#114: Why Do I Feel Bloated After Eating?

Hi, I'm Dr. Tabitha, the gutsy gynecologist. I'm a triple board certified, OB, GYN and Functional Medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey. And I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyne health and your overall health. And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more band aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. Hi ladies. I'm super excited for this episode because we're going to talk more about gut health today. Today and how it impacts your gyn health, your hormone health, just your overall health. So today I want to talk about how stomach acid helps you digest your food and the importance of stomach acid and what happens when your stomach acid is low, what kind of symptoms you can experience, how to test for it, and most importantly, how to get it fixed and back into balance. Right? So excuse me, I see this all the time in my practice. Women have symptoms of low stomach acid levels and that can look like bloating or belching or having excess gas right after you eat, especially like upper abdominal type of bloating and discomfort up and where your stomach area would be. You can also have changes in your bowel function like diarrhea, constipation, indigestion. You can have fatigue, you can have rectal itching from low stomach acid levels. You can get yeast overproduction, ladies. You can have hair loss from low stomach acid. You can get iron and B12 deficiency. It can feel like heartburn. We're going to talk about that. You can develop food sensitivities. You can have weak peeling, cracked fingernails, dry skin, dandruff, acne, all of this because of low stomach acid. What the heck is stomach acid? Right? Our stomach has cells that produce hydrochloric acid. That is what helps break down our foods as well as our digestive enzymes like protease, things like that. And so having stomach acid is super important to be able to digest your foods. It also keeps bad bacteria from overgrowing and getting into your intestines where you don't want it to be. And so hydrochloric acid is super important, and a lot of us aren't making enough of it. So what has happened over the past 15, 20 years or whatever is that big pharma has really made gazillions of dollars on this whole idea of heartburn because you're making too much stomach acid. And here's the problem. You're not making too much stomach acid. You're actually not making enough in most situations. And taking the medications like Protonix, Pepcid, Nexium, Prilosec that is supposed to suppress acid production is actually making your situation worse and making you dependent on those medications. So what's really happening? So normally when you eat food, you want to do it in a slow, relaxed state, right? So that your brain has time to realize that you're actually putting food in your mouth, you're digesting it and putting it into your stomach, because your stomach needs time to create and release pancreatic enzymes and digestive enzymes and acid from your stomach. And so the acid and the enzymes start to work on the food that your mouth has already started to digest. By chewing, that type of process releases amylase and a little lipase as a digestive enzyme, and then it goes down to the stomach and it keeps working. So you need that acid to help that process, especially with protein. Protein like, you know, a steak or something like that. It takes a lot to digest that. And so you need to have adequate stomach acid levels to make that process happen. So what happens often is that we'll eat too quickly so that our body, our stomach, doesn't have time to even know to make that acid. By the time we, you know, chew it twice, swallow it halfway whole still, and it's in our stomach already. And so it's about slowing down and eating, but it's also about what's living in our gut. And when we don't have enough acid, the food sits in our stomach longer. Right? So I don't know about you, but I hear from patients all the time. I just feel like food is stuck. I just feel like it's in my stomach too long. It doesn't want to leave. I just get bloated as soon as I eat, and I feel horrible. I get really tired after I eat. These are all symptoms of low stomach acid. And so that food sits in your stomach a lot longer than it should because it hasn't been yet digested enough for your intestines to accept it. And so it just sits there, and that causes reflux into Your esophagus, the tube from your mouth to your stomach. And so anything in your esophagus that shouldn't be there, like undigested food or any stomach acid, that feels like heartburn. And so what's really happening is that the food is sitting in your stomach. It's not being digested because of low stomach acid. It's eventually being swooshed back up into your esophagus, and your esophagus is feeling irritated. And so you have this compression complaint of heartburn. And so you get on this medication to suppress that symptom instead of addressing, why is that symptom happening? Why am I feeling heartburn? It's because you're not digesting your food in an efficient manner and getting it out of the stomach into the intestines to keep going. And so that's the key. The key is to get you digesting and moving that food along. The other big component of that is that our stomach and intestines have to physically contract and peristalse and move things through. And so many things affect our stomach contraction. We have this entire nervous system in our gut called the enteric nervous system. It's different from our central nervous system. Definitely partly controlled by that, but it's also controlled by hormones, especially our stress hormone cortisol and adrenaline. So that's why when you're really scared or excited, you feel butterflies in your stomach, because it can affect that. Or if you have irritable bowel syndrome, what's happening is that rush of cortisol and adrenaline are stimulating the enteric nervous system to contract in peristals, and you get all this crampiness in your gut, and then you have, like, diarrhea that you can barely make it to the bathroom. And so the centric nervous system is really important to nurture and help function in a proper way so that things can move through your gut. I see women with low thyroid issues, hypothyroidism, that affects your enteric nervous system. So a lot of things can affect it. And we really want to stimulate proper movement, proper digestion, so that you stop having these low acid symptoms. You know, there's a really easy way to check for low stomach acid that you can do at home. It's like the poor man's test. So what you can do is you can get baking soda and do like, a quarter teaspoon of baking soda and 4 to 6 ounces of cold water. First thing in the morning before you eat or drink anything else, you drink this baking soda and Water and see how long it takes for you to have a really good burp or, you know, belcher and wait up to five minutes. So if you haven't burped in five minutes, that is a sign of insufficient stomach acid production because baking soda is bicarbonate, sodium bicarb. It's very basic on the ph scale. And stomach acid is hydrochloric acid. It's very acidic. And so they're supposed to balance each other out. And so if you don't burp or belch, you haven't created that chemical reaction necessary. And so I would say do this at least two or three times, you know, two or three mornings to see, am I really not burping? You know, within three to five minutes. And don't confuse that with, like, the little burps or feelings that you would get just from drinking it, that you know when to first drink it. You might feel little burps of swallowed air, that type of thing you're looking for, like a real burp or belch, you know, in three to five minutes. So that is your poor man's test or woman's test of how you can see if you have sufficient stomach acid. So that's really important to know. With my patients, I often see low stomach acid look like gut dysbiosis on stool tests. So major H. Pylori, overgrowth, staph, strep, bacillus, all these species that are supposed to be at lower levels, like, they get out of control because there's no acid to kill them off. Same with yeast or candida. So that's another thing to look for is if you're having recurrent yeast infections and that type of thing, then it could very well be low stomach acid. So why does it matter if your stomach acid is low? Well, like I said, you're not going to digest your foods appropriately. And that can lead to food sensitivities that also leads to major vitamin and mineral deficiencies. So, you know, another thing is if you're working with a functional practitioner, they'll often look at your blood work just like a CBC and a cmp. Those are normal blood tests that a lot of doctors will run. But most conventional doctors don't look at the levels, thinking, is she making enough stomach acid? They're looking for outright disease. But you can see on your blood work certain things like low chloride levels. Low chloride level under 100 is often a sign of low stomach acid because HCL is hydrochloric acid and it needs chloride to make that serum protein. And Globulin levels. So if your serum protein is low, like less than 6.9 or over 7.4, that could be a sign that you're not digesting and absorbing your proteins properly. Low phosphorus and vitamin D levels can be a sign high BUN levels. So BUN stands for blood urea nitrogen. Those are waste products that our cells give off that you're trying to get rid of. And so a lack of stomach acid might result in high BUN levels because you have excess waste from poor protein digestion. So if your bun is over 20, that could be a sign of it as well. Also abnormal red blood cell sizes. So methylation with B12 is a critical part of your red blood cells maturing in your bone marrow when they're being made right. So inadequate B12 levels can result in immature red blood cells that end up being larger than they're supposed to be because they. And that makes them less effective at carrying oxygen. So you don't want really big red blood cells. You don't want this abnormal MCV level. Hcl or stomach acid is necessary for iron absorption. So that's also something that to look for. And you know when you're talking about B12 absorption, that stomach acid is critical for your B12 absorption. So B12 is one of the key components of methylation. That's a super important process that your body does, and it keeps your homocysteine levels optimal. You want those to be like 5 to 8. Or when your B12 levels are low, your homocysteine becomes elevated. Elevated homocysteine is associated with high risk of cardiovascular events. So this all is connected. I promise you, it's super important. The gut health determines your overall health. So intrinsic factor is a protein in your stomach that's necessary for B12 absorption. So I will see a lot of women who have had gastric bypass and stomach surgeries, things like that, and they don't make intrinsic factor the way that they're supposed to. They don't absorb their B12 efficiently. It's like a cascade. One thing affects the other. It's a domino effect. It's really important to know that there's ways to figure out if you have low stomach acid causing almost always like immediately having bloating, gas production, discomfort, feeling like food sitting in your stomach too long, that type of thing. And so what can we do about it? So many good things you can do about it, first of all, like slow down and enjoy your food. Don't eat in a rush, don't eat while you're walking or Driving like I used to do, running to labor and delivery to catch a baby. I would shovel the food in and like two minutes flat. I was a master of eating so fast and that really destroyed my health. But use lemon, apple cider vinegar, any citrus pectin, things like that. Get that in your water first thing in the morning. You can do like a teaspoon of apple cider vinegar and some water, and that will set you up for the day. It will tell your stomach, hey, we need some acid in here. Stay hydrated through the day. Your body needs water to make these chemicals and you know, these processes. For these processes to happen, I like to say drink 8 to 10 glasses of water a day. But not with your meals. Like, keep your fluids away from your meals as much as possible. If you are going to drink with your meals, try drinking fermented drinks and keep keeping it toward the beginning of the meal. Because once you have food in your stomach, especially protein, you don't want to dilute, you know, your digestive enzymes and your hydrochloric acid. So that's just a tidbit, like, drink lots of water away from your meals. Use ginger. Ginger stimulates that enteric nervous system and really helps move that food out of your stomach. So definitely you can use that. You can take it as a supplement. That is why, honestly, sushi comes with a side of ginger. It's very stimulating to your digestive system. The Asians knew what they were doing when they, you know, put their food together because they have fermented foods. They have these foods to stimulate digestion and peristalsis and to feed the good bacteria. They have food to heal the gut lining, like miso and tempeh, like all of that food is all very healing and beneficial to the gut. So like I mentioned, fermented veggies are super good for stomach acid production and eat when you're relaxed. So I hope this was helpful because if you got low stomach acid and you're having these gut symptoms, it's not going to end there. It's going to lead to food sensitivities. It's going to lead to leaky gut and gut dysbiosis, which can turn on autoimmune processes, which definitely to systemic inflammation, which drives things like cardiovascular disease and diabetes and hormone imbalance. And so everything is connected and it almost always starts in the gut. So I would say if this is an issue for you, do the poor man's baking soda test. Try to get it figured out. If you want to do real testing with me. I would love that as well. Or you can find a practitioner to work with you. But figure this out, because this could be a game changer for you. So I hope this was helpful. That's all I have for today. You know, meet me back here next time and we'll learn something new about the gut. Something new about how to be healthy as a woman. How to be vibrant and amazing and do all the things you have to do in this life. So go have a kick ass week, ladies.