaking engagements, including teaching a class on eating disorders at Michigan State University, presenting at the Michigan Academy of Nutrition and Dietetics Annual Conference, and being a guest podcaster!
Lots of people have asked me what Florida was like. Most importantly, I loved every minute of it! The days were very long and consisted of one off day for the 50 total days I was there. Working days included St. Patrick’s Day, Easter, and every weekend. This is the life of a sports dietitian. You cannot do this job unless you truly love it!
Possibly, the most challenging part about being in Florida for 2 months was living in a hotel room; especially a hotel room with limited space and kitchen equipment. As a dietitian, I thoroughly appreciate a home cooked meal and do not eat out more than a couple times a month. In Florida, there were plenty of restaurants around the hotel that could have been frequented; however, I did my best to limit eating out to once or twice per week. Thankfully, there was a Target within walking distance, and Publix and Whole Foods were an easy drive away; which allowed me to keep a healthy supply of groceries in my hotel room at all times. Below is a list of my regularly purchased items.
The other day, I was sitting in a coffee shop doing some work between my nutrition education classes at a local hospital, when I heard a conversation that made me want to gouge my eyeballs out. This conversation was between two women – one was a bride getting ready for her wedding; the other was what appeared to be her wedding planner. I swear I am not some eavesdropping creeper – I forgot my headphones that day and the conversation was impossible to ignore.
The bride and her planner discussed her colors, the flowers, her bridesmaids, and the groom. Then the conversation fell on the dress. I heard the wedding planner say, “well you don’t want to gain any more weight, so I can give you all of my nutrition tips and tricks. Naturally, my ears perked up and I started listening a little harder.
The woman went on to tell the bride that she should cut out all fat a month out from the wedding and no carbohydrates two weeks out. And she pretty much told her to not eat at all the 2 days before…. I was astounded! And the poor bride was hanging onto every word.
This is not the only time I overhear terrible nutrition advice. The grocery store, the gym, the tire place – it feels like we cannot get away from diet talk. So how is the public supposed to know when they are actually getting good nutrition information?
In addition, in most states registered dietitians are licensed. The goal of licensure is to protect the public in that state. Licensing dietitians assures the public that individuals giving nutrition advice have the appropriate education and experience to do so. Individuals seeking nutrition advice who are medically compromised deserve the assurance that the individual treating them has the necessary education and experience. Licensure laws protect the public from unscrupulous and unqualified individuals who portray themselves as nutrition experts and who could potentially give out harmful or damaging advice.
My advice? Seek out a health professional for all medical needs, including nutrition, not your unqualified wedding planner. Talk about flowers and table pieces all you want, but leave the medical talk between you and your health care team.
Allison Tropf, MS, RD, CSSD
Allison is a Sports Dietitian in Michigan. She enjoys helping others reach their nutrition and fitness goals through reliable and trustworthy recommendations.
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