Nobody likes feeling bloated. We all experience it occasionally, whether it’s after an indulgent meal with friends or after we’ve accidentally eaten something our gut isn’t used to. However, if you’re often bloated or find it’s happening after every meal, there’s likely more to the story.
In this article, we’ll look at the top 6 reasons we might feel bloated regularly, how we test for the causes of it, and when it’s time to speak to your doctor.
Top 6 Reasons for Bloating
If you aren’t having a regular bowel movement or are having to strain to go to the bathroom, you’ll likely experience bloating. The definition of constipation in my book is not going to the bathroom once a day or having hard, small stools. So, if your bowel isn't moving and you're not emptying your stool, then you're more likely to be bloated by what’s trapped inside.
SIBO stands for small intestinal bacterial overgrowth. This is where the microbiome in the small intestine becomes unbalanced, with the bad bacteria winning. After eating certain foods that could trigger these bad bacteria, the bad bacteria will produce certain gases, either methane or hydrogen gases, depending on the type of bacteria that have overgrown.
In other words, if a patient is bloating after eating certain foods, with or without constipation or diarrhea, it’s likely SIBO. SIBO is a common issue; I’d say around 80% of my patients have it.
SIBO is becoming much more common nowadays because our diet and our lifestyles are contributing to it. It's also being more acknowledged and tested, so it's being diagnosed more often. You can easily test for SIBO with a breath test, and I often do that for my patients in my office. You fast, drink a solution that aggravates the bad bacteria, and then you can detect the bad gases they produce after about twenty minutes after ingesting the solution.
If SIBO is detected, I often treat the bad bacteria with antibiotics to kill them off, but you also need to starve them by making dietary changes to ensure they can’t replenish. Sugars and highly fibers foods can trigger bad bacteria, so it’s one of the few occasions when I recommend white rice and other starchy foods over their wholegrain counterparts. The best way to know is to see a gastroenterologist for the SIBO test.
3. Candida Overgrowth
Similarly, candida overgrowth can also cause bloating, which is yeast. This often happens when you consume too many yeast products, such as bread, pasta, pastries, and sugar. This can be tested for in a stool test. We can do this for you or you can see your gastroenterologist.
4. Food Sensitivities
This is something you develop over time if you don’t maintain good gut health through a healthy diet. Food sensitivities can be resolved, but a patient can develop a food sensitivity because of the negative impacts of their food choices on the environment in the gut. This causes inflammation in the gut, which can affect the lining of the intestines, which should be “sealed” and only certain foods should be able to be absorbed into the bloodstream. But in an inflammatory state, and with the overgrowth of certain bad bacteria, this lining can be compromised.
We can see this inflammation through increased IgG levels (immunoglobulin) when the bloodstream is exposed to that food. So if your blood shows an increase in IgG levels, when for example, it's exposed to spinach or broccoli, that indicates a leaky gut. In this case, food particles prematurely pass through the lining of the gut, and the body has an inappropriate inflammatory reaction to those foods. When you heal this inflammation and thus the lining, this food sensitivity will usually go away.
5. Celiac Disease
Celiac disease is being better recognized nowadays, largely because more people choose to get tested for food intolerances. You can test for celiac disease via a blood test, but it’s preferable to confirm the diagnosis with endoscopy and a biopsy of the intestine, as blood work isn’t fully reliable.
Celiac disease is an autoimmune reaction to gluten. It’s a little more severe than the common gluten sensitivity. If you're celiac, you have to be monitored a lot more closely. And having gluten is going to be a bigger problem than just not feeling well if you consume things like bread and pasta, beer, rye, and barley. If you eat gluten as a celiac, you’re likely doing more damage than someone with a simple gluten sensitivity.
Someone with gluten sensitivity may experience some discomfort, but someone with celiac can do long-term damage, so if you believe you may have celiac disease, it’s well worth confirming the diagnosis with a gastroenterologist so you can take appropriate action.
6. Hormone Imbalances
Hormone imbalances, particularly thyroid, can also contribute to bloating. Estrogen and progesterone imbalances can also contribute to bloating. That’s without mentioning the effect stress can have on the the product of the stress hormone cortisol. High cortisol levels also negatively impact the gut. It’s important to remember that cortisol isn’t a hormone we are designed to experience long-term, and so when we experience long-term stress, our gut health can suffer, and thus we can experience the growth of bad bacteria and bloating that results from the gases they create.
Don’t Ignore the Signs
We’ve been through several common reasons for bloating, but it’s important to understand that chronic bloating should be evaluated by a doctor. You shouldn't ignore it. Bloating is something that you should mention to your primary care physician or your gastroenterologist, along with any other symptoms you may be experiencing, to make sure that it’s not something that can and should be treated to protect your long-term health or make you more comfortable.
Dr. Nancy Rahnama, MD, ABOM, ABIM, is a medical doctor board certified by both the American Board of Obesity Medicine and the American Board of Internal Medicine. Her specialty is Clinical Nutrition, that is, the use of nutrition by a medical doctor to diagnose and treat disease. Dr. Rahnama has helped thousands of people achieve their goals of weight loss, gut health, improved mood and sleep, and managing chronic disease.