Why am I so bloated? Finding the source of your abdominal discomfort
ByAidanne MacDonald-Milewski, ND •October 26, 2020
Bloating is one of the most common digestive symptoms I see in my practice. It can present as abdominal distension, swelling and discomfort, that can come and go throughout the day or be persistent. Often complaints of bloating are compounded by other gastrointestinal complaints, such as heart burn, cramping, diarrhea, constipation or flatulence and signals an imbalance in the digestive system. Some of the most common imbalances that I see contribute to bloating are indigestion and dysbiosis.
Indigestion, or an upset stomach after eating, is ultimately a sign of poor digestion. Often this is rooted in the stomach and may be due to chlorhydria (high stomach acid), hypochlorhydria (low stomach acid), poor enzyme production, food allergies, or food sensitivities.
Stomach acid is needed to break down proteins and prevent infection from the foods we eat. When we either produce too much or too little stomach acid, symptoms of indigestion, such as heart burn and gastritis, can present. Often proton pump inhibitors are given to counter the effects of acid over production. If you find that PPIS are unable to provide relief, then low stomach acid is more likely to be the problem. I see this commonly with older patients of mine, as stomach acid levels decline over time as we age. A challenge of betaine HCl can be useful in determining if low stomach acid is the problem.
Low Enzyme Production:
Enzymes are of the utmost importance in breaking down the foods we eat. They are produced in the mouth through saliva, as well as in the stomach, pancreas, gall bladder and liver. If certain enzymes are not produced in sufficient quantities, foods may become more difficult to digest and intolerances may present. A classic example of this is the case of lactose intolerance in those who are unable to produce sufficient levels of lactase. Until the underlying cause of low enzyme production is investigated, taking digestive enzymes in a supplement form can provide relief from bloating and indigestion.
Talk to your naturopathic doctor about which form and dose would be right for you.
Not all foods were created equal nor are they digested equally in all people. Even if you don’t have an allergic or anaphylactic response to foods, you may not digest them all properly. A food sensitivity is a delayed reaction to food, in which your immune system identifies the food as problematic and can produce low grade inflammatory response in the gut tissue. I see food sensitivities commonly come up positive when tested in those who live with heartburn, gastritis, esophagitis, and other malabsorptive or chronic conditions of poor digestion. When we’re sensitive to foods and eat them frequently, it can also contribute to bloating, abdominal cramping, migraines, acne, eczema, etc. I find the IgG sensitivity testing to be a useful guide in determining which foods may be problematic for you and tailoring the diet to fit your body’s needs.
Dysbiosis is defined as an imbalance in microbes or gut bugs. It can occur in both the small and large intestine and lead to bloating, flatulence, indigestion, constipation, diarrhea, abdominal cramping, etc. Dysbiosis can include imbalance in both bacteria and yeast. An overgrowth of bacteria in the small intestine is known as SIBO. This can be tested by measuring gases produced by bacteria that are exhaled through the breath. In the large intestine and colon, over growth of bacteria can cause constipation, diarrhea, and other uncomfortable symptoms. Additionally, yeast overgrowth in the intestines can contribute to migraines, fatigue, abdominal cramping, sugar cravings, etc.
If you feel that any of the descriptions above fit with what you’re experiencing, talk to your naturopathic doctor today to see what testing and management options would be best for you!
Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.