Feeling Bloated

By Dr Harold Gunatillake - Health Writer

Do you feel bloated most days, uncomfortable enough to avert concentration on your daily work? Most people do not get checked up, but live with the condition. This article will enable you to evaluate your problem, if you have one, to take remedial action.

Bloating may be in most situations a dietetic issue: not eating enough high fibre foods, including fruits resulting in constipation and not having a satisfactory bowel motion. People eating too much of food can result in gaseous bloating which could be relieved by the next good bowel evacuation.  In such situation you burp a few times to get relief.Those who eat small meals more frequently like the Chinese have less chances of getting bloated.

The bloating could be due to a possible cause like irritable bowel syndrome, or lactose intolerance and many other such causes. You need to see your doctor to find out the cause in such situations.

Salt
Eating too much of salt in your food, coming from pre-packaged and fast foods, in addition to using a saltshaker whilst eating, may be a cause for your bloating. In addition you may drink more water and accumulate more to cause the problem.

Eating Carbs
Eating too much of carbs like white bread, processed white rice, pastries, and soda drinks can bloat you up. Crucifers like cabbage, cauliflower and beans are notorious for bloating. Changing your diet for a healthier one by eating unprocessed foods like wholemeal bread, brown or red rice in smaller quantities would be the solution. Eating processed foods do get absorbed faster and make you retain more water. Vegetarians including vegans seem to produce gas and bloating more frequently than the non-vegetarians. Sodas are the worst culprits- those gaseous bubbles in beer, champagne and other bubbly drinks tend to distend your stomach and may cause bloating. Obviously you are going to burp a few times to get relief.

Eating fast
Those people who eat fast on the run swallow more air. This air passes onto your small gut which makes you feel bloated. Again, eating healthy food more slowly would be the solution.

Dairy
Certain food like milk and ice cream can cause gas. This is mainly due to the lactose in dairy that causes the problem. If you have lactose intolerance due to insufficient lactase enzyme the dairy may not be digested and results in gaseous bloating.

Some causes of lactose intolerance are certain digestive diseases such as Crohn’s disease, ulcerative colitis, celiac sprue and other inflammatory bowel diseases may reduce the amount of lactase available in your gut to process properly.

The most common test for the diagnosis of lactase deficiency is the hydrogen breath test. This test measures the amount of hydrogen in the breath after drinking a lactose-loaded beverage.

If you think you suffer bloats due to lactose intolerance you need to avoid or slow down on consuming milk, milkshakes, Ice cream, cheese, butter, puddings and custards, cream soups, cream sauces and foods made with milk.

Weight Gain
If you gain weight due to over-eating and not exercising daily, you may feel bloated due to the accumulation of more visceral (intra-abdominal) fat which also retains more water. See your dietician for a low fat, low calorie diet and plan to help you to lose that weight. Daily walk may be part of the solution.

Fructose
Fructose is a monosaccharide like glucose. It is present mostly in fruits, including dry fruits, corn syrup and so on. This sort of sugar the gut finds it hard to digest resulting in bloating and abdominal pains.  Common sweeteners in your sodas can cause bloating, flatulence.

A study, published in the June issue of the American Journal of Gastroenterology, suggests that fructose intolerance is a common yet under-recognized cause of digestive problems like flatulence and bloating Fructose is abundant in honey and fruits such as apples, peaches, pears and oranges and it are the main ingredient in corn syrup. Those who are intolerant to fructose, the latter may travel on to the colon where microbiota ferments the fructose. This releases hydrogen and methane gases, which cause pain, bloating, flatulence and diarrhoea,

Fats
After enjoying a spicy meal like biriyani, you may feel bloated. This is because the gut takes a longer time to digest the food, especially the fat content. This delay can cause distension, bloating and flatulence.

Gallstones
These stones are formed in adults, especially the fat fertile forties. You start with nausea after a fatty meal, followed by upper abdominal pains or colics, and frequent bloating of the tummy is quite common. Surgery would be the solution for gall stones

GERD
This stands for gastro-oesophageal reflux disease. This occurs when the valve between the stomach and the gullet is not functioning well and acid from the gastric juice eructs into the gullet and you get the feeling that your heart is burning. Gaseous bloating is part of the picture in this situation. You may need to start with antacids for relief.

Large Bowel Cancers
Large bowel cancers grow insidiously and change of bowel habits and bloating are early symptoms. See your doctor for stool examination for occult blood and endoscopy.Just before menses or during premenstrual syndrome (PMS) most women get bloated with accumulation of water. Hormones seem to play a part and the real cause is not known. It is best to keep away from salt, sugar and certain carbs.

FODMAPs
FODMAPs are a collection of short chain carbs and sugar alcoholsfoundin foods naturally or as food additives. They include fructose, fructans, galacto-oligosaccharides, lactose, polyols (e.g. Sorbitol) and mannitol

A diet low in FODMAPs (“a Low FODMAP Diet”) is scientifically proven, and is now used internationally, as the most effective dietary therapy for Irritable Bowel Syndrome (IBS) and symptoms of an irritable bowel.  Such symptoms include excessive wind (flatus), abdominal pain, bloating and distension, nausea and changes in bowel habits (diarrhoea and/or constipation). A Low FODMAP Diet has also been proven, with solid scientific research2, to reduce symptoms of fatigue, lethargy and poor concentration. (Ref: fodmapfriendly.com)
FODMAP stands for Fermentable, Oligosaccharides, Disaccharides, monosaccharides, And

Polyols
These when consumed in foods and drinks FODMAPs can be poorly absorbed in the small gut and pass through to the large gut where the microbiota ferments them contributing to the gas. They also attract water into the large bowel and cause the bloating

Celiac disease
Gluten is a protein in wheat, barley and rye found in many pre-packaged foods. When gluten is not digested by the enzymes in the gut, they attack the inner lining of the small gut and cause inflammation. It can cause diarrhoea, weight loss, pain and bloating of your tummy.

You need to stay away from foods that have gluten.

Conclusions: You may experience just functional non-specific bloating which needs no further investigations and temporising with home remedies and avoiding factors that cause them would suffice.

If bloating is accompanied with, other gastro-intestinal symptoms like vomiting, heart burn, diarrhoea,  brown coloured stools, constant pains with loss of appetite and losing weight- you need to go for further investigations like endoscopies, ultrasounds, stool examinations and so on.

Hope this article was useful. Any comments or queries you may direct to the author on haroldgunatillake1@gmail.com

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