Belly bloat is uncomfortable and, often, embarrassing.  While some common causes of bloating can be obvious (overeating, drinking carbonated beverages, constipation), others may be more elusive. Whether it’s acute or chronic, it is good to know why bloat is happening. Let’s look at two surprising reasons behind belly bloat that you may not have explored yet.  We’ll also cover a few of my best tips for dealing with bloat (no matter what’s the cause.)

Surprising Reason #1:

SIBO.  Small Intestinal Bacterial Overgrowth.  It sounds complicated… and it is!  So often, we hear about using probiotics as a way to ease belly bloat and digestive issues.  In SIBO, too much bacteria ends up colonizing the small intestine.  Common symptoms include INTENSE bloating after any meal (even water).  Nausea, constipation or diarrhea can also occur.

If you’ve ruled out common causes of bloating, see your doctor to check for SIBO.  Testing involves a breath test that measures the amounts of hydrogen and methane in your breath over the course of a few hours.  Treatment can include dietary modifications and/or a short course of antibiotics.

Surprising Reason #2:

Endometriosis!  Persistent gas and bloating is one of the most common things women with Endometriosis encounter.  Because these symptoms are commonly caused by other issues, women are often dismissed and given antacids.  When the pain and bloating persist or worsen over time, doctors may begin to look for other causes of inflammation in the gut.  Still, SIBO and IBS diagnoses are common among women with Endometriosis.  If a gastroenterologist has diagnosed you with SIBO or IBS and treatment including specialized diet or antibiotics and it is not working, it may be time to see an endometriosis specialist.

Figuring Out What is Causing Your Bloat

Figuring out what is actually causing you to be bloated can be harder than a 10,000 piece puzzle. While it may seem overwhelming, there are a few things to look at first.

Where is your bloat?

You may think that it’s your stomach causing issues, when the bloating may be coming from your intestines.  Take a look at the images below to see if you can determine the location of your bloating or gas pains. 

Notice that the stomach is positioned low in the chest cavity or at the very top of the abdominal cavity.  In women, the stomach is basically just under your ribcage below your breasts.  The small intestine is the next stop after the stomach.  If you pain and bloating happens shortly after meals, it may be in your stomach or small intestine.  Several hours after a meal may indicate the lower part of your small intestine or the start of the large intestine.  Where most people hold low on the abdomen for gas pain is actually intestinal pain rather than stomach!

Chyme travels into the large intestine.  Water is reabsorbed through the colon wall.  Bacteria continue to break down food particles and form stool that is excreted through the anus.

Think about your diet.

Are you eating anything new?  Is there anything different about when, where or how you eat?  Sometimes a new food or a food cooked in a different way can be the culprit.  If you normally sit to eat and find symptoms happen when you’re eating on the go or when you’re rushing, then you can likely make simple modifications and ease your symptoms.

Get to know your response.

Do you know how you feel after you eat eggs?  How about caffeine, gluten, dairy, sugar, etc?  Do certain foods increase your bloating response?  Do certain foods increase constipation?  Are your symptoms different at various times of the month (hormonal cycles, moon phases, deadlines, etc)? By recording your symptoms along with your intake (food, drink, stress, work, exercise, etc) and output (bowel movements, emotions, energy level, etc) you can begin to assess your body’s response.  You can use a notebook or use a form like this one that I use in my practice. 

Whether you figure out what’s causing your bloat or need to take the next step and see your doctor, 5-10 days of journaling can provide some insight for your clinician.

Seek support

If your bloating doesn’t ease after some simple shifts then you may want to seek the support of your doctor.  A general practitioner can assess your overall health and guide you to a specialist if needed.

Tips for Relieving Bloat

If you’re tired of being bloated all the time, here are a few things that may help:

Chew — Chewing food until it’s liquid is needed for proper digestion.  Chew smoothies and soups so your stomach gets the signal that food is coming and so digestive juices are stimulated.  Simply slowing down and chewing can drastically help digestion!

Sip still water – Still water (rather than carbonated) may relieve bloat.  Avoid drinking too much with meals.  Instead, sip during meals.

Get regular exercise – Walking is one of the best exercises to help relieve bloating, but there are also some yoga poses that can be great.  Child’s pose, gentle torso twists, etc.

Try peppermint or ginger tea – Peppermint and ginger do wonders for bloating and the gut in general. Try drinking 1-2 cups of either tea each day and see if it helps.  Fennel tea can be another ally for gas and bloating.  This blend from Traditional Medicinals can be helpful: https://amzn.to/3yKwTGu

Address your medical conditions – Of course, if your bloating is from medical conditions like SIBO, Endometriosis, IBS, Crohn’s or Celiac, then you need to address those before your bloating will ease.