Why am I always so bloated?
Gut health is at the core of our overall health, it plays a role in every other system in our body. Your gut greatly influences your mental, immune, skin, genitourinary and cardiovascular health. It’s the basis of our absorption and our elimination. Nutrient absorption and toxic/waste elimination rely on the health and proper functioning of the gastrointestinal tract (GIT).
If your gut isn’t functioning properly then this can lead to deficiencies in many nutrients such as vitamins and minerals, it can reduce proper elimination causing build up of chemicals, waste and can trigger inflammatory processes.
Let’s talk specifically about bloating though. Bloating is an extremely common symptom. Unfortunately, it’s not usually obvious what the cause is, but the good news is that there are ways to investigate the problem! Bloating is most often caused by processes in the GIT not functioning properly, but can be caused by hormones and other structures as well. The GIT involves everything that digests your food from your mouth to your bum. That includes the mouth, esophagus, stomach, liver, gallbladder, pancreas, small and large intestine and the rectum. Each has their own functions and they all work in tandem together to keep things running smoothly. As I don’t want to bore you with all of the details of what occurs in each when you eat food or while you fast, I’ll skip to the (very) simplified functional aspect of the gut.
The basic movement of food through the digestive tract goes from mouth (including the teeth & tongue) —> esophagus —> stomach —> small intestine —> large intestine —> rectum. The accessory organs which include the salivary glands, liver, gallbladder and pancreas do not come into direct contact with food, but they play important roles in digestion.
Major Functions of the GIT include:
Propulsion = moves food down the gastrointestinal tract
Digestion = both mechanical and chemical digestion
Mechanical: mix food and secretions and increase the surface area of the food allow optimal chemical digestion.
Chemical: mostly involves enzymes that break down food & improve solubility for easier absorption.
Absorption = absorb nutrients & fluid from the mucosa into the blood.
Other = processes that include hormones, immune function and impact fluid balance in the body.
Bloating can occur due to any one of these processes improperly functioning. Propulsion can be slow, gut motility can be impaired. If the gut motility is slowed or impaired, this can cause distention in the abdomen as food gets a bit “stuck.” This can occur often in small intestinal bacterial overgrowth (SIBO) or dysbiosis. Gut motility can be inappropriately quick as well which occurs with diarrhea caused by inflammatory bowel disease (Crohn’s disease, colitis, celiac disease). If motility is too quick, food doesn’t have a proper chance to absorb fully and this can cause bloating as well.
If mechanical or chemical digestion is impaired in any way then bloating can occur. When the proper enzymes aren’t released into the GIT to break down food fully then this makes it more difficult to digest further down the line. This occurs most notably in the stomach, if the stomach doesn’t get the proper enzymes or release enough acid then the small intestine has to work much harder to break down the food than it should. This can be caused by hypochlorhydria (low stomach acid), gallbladder or pancreatic dysfunction or insufficiency or even just simply eating/chewing too quickly.
Inadequate absorption is a significant contributor to GIT issues and bloating. If you aren’t able to absorb the proper nutrients or amount of fluid, then bloating can be a big problem. Inadequate absorption occurs in food sensitivities, IBD, celiac disease, H. pylori or parasitic infections, SIBO, dysbiosis, and gastric or peptic ulcers to name a few.
On top of all the functions in the gut that can go wrong, bloating can also be caused by other things such as hormones, inflammation and conditions involving the genitourinary system. Some conditions involving the uterus or ovaries include endometriosis, endometritis, uterine fibroids, ovarian cysts or pregnancy. The urinary system including the kidneys, ureter and bladder can also contribute to abdominal distention. Some examples include interstitial cystitis, urinary tract infections and kidney stones.
As you can see, there are many different functions and structures in the GIT (and other systems) that can lead to bloating and other digestive concerns. Not to mention that this was a brief summary that does not encompass all underlying causes. This is why it is so important to properly diagnose the cause (or causes) and directly treat those. Otherwise, you may just be guessing and taking a gamble, while you allow another issue to go untreated. Sometimes some trial and error is necessary as diagnosis isn’t always straight forward, but getting a naturopathic doctor on your health care team can be a major asset when it comes to digestive concerns. Testing for these conditions can include serum (blood), stool, breath and/or urine testing and treatment options vary greatly depending on the cause.
Simple things that you can try to help reduce bloating on your own while you wait for proper diagnosis and treatment include:
Cook at home and allow yourself to relax before eating your meals. Digestion starts before food enters our mouth. The smell, sight and small bites of our food beforehand get our salivary glands and our enzymes ready for food.
Calm yourself down and relax before a meal. Relaxation is key for proper digestion as well - we must get into our nervous system’s parasympathetic state, also known as “rest & digest.” You can facilitate this by taking deep breaths before a meal and forgetting about the stressful things that happened during your day.
Light movement can be helpful before or after meals. Stretching, walking and deep breathing can help gently facilitate proper movement in our digestive organs. Avoid strenuous exercise right before or right after a meal as this will put you into a sympathetic (“fight or flight”) state and make it more difficult for you to absorb and digest your food.
Avoid eating foods that you know cause you pain, bloating or indigestion. The food may taste amazing, but trust me, it’s not worth it and there’s probably a delicious alternative out there!
**Disclaimer: this information is intended for educational purposes only. This is not medical advice, always consult a licensed naturopathic physician or other health care practitioner before starting any treatments.