Can’t Beat the Bloat? There May Be More to Blame Than Diet
Most people have experienced bloating at some point in their life. More often than not it is our own eating habits that are the culprit – overeating, eating too fast, consuming large quantities of salt or fat. But when the occasional bloating turns into weekly or daily episodes, it may be indicative of a much larger systemic issue.
In our practice, we see three core causes of chronic bloating: hormone imbalance, gastrointestinal disorders, and food sensitivities. Because of the similarities in symptom manifestation, these three conditions are often brushed off as run-of-the-mill bloating and too often go unchecked. If you can’t beat the bloat, read on to see if a systemic disorder may be to blame.
Bloat Trigger #1: Hormonal Imbalance
Women often experience bloating during hormonal changes in their cycles. Typically, this takes place during the second half of the menstruation cycle leading up to menses in which levels of estrogen dramatically shift and progesterone is released. While estrogen increases water retention, progesterone slows down the GI tract resulting in constipation and.. more bloating. And if your go-to PMS craving is an extra glass of wine or a bag of potato chips, that only makes things worse – alcohol consumption and salty foods further increase bloating. Triple whammy!
Problematic is the tendency for women to be told not only to expect but to accept bloating as part of the normal menstruation cycle. However, chronic bloating could point to a hormonal imbalance stemming from either an estrogen dominance or a lack of adequate progesterone (or both).
Estrogen dominance is a common hormonal imbalance that occurs during perimenopause, the 8-10 year period before the onset of menopause. The higher levels of estrogen in comparison to progesterone encourage increased water retention and bloating. Progesterone deficiencies during this time period similarly lead to increased fluid retention as it skews hormone balance to be predominantly estrogen.
If you feel like your bloating occurs during specific times each month then it is a good idea to get your hormones checked. A medical professional can look at your full hormonal cascade along with timing in your cycle to determine if you are perimenopausal. Hormones can be tested via blood, saliva, or urine samples.
The gold standard, and most thorough, for evaluating female hormone levels is the DUTCH test. DUTCH stands for dried urine test for comprehensive hormones. Our Naturopathic Doctors examine your labs through a functional lens to ensure you are not only in the normal range, but the optimal range.
Following proper testing, hormonal imbalances can be addressed with natural therapies like diet, lifestyle, supplementation or bioidentical hormone replacement therapy when needed. Each hormone balancing approach is customized to the patient depending on their symptoms as well as their lab testing.
Bloat Trigger #2: Gastrointestinal Disorders
In contrast to the “puffiness” characteristic of menstrual bloating, GI disorders cause the belly to become distinctly hard and distended. This is due to a buildup in our intestines, either of gas or stool, that pushes against the walls of our abdomen and produces the uncomfortable feeling of bloat.
What causes this gaseous build up to occur? Gastrointestinal Dysbiosis – an overgrowth of bad bacteria in the small intestine. The microbial balance of good and bacteria in our stomach and intestines is incredibly sensitive and dietary changes, alcohol consumption, the introduction of new medications, stress, poor dental hygiene, and unprotected sex can all lead to an imbalance.
Once Gastrointestinal Dysbiosis is present, sensitivities intensify. While common sense tells us to eat healthier foods to counteract discomfort, this often worsens the condition. Foods high in fermentable oligosaccharides (FODMAPs) like apples, garlic, onions, cauliflower, broccoli, avocados are highly fermentable by bacteria, producing more gas and bloating as a consequence. In this case, an apple a day does not keep the doctor away.
The first step to diagnosing your Gut Dysbiosis is identifying whether a Small Intestine Bacteria Overgrowth (SIBO) is present, which can be determined through a simple breath test. If SIBO is ruled out, we often examine the large intestine via a comprehensive stool analysis. This test can tell us the status of your good and bad bacteria, yeast, digestion and absorption markers, immune system function, and if there is any inflammation happening directly in the gut.
Bloating can stem from an overgrowth of pathogenic organisms or a lack of digestive enzymes. It can also come from a lack of proper GI motility or constipation. It is important to identify what may be causing for the proper treatment. This could be adding in the right strains of beneficial bacteria in a probiotic, digestive enzyme support, or botanicals that can eradicate the overgrowth of certain bacteria, yeast, or parasites.
Bloat Trigger #3: Food Sensitivities
The third common trigger of bloating is one that is often misunderstood. Food sensitivities differ from food allergies and intolerances in that they can cause a delayed reaction, such as bloating, hours to days after consumption. And because food sensitivities include a wide range of foods such as gluten, dairy, eggs, soy, alcohol and nuts/seeds, this makes determining the trigger food even more difficult.
So, while the gold standard for determining food sensitivities is an elimination diet, it can be helpful to start with food sensitivity testing to determine which foods to try removing. A food sensitivity test looks is a blood test that examines the IgG response to certain food groups. The IgG response is the delayed immune reaction characteristic of food sensitivities, as opposed to the IgE response of a food allergy that happens within seconds to minutes in the form of hives or anaphylaxis.
If a test comes back with several food sensitivities, then a patient may be experiencing some hyperpermeability of the gut causing them to be at risk for more food sensitivities. We then use a combination of an elimination diet along with gut healing support in order to address food sensitivities. Sometimes, these can resolve over time with a healthier gut lining and may not be a true food sensitivity lifelong.
Bottom line, if you can’t beat the bloat then consulting a medical professional can help. Come see us at Spark Health today – whether it’s hormones, gut dysfunction, or food sensitivities causing your bloat, we will work with you to rid yourself of its discomforts once and for all!
Founded in 2013, Spark Health Integrated Medicine is located in Solana Beach, San Diego County, CA.
Article written by Dr. Christina Bradshaw, ND