If you have bloating, you’ve probably looked up what causes bloating and eliminated certain foods from your diet. You may have even tried supplements or remedies that relieve bloating fast. While some of these strategies may have reduced your pain and discomfort, they don’t explain why your problem even started. Why can’t you tolerate certain foods while your friend or spouse can? Is it possible to get rid of bloating and not worry about it ever again? In this post, I answer these questions and address the 4 underlying root causes of bloating and what you can do about them.
If you haven’t seen it already, in episode 22 of the Thank Gut It’s Fixed Show, I talked about the low FODMAPs diet, a popular diet to relieve bloating and IBS. It eliminates certain foods that contain easily fermented fibers like garlic, onion, apples, among many others vegetables and fruit. If you followed a low FODMAPs plan or any other elimination plan, you might wonder what the next step would be. Are you meant to follow the FODMAPs or any other diet forever?
The answer is NO. You’re not supposed to eliminate high FODMAPs foods for the rest of your life! You’ll miss out on several nutrients, especially good prebiotic fiber that nourishes your gut flora! But if you want to enjoy these foods again, you have to peel the layers and understand why your body stopped tolerating them. You have to uncover what causes bloating for you and fix the underlying problem first.
If all you’re looking for is a quick fix, a medication, or a pill to relieve bloating, this isn’t the video or article for you. But if you want get to the root of the problem, understand why your gut stopped working (or never did), and what you can do to get long-term results, watch the video or keep reading. You may discover that the underlying root causes are more serious than just not digesting some foods. Bloating can be a sign of something more serious. If you don’t address it, your overall health, immunity, hormones, skin, weight, and mental health may suffer.
What Causes Bloating?
The underlying causes of bloating or IBS can fit into 4 categories; problems with digestion, disruptions with gut motility, dysbiosis, and immune reactions. Watch the video and read the article for more details.
Problem 1: Reduced Digestive Enzymes
Several organs in your digestive system secrete enzymes and compounds that boost enzyme function. The stomach produces hydrochloric acid (HCL) and pepsin, the pancreas produces protease, amylase, and lipase, the liver makes bile salts that get stored in the gallbladder, and the small intestine produces brush border enzymes like lactase, maltase, peptidases, and others. The digestion process is quite intricate and more complicated!
Reduction in digestive enzymes will cause bloating and other digestive problems like stomach pain, diarrhea, or constipation. As we age, the stomach, pancreas, and other cells produce less enzymes. Acid blocking medications, especially Proton Pump Inhibitors (PPIs), block the production of HCL, which is absolutely needed to activate pepsin, the enzyme that starts protein digestion in the stomach. Certain pathogenic bacteria also reduce the production of HCL in the stomach. Gallbladder removal interferes with proper fat absorption and can lead to diarrhea, as well as bloating.
If the gut is inflamed–as a result of dysbiosis or lack of antioxidants, short chain fatty acids (SCFA), or fiber–the cells that line the intestine won’t produce enough enzymes. And that creates a vicious cycle. When you don’t have enough enzymes to digest your food, your gut microbes will go out of balance! Bacteria and other pathogens will ferment your food and produce hydrogen, methane and other gases. These gases, when trapped in the gut, will cause bloating, in addition to stomach pain, cramping, and sometimes even diarrhea and/or constipation. Adding the right mix of digestive enzymes will allow your body to breakdown the food and absorb it before the microbes in your gut beat you to it.
Problem 2: Gut Motility Disruptions
How does food travel through the digestive system? Your digestive tract is made of smooth muscle cells that contract involuntarily in a wave-like motion to move food downstream. This motion is called peristalsis, and it’s turned on and off by hormones and signals from the central nervous system.
When peristalsis is not working properly, it takes a long time for food to pass through your digestive tract. That means more time for gut microbes to ferment the food and produce those gases that lead to bloating. If you also suffer from constipation, it’s very possible that what causes bloating is related to slow gut motility.
There are several things that disrupt digestion motility. With chronic stress, your nervous system will favor a constant “fight or flight” state that stops the muscle contractions in the gut. The vagus nerve connects your brain to your gut, and it times of stress, it sends signals to shut down digestion to preserve energy and survive the critical situation. It even shuts down enzyme production. In occasional acute stress, that reaction is protective. However, in chronic stress, your digestion never gets to catch up. Chronic stress can be related to your work, finances, or relationships. It can also be physiologic stress like chronic infections, dysbiosis, immune reactions (allergies, sensitivities, or autoimmune conditions), or increased chemical toxic load. High blood sugar, in the case of diabetes and prediabetes, will also interfere with the nervous system signal.
Another gut motility problem involves different muscle contractions called migrating motor complex (MMC). While peristalsis pushes food downstream to be digested and absorbed, the MMC works after you finish eating. It pushes undigested food particles, bacteria, and any waste downstream to clean up the gut. The MMC needs about 3 hours to fully sweep the stomach and the small intestine, and eating interrupts this cleaning wave and forces it to start again from the beginning. When the MMC is not cleaning up properly, gut inflammation and dysbiosis are likely to happen. That’s one of the reasons I don’t recommend constant grazing throughout the day.
Gastroenteritis, or having the stomach flu, increases the risk for gut motility problems. Some bacteria, viruses, and parasites that cause the stomach flu produce a toxin called cytolethal distending toxin (CDT). This toxin destroys the cells that act as a pacemaker for the MMC. Did your bloating and stomach problems start after a stomach flu or food poisoning incident? That’s a red flag and a warning sign that you may have an underlying infection and gut motility issue. Slow thyroid function, or hypothyroidism, is associated with bloating, stomach pain, and constipation.
Low thyroid hormone level, specifically low free T3, will slow down every cell in your body, including your intestinal muscles. I talked about the link between the thyroid and bloating in episode 8 of Thank Gut It’s Fixed show. How can you fix gut motility issues? First, you have to address the underlying root cause. If you have dysbiosis or SIBO, which I will talk about next, you must eradicate it while you also support proper gut motility. You have to follow a comprehensive plan to get completely get rid of bloating! Digestive bitters, ginger, lemon, and peppermint promote digestion and muscle contractions. I use a specific supplement product that stimulates gut motility with my patients. There are also prescription medications that serve the same purpose.
Want individual help? Read more about my comprehensive and custom gut healing program.
Problem 3: Dysbiosis (Bacterial and Other Pathogenic Imbalances)
Dysbiosis means having the wrong balance of microbes in your gut. Dysbiosis typically involves an overgrowth of pathogenic bacteria, yeast, parasite, mold, or a combination of all. It also involved inadequate levels of good healthy bacteria to fight the bad ones.
While there are many pathogen that could invade the gut, they can be grouped into these 3 categories. Each one requires an article or episode on its own, but here are some quick key points.
- H Pylori: it’s a common bacteria that grows in the stomach when there isn’t enough stomach acidity. Symptoms include bloating in additional to stomach pain, ulcers, and heartburn. Taking acid blocking medications and antacids increases the risk for H Pylori infection.
- SIBO: I take in depth about SIBO in episode 16. When bacteria migrates from the large intestine and overpopulate the small intestine, they will ferment your food before your enzymes get to to digest and absorb it. Bloating is one of the red flags for SIBO.
- Other gut infections: the intestine can suffer from pathogenic infections of bacteria (like E.coli or clostridia), parasites (like giardia) viruses, or yeast (like candida). These infections inflame the gut and interfere with proper digestion and motility. They feed on your food and produce gases that lead to bloating. They also produce waste and toxins as they metabolize nutrients and populate in your gut, and this could show up as stomach pain and bloating, as well as skin issues, brain fog, depression, anxiety, sugar cravings, headaches, or others.
How do you know if you have a gut infection? Testing is key. If your doctor doesn’t do the appropriate tests to properly diagnose and address the root cause of your symptoms, they’re not doing their job. Not all blood or stool tests are equal. A colonoscopy, endoscopy, CT-scan, or ultrasound won’t detect pathogens. Traditional stool tests are likely to show a false negative (results show no growth when in fact there is). Only when you have the right tests ordered is when you’re able to create a lasting solution for your bloating and other digestive symptoms.
Problem 4: Immune System Overactivity
All the above problems create the perfect storm to develop leaky gut syndrome, or intestinal permeability. When your food isn’t digested properly and your gut is leaky, undigested food particles pass through the gut lining and activate the immune system. Immune cells stop recognizing food as safe and start to attack it, creating more inflammation and a source of chronic physiologic stress. What causes bloating for you may be food sensitivities! You may also experience stomach pain, heartburn. diarrhea, constipation, and even symptoms outside of your gut like eczema, psoriasis, brain fog, muscle and joint pain, headaches, anxiety, and others.
If you can’t tolerate certain foods because your gut is leaky, you must ask yourself this important question. What else may be passing through the gut barrier and activating your immune cells? What is the long-term effect of that? Studies found that pathogens in the gut can pass through the intestinal lining and switch turn on the genes for autoimmune diseases. People with autoimmune conditions often have digestive complaints. And in my practice, when my patients fix their gut, their autoimmune symptoms improve. They are able to put their autoimmune condition in remission. Some patients with Crohn’s diseases were able to completely avoid harsh immune-suppressing medications because they focused on healing the gut in a comprehensive step-by-step approach.
It’s always better to prevent an autoimmune disease. Since 70% of immune cells are in the gut, your digestive symptoms are the warning signs that something serious is on the horizon. Once you have an autoimmune disease, such as Hashimoto’s, Crohn’s disease, psoriasis, celiac disease, rheumatoid arthritis, lupus, or one of the many others, you will always have it. If you have a family history of autoimmune conditions, you may be genetically predisposed to developing one. If the elements of the storm combine, such as high-sugar low-fiber diet, gluten, stress, lack of sleep, infections or food poisoning, the switch for that gene will turn on.
How do you know that you have immune system problems? Testing for food sensitivities, leaky gut markers, and intestinal dysbiosis will first help diagnose and then outline a clear treatment path. You will need to select foods that don’t trigger sensitivities so you can calm down your immune system. You will need to eradicate any underlying infections. And you will need to support the lining of the intestine so it can rebuild and heal with the use of certain vitamins, minerals, amino acids, and antioxidants. It’s important for the gut healing process to be complete and done in the right order so that you can eliminate bloating and other stomach issues, as well as prevent serious immune conditions from developing.
What Causes Bloating: Take Home Message
As you can see, bloating can be just the tip of the iceberg. There are many imbalances and disruptions that could be happening beneath the surface. If left ignored, they may lead to more serious and more painful complications. I hope this video and this post gave you insights that you may have not considered before. From what my patients tell me, this kind of in depth analysis of a simple symptom such as bloating or IBS is never done by their doctors.
If you still don’t know what causes bloating for you, and you have no answers or a convincing treatment plan from your doctor, reach out and book a free call to see if my gut healing program is the right fit for you.