Causes, prevention and treatment for BLOATING
MORE COMMON THAN YOU THINK - PART XII
Is bloating really common? More common than you think? And doesn't treatment for bloating lie in having antacids? Here are some numbers to tell us how common it is. According to a Cleveland Clinic, upto 25% of otherwise healthy people complain of occasional bloating i.e. about 2 bn people in the world suffer from occasional bloating if this data is extrapolated. What is worse is that more than 75% describe their symptoms from moderate to severe. Bloating is again one of the ailments that affects more women than men. 75% women reported bloating either before or during the periods. The instances of bloating are scarier with certain medical conditions like Irritable Bowel Syndrome (IBS) wherein 90% people reported to having felt bloated.
What is bloating?
Bloating is when one feels that the stomach is full, feels tight and at times feels swollen. It can also be painful in many cases. Typically, this feeling of being full or tight comes when there is excess gas in the digestive tract. Usually this feeling goes away in sometime. But sometimes this can be severely painful, long lasting or recurring. This could then become a cause of concern.
What causes bloating?
One of the primary reasons for bloating is the formation of excess gas in the stomach. The word "excess" is important since gas is produced as a by-product of digestion even when one does not feel bloated.The gas flows out of the body either as burps or flatulence. This gas is a result of the fermentation of the carbohydrates caused by the gut bacteria while absorbing them. This means that one of the reasons for bloating is more than could-be-digested carbohydrates reaching the bacteria. One simple reason for this could be eating too fast, hence giving very less time for digestion and absorption of carbohydrates causing them to remain in excess, get fermented and produce excess gas. The other could be that one has eaten food that they are not able to digest. Some of the common examples are:
Typically found in wheat, onions, garlic, legumes and beans, these compounds lead to production of gas and thereby more chances of bloating.
Found in milk and milk compounds, these are most likely to affect people with lactose intolerance
Monosaccharides (including fructose)
These are present in fruits like apples and pears and honey
Polyols or sugar alcohols
Chewing gums and candies are the processed foods that contain polyols; they are also found in naturally occurring foods like plums, apricots and cauliflowers.
These category of food are popularly known as FODMAP diets. Avoiding these can help with lesser bloating attacks and also reduce the intensity of these attacks.
One must wonder that many of the food items listed above have always been known to good for health. Who hasn't heard "An apple a day keeps the doctor away"? It is important to understand that the trigger for bloating in every person is different. There might be cases wherein an individual is not able to digest an apple the way it should be "to keep the doctor away" and hence results in bloating. When a person is not able to digest FODMAP, they are passed into the colon wherein they are fermented by the bacteria and produce gas thereby causing bloating.
One of the direct outcomes of stress for some people is indigestion. It could manifest itself in many forms of digestive issues, bloating being one of them. An indirect reason for stress to cause bloating is people tend to breathe in more air (and from the mouth) when they are stressed. This air, occupies the space in the abdomen that was to be used for the digestive gases and hence makes one feel bloated.
What other underlying medical conditions can result in bloating?
While most people can avoid and prevent bloating by having certain changes to their lifestyles, some medical conditions also result is frequent and aggravated bloating attacks.
The most common underlying condition that can cause bloating is constipation. You can read more about symptoms, causes and treatment of constipation in our blog. But simply put, with not passing the stool as one should, the space in the stomach is blocked which could have otherwise been used to contain the gases. With a part being lost out owing to infrequent bowel movements, the gas produced does not have enough space and causes bloating.
Irritable bowel syndrome (IBS)
As mentioned above, 90% of the patients suffering from IBS are known to suffer from bloating.
Especially women are prone to this just before or during their periods. The changes in the hormones are known to cause bloating.
While it is not a medical condition per se, weight gain is also a known cause for bloating. Excessive weight gain first starts getting accumulated in the stomach. This leaves less space to accommodate the regular digestive process and causes bloating.
Any sort of tumours, scarred tissues, inflammation (either temporary or chronic owing to ailments like Crohns) can block the passage of the gas causing it to remain in the stomach and give the feeling of bloating.
These are disorders that affect the muscles and nerves of the digestive tract making the movement of everything slow. Whether it is being able to absorb nutrients or pass the waste, the activity is affected resulting in excess gas accumulation in the stomach causing bloating.
If the pancreas are not working optimally due to ailments like cancer, perforation of GI tract or accumulation of pathological fluid, it is bound to cause flatulence and bloating as symptom for a much more serious condition.
Small Intestine bacterial overgrowth (SIBO)
This occurs when bacteria flow from the colon to the small intestine. This causes an imbalance of the bacteria wherein the bacteria absorbing the gas are "outnumbered" and hence results in bloating.
Function digestive disorders
Functional dyspepsia are diagnosed when the food is not digested by the body as it should. This is usually accompanied by other symptoms like diarrhea, nausea, vomiting, fever, bleeding, anaemia and unintentional weight loss
For some people, even the normal amount of gas makes them feel bloated. Some of them even develop muscular hyper-reaction to make more space in the stomach for the gas. Their abdominal muscles relax and protrude outward in the presence of gas, even when the actual volume is normal. Hence, they tend to feel bloated all the time.
How can one prevent bloating? What are the treatments for bloating?
Bloating, more often than not, is a result of the lifestyle and the kind of foods we eat. Here are somethings one can do to avoid bloating:
Eat a fibre rich diet
Fibres are difficult to digest and might cause bloating initially. But slowly increasing the amount of fibres helps the digestive system. In the long run, it not only avoids bloating altogether but also helps with other digestive ailments like constipation
Drink enough water
This causes enough motility in the digestive tract and thereby leaves less chance for undigested food to remain for the gut bacteria to ferment and avoids bloating
Get some exercise
Exercising keeps the digestive tract healthy by avoiding the retention of too much water. This also helps weight loss / avoids weight gain keep the abdominal cavity sufficient to accommodate the gases.
Make sure you chew your food properly before swallowing. This aids in the digestion beginning in the mouth with the saliva and gives enough time for the bacteria to react with the food to completely digest them rather than have an overflow of food which remains undigested and gets fermented to produce gas
Maintain a journal
Many people maintain a food journal to identify the trigger and then start avoiding it to prevent getting bloated. These could me FODMAP or any other foods that might result in bloating but avoiding triggers is the simplest way to avoid bloating.
Avoid processed foods
Processed foods are low in fibre and high in salt and fat. Salt causes water retention, and fat slows down the digestive process because it takes longer to digest. All of these things can lead to constipation and bloating. Processed foods are also low in nutrition, so they will leave you feeling hungrier even after you’ve consumed a lot of calories. This leads to more eating and compounding the problem.
Avoid carbonated beverages, especially drinking them with a straw
Carbonated drinks contain gases which can add to the bloating when had with food. The bacteria are producing and absorbing the gases, processing the food. This excess dose of gases in the beverage adds more to do for the absorbing bacteria. In excess, this is sure to cause bloating. Also, when you have a beverage with a straw, you are ingesting more air than required. This air can reside in the abdominal cavity leaving less space for the gases thereby resulting in bloating.
Apart from the lifestyle changes, there are supplements that can help you in the treatment of bloating. These supplements include herbal teas, peppermint oil capsules, antacids, magnesium supplements, probiotics and psyllium husk. Many women find hormone therapy or hormone control useful for the monthly bloating cycle.
What does Ayurveda say about bloating? Is there an ayurvedic medicine for bloating?
Bloating with distention is known as Adhmana and is caused by the vitiation of the Vata dosha. The primary causes are improper eating habits (vata prakopaka aahara), lifestyle (vihara) and weak gut unable to digest whatever is consumed. While ayurveda suggests Panchkarma treatments for bloating, home remedies and herbs to treat the symptom (i.e. bloating) like Ajwain, cardamom, mint and cumin, coriander, fennel tea, it recommends correcting the root cause (i.e. poor gut health). Not only in reference to bloating but ayurveda also treats gut health as the most important bodily function to remain healthy.
We, at Chyavan Rishi Ayur Siddha proudly present our digestive churn Chyavan Pachan, the ayurvedic medicine for constipation, bloating, acidity, GERD and overall gut health.
If you would like to read up on the other blogs in this series called 'More common than you think', here are quick links for Urinary Tract Infection, Mental wellness, Tuberculosis, Constipation, Arthritis, Erectile dysfunction, Periodontitis / Pyorrhea, Anaemia, Kidney stones, Asthma, GERD / Acidity.