Why Am I Always Bloated?

Most people experience bloating at some point in their lives, maybe even frequently. But when is it normal, and when is it a sign of a more serious root cause? That's today's topic. Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. I'm Lindsey Parsons, and this is my podcast, and for today, for the first time, videocast, so that YouTube listeners can see me in person.

Lindsey Parsons.

I'm a certified health coach and I work out of Tucson, Arizona, and virtually for clients anywhere in the world. So to start, let's just define what bloating is. Bloating is when gas is building up in the digestive tract due to bacterial fermentation and pushes the stomach outward, causing pain and tenderness. I'm well familiar with bloating as it was one of my primary symptoms of gastrointestinal distress from a young age. For me, it usually would happen after big meals out, or I'd get what I now call a food baby, and I did look about 6 months pregnant. But it became more and more frequent for me as I got older, and not just after big meals, but after almost every meal. And then I even found that I was waking up bloated. So that's when it's really— if you're having that— become a real problem. And if you're not sure if what you are is bloated, most people will describe it as feeling as if you're really full like you've just had a huge meal, or a tight feeling in your stomach and abdomen. But you may also find that your stomach is swollen and painful to the touch and have other symptoms like gas or excessive burping. This can take all the fun out of eating, so let's get down to why it may be happening. So sometimes bloating is caused by something simple and mostly harmless, like eating too much or too quickly. Or even chewing gum. So simple tips like eating and drinking more slowly, drinking less water with meals, chewing gum less frequently, eating smaller meals, and not drinking with a straw could all help if there's no underlying gastrointestinal issue. Many people also swallow excess air while drinking, so do double-check your drinking technique and make sure you're not taking in air, especially if you're also dealing with frequent burping. Carbonated drinks also can cause bloating because of the extra gas that you're drinking. So if you've made these changes but you're still finding that the bloating is persisting, what else could be causing it? A whole range of gut issues can cause bloating, and one of the most common actually is food sensitivities. So gluten and dairy sensitivities are two of the most common, and two that I had to eliminate in order to get rid of my bloating. So bloating is a common sign of lactose intolerance, which is incredibly common in adults, and I have it. If you've done a genetic test like ancestry.com or 23andMe and have access to your raw data, you can actually find out whether you have the gene for lactase persistence. And lactase is the enzyme that digests lactose. And so what you do is you take your raw data and you run it through a free tool called Genetic Genie. So if you don't have the lactase persistence gene, then lactose intolerance is likely one, uh, or the root cause for you. If you notice bloating after enjoying some cheese, yogurt, ice cream, you're definitely not alone. About 75% of the global population is estimated to have some degree of lactose intolerance. Thankfully, lactose and dairy-free foods are widely available, so you may not have to sacrifice at least not all of the dairy foods that you love. But do be aware that casein intolerance, which is an intolerance to the protein in dairy, is also a thing. So it's possible that you could have more than just lactose intolerance. Gluten is another common trigger of bloating and other GI issues, both for people with celiac disease as well as people with non-celiac gluten sensitivity. So signs of celiac disease include bloating and gas, abdominal pain, anemia, and diarrhea, among others. And then some people with gluten sensitivity don't have celiac disease but will have those similar symptoms. And in that case, eliminating gluten can increase your digestive comfort and help avoid bloating and gas. So if you do have a positive celiac test, it is essential to strictly eliminate all sources of gluten to avoid further damage to the intestines and dairy too for a while as the villi in your small intestine are healing. So what I would recommend is to get tested for celiac first, and then if it's negative, try going gluten-free for a few weeks and then reintroducing gluten to see if first your symptoms go away and then whether they return when you reintroduce the gluten. Even if you don't have any food intolerances, some high-fiber foods like legumes—beans, lentils, peanuts—or cruciferous vegetables like cabbage, cauliflower, and broccoli can cause uncomfortable bloating and gas for some people. So by slowly introducing nutritious and high-fiber foods like beans and lentils and then including them regularly in your diet, rather than eating a ton of beans in that occasional bowl of chili, you're less likely to experience bloating after eating them. But ideally, if you suspect a food sensitivity or have never checked for this, I recommend a basic elimination diet where you eliminate the most common problematic foods at the same time, as often your gut just needs time to heal if you do have one or more food triggers. So the foods that I would eliminate for this, you know, maybe 30-day trial would be gluten, dairy, soy, corn, highly processed foods with tons of ingredients, processed seed oils, added sugar in any form, even natural forms, artificial sweeteners except stevia, monk fruit extract, allulose, or erythritol, and then also caffeine and alcohol, or as many of those items as you can handle. I know some people can't give up caffeine. So do that for 3 to 4 weeks, and then one by one reintroduce foods a couple of times a day for 2 days, and then wait 2 more days to check her reaction before reintroducing another food. So another cause of bloating could be poor enzyme function, enzymes being the substances that help you digest food. So poor enzyme function or production can cause bloating with certain foods, even healthy ones like raw fruits and vegetables. So if you have issues with these foods or see pieces of undigested food in your stool, the General Digestive Enzyme may be helpful to take with meals, and I can link to one in the show notes. Then if fatty foods cause you bloating and discomfort and you have light-colored stool, low bile flow due to poor gallbladder function may be at work. Bile is produced by the liver and stored in the gallbladder, and the gallbladder is then responsible for secreting a bolus of bile to the digestive tract to aid in digestion of fats. And when it's not functioning properly and you eat high-fat foods, you may experience other symptoms such as nausea and gas. And there are also other conditions that can cause gallbladder dysfunction, like hypothyroidism and fibromyalgia. Other symptoms of gallbladder dysfunction include headaches, problems losing weight, pain in the feet or right shoulder, hormonal imbalances, yellowing skin, and constipation or diarrhea. Natural healing strategies can help improve gallbladder function, including starting your meals with a bitter food to stimulate bile flow, like dandelion leaves, which are free in pretty much all of our yards as long as they're pesticide-free. Other bitter greens, lemon zest, or beets. But you could take Swedish bitters before meals or consider a bitter aperitif before dinner like Campari, Aperol, Amari, Pastis, or Ouzo. Or if you've had your gallbladder removed or have been diagnosed with low bile flow, you may want to take an ox bile supplement with fatty meals. So I've linked to some good brands of these supplements in the show notes, or you can also look for them in my Fullscript dispensary if you want to compare prices. So bloating may start during a period of high stress, as eating in a sympathetic or fight-or-flight state rather than a parasympathetic or rest-and-digest state will leave food stagnating in your stomach. So if you do find yourself visibly stressed at mealtime, stopping to take 4 or 5— 5-5-7 breaths, which go 5 seconds in, hold for 5 seconds, 7 seconds exhale can help trick your body into a parasympathetic state so that you can digest better. Then using meditation, exercise, yoga, those types of things, therapy, coaching, etc., to manage your stress and try and eliminate the underlying causes of stress is a longer-term solution.

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Also, some sugar alcohols common in many sugar-free or diet-friendly sweets, such as light ice cream and sugar-free candy and gum, could also be a cause of bloating for people. So the bacteria living in your intestines do ferment sugar alcohols like xylitol, sorbitol, and mannitol quickly. They can produce large amounts of gas. So although sugar-free gum and ice cream may sound appealing, you may be causing bloating and other digestive issues by choosing these foods. Safer choices are erythritol, stevia, monk fruit extract, and allulose, although some people may have issues with nausea with erythritol. If all these solutions have been tried and failed, you may have a gut infection from an overgrowth of dysbiotic bacteria, Candida, or other fungi. Officially, this may mean a diagnosis of SIBO, or small intestine bacterial overgrowth, which is a— the root cause of most cases of IBS, or irritable bowel syndrome. Some GI doctors will test for SIBO with a hydrogen, methane, and then the newest addition, hydrogen sulfide breath test, which is taken after eating a low-fiber diet for 24 hours or after an overnight fast. I don't typically use them with clients as they're not terribly reliable and don't tell you anything about fungal overgrowth, which most GI docs don't believe in, or parasites or other potential causes of bloating. So rather, I prefer the GI MAP test or the organic acids test depending on my client's other symptoms, history of antibiotic and other medication use, and past testing. So if your GI doc does diagnose you with SIBO, you may be prescribed an antibiotic called Rifaximin or Xifaxan, which is very expensive and you're lucky if your insurance actually covers it, but it only impacts your digestive tract. That being said, I still think it's wiser to use herbal antimicrobials because they will also reduce fungal overgrowth, and just taking antibiotics can often leave you overgrown with fungi like Candida and cause more long-term issues. So digestive system Candida overgrowth, also known as SIFO, or small intestine fungal overgrowth, are one of the most common things I find in my clients and are best diagnosed using the organic acids test. Candida is a yeast that's present in all healthy people but can grow unchecked when the bacterial balance of the microbiome is off. Usually because of antibiotic usage, which may not seem heavy to you, but you know, a typical American takes antibiotics once a year, so even regular antibiotic usage. Also, it can be caused by high sugar, high carb diet. Other symptoms of Candida overgrowth include sugar cravings, brain fog, rashes, a white tongue, and vaginal yeast infections in women. So treatment for SIFO is trickier and can take longer than SIBO treatment. As it can take some time to restore the microbial balance and bring the Candida levels down. And that usually requires removing added sugar and simple carbohydrates for a while, as well as other foods associated with Candida growth, and then limiting them in the long term, of course. The primary short-term diet changes recommended for SIBO that's solely bacterial in nature is a low FODMAPs diet, which is fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. And— that's a mouthful, I know— this diet involves limiting high FODMAP foods for a period of time and then monitoring for a decrease in symptoms. So some examples of those high FODMAP foods include wheat, milk, onions, garlic, cauliflower, cabbage, artichokes, beans, apples, pears, and watermelon, but it's a way longer list than that and you can just find it by Googling it. So removing these foods will deplete the bacteria in your gut, so it's important not to do this long-term, but rather once your symptoms are gone for a couple of weeks to start reintroducing foods by groups and checking for a reaction to a given group. On a longer-term basis, you may need to limit quantities of these foods if you find yourself with recurrent SIBO, but you should still be able to eat some of them. You'll also need to determine the root cause of your SIBO, which, if it isn't from dysfunction of one of your digestive organs, as I've already discussed, or a gut infection, is likely related to issues with peristalsis or intestinal motility in the small intestine, leading to the stagnation of the food, which causes the bacteria to overgrow, much like stagnant water has bacterial overgrowth. So that can be from vagus nerve dysfunction, the vagus nerve being the nerve that controls your digestion, comes all the way down, goes all the way down and controls all your organs. And that can also stem from a stressful event or brain injury, or could be from low serotonin, which can arise from a poor diet, lack of exercise, a lack of exposure to natural light, chronic stress, or insufficient protein intake or digestion. So I know that was a lot. What else causes bloating? Well, there are a few more things. Low stomach acid levels can also be a cause of bloating. When you have insufficient stomach acid, it makes it hard to digest proteins, so proteins may not be completely broken down into amino acids. Stomach acid is also protective against pathogenic bacteria and sterilizes them, so you're going to be more susceptible to overgrowth of bacteria like E. coli that are present in SIBO and that thrive in a neutral pH environment. We tend to have decreased stomach acid as we age also, and when we're under stress. So you might try taking a small dose of betaine HCl, which is just hydrochloric acid or stomach acid, with meals. That can help not just increase your acid and help with protein digestion and sterilizing your food, but will also help stimulate bile and enzyme flow. So it's a good thing to try if you're middle-aged or older, under stress, or are experiencing these symptoms. Another sign of potentially low stomach acid is GERD or acid reflux, as the pH of the stomach regulates the opening of the lower esophageal sphincter, and an insufficiently acidic stomach environment can lead to a sphincter left open for acid to go up and cause heartburn. It can cause a warmth in your chest or a subtle cough like I used to have with what they call LPR. It's like, ah, ah, all the time. A common bacterial infection that also causes low stomach acid is H. pylori or Helicobacter pylori. It's a bacteria present in many people's gut gut microbiomes and for some people can cause inflammation, GERD, insomnia, nausea, and for some virulent strains, ulcers and stomach cancer. I've seen it in many of my clients even at levels that are not considered abnormal. I want to educate them on how to eliminate it in a safe way using Mastic Gum and not the triple antibiotic therapy as a GI doctor might prescribe. They always feel better. Taking probiotics may also be helpful with bloating as they can help restore a healthy gut microbiome. However, it can take time for the microbiome to rebalance, so be patient when starting probiotic and don't expect immediate results. One with evidence to help SIBO is Saccharomyces boulardii, which is a beneficial yeast, which I will link to in the show notes. Another home remedy to try for consistent bloating is peppermint oil, which has been shown to help IBS patients with bloating. You can take one gel cap 15 minutes before meals. It used to be helpful for me, but it does cause that sometimes lead to pepperminty kind of stomach sensation and burps, but There's worse things, like bloating. But overall, bloating is an unpleasant and very avoidable experience that I personally put up with for way too long. It's not normal to have a food baby after eating unless you just ate an entire 16-inch pizza, and it's definitely not normal to wake up bloated. I can't tell you how much better I feel and look now that I don't regularly bloat after eating. So if you find that you have consistent painful bloating and simple behavior and diet-based interventions haven't helped, or it's feeling too overwhelming to sort through everything I just said, or you've, you know, all the other potential reasons, just please set up a free 30-minute breakthrough session with me, or you can do a 1-hour consultation if you're ready just to jump to starting to solve the problem, and we can talk about the best next steps for you to solve your bloating problem. You'll see links for both in the show notes or under the video. And also, I wanted to let you know that I've begun transcribing the shows and putting it out in blog format. I'll send it out about a week after I publish the podcast, and I'll send it in a newsletter with links to that. And so if you want to get on that list, you should go visit my website, HighDesertHealthCoaching.com, and sign up for my newsletter. There'll be a pop-up box soon after arriving on the website, or you can just visit the newsletter page under the heading Podcast, Blog, and Videos. Also, if you appreciate the free information I'm giving you, there are some painless ways to support the show. First, you can buy high-quality, vetted supplements in my online Fullscript or Wellivate dispensaries. So there is a link in the show notes if you want to sign up for an account there, and you can find a lot of supplements I mentioned there, you know, supplements that have been vetted for quality and temperature control and all that. Do compare prices if you find the same supplements elsewhere. I also have an affiliate account at iHerb, which will be most of the links in the show notes. So if you buy from there and press the link or from the recommended supplements page in the show notes, I'll get a percentage. And you can also connect with me by joining my Gut Healing Facebook group if you want to ask a question about gut health or suggest a topic for our guests for the show. And you can also follow my High Desert Health page on Facebook or on Instagram, Twitter, or Pinterest. All those links are in the show notes. And if you haven't yet followed or subscribed to the show or the YouTube channel or within your podcast app, be sure you do that so you won't miss an episode. And please share it with a friend who you know has a gut health issue or in your favorite gut health Facebook group if you haven't seen it mentioned there already. Thanks for listening or watching today, and here's wishing you all the perfect stool.