Feel Bloated? It Could Be Your Diet

N E W   Y O R K, Feb. 12, 2002 -- Some days your favorite pants button without a struggle, while other days it's a battle — yet the scale hasn't moved. What gives?

You may think you simply ate too much for lunch and dismiss it. But abdominal bloating, whether it's painful or just uncomfortable, is an everyday problem for some people.

Eva Bowen suffered with daily bloating for decades before getting relief. "I would eat lunch and I would have to unzip my clothing,and put a sweater over me, and would feel so uncomfortable and bloated," Bowen said on Good Morning America.

Dr. Leo Galland, Bowen's doctor and the director for the Foundation of Integrated Medicine, told Good Morning America that in Bowen's case diet changes worked to treat her bloating. After diagnosing her with carbohydrate-related bloating, he told her to cut starch, wheat, soda and other types of food and drinks from her diet.

"You need food, and the foods that are less likely to cause symptoms if you have carbo bloating are fish, meat, poultry, eggsand non-gassy vegetables — but it's an individual thing," he said.

Bowen's bloating has decreased since she started eating more non-bloating foods.

Who's Bloated?

Bloating affects both men and women, but seems to affect women more. In some cases, the cause can be a lot more serious than gas. People with late-stage ovarian cancer, severe liver or kidney disease may experience abdominal swelling that is persistent. Anytime that abdominal bloating is accompanied by severe pain, fever, the inability to pass gas, diarrhea or blood in the bowel movements it can be a sign of intestinal obstruction or inflammation.

Simple abdominal bloating doesn't usually get much attention from doctors since it is not a life-threatening disease, even though it can cause a great deal of misery in otherwise healthy people. It is associated with discomfort, mild constipation or diarrhea, burping, fatigue, or feelings of general un-wellness or just social embarrassment, Galland says.

There are four major causes, Galland says:

Intestinal Infection: The person could have an intestinal infection, brought on by a parasite like Giardia lamblia, which is commonly found in contaminated drinking water, and occasionally found in food. This often occurs in people who develop sudden bloating, along with a degree of constipation or diarrhea after a trip. Diagnosis requires a stool test at a lab experienced in testing for parasites or in tropical medicine.

Gut Fermentation Syndrome: A disruption of the bacteria in the intestinal tract. The stomach normally has very few bacteria present — just yeast and acidophilus — but as you travel down the small intestine, which is 25 feet long, the concentration and the types of bacteria increase. The large intestine, which is five feet long and much wider than the small intestine, is filled with bacteria. All of the bacteria are kept in balance by the different types keeping each other in check, and the motility of the intestines, which keeps the contents flowing to the rectum.

Antibiotics can disrupt the bacteria by killing some species and allowing others — yeast in particular — to flourish. Acid-lowering drugs like Prevacid and Prilosec can also make the stomach less acidic and stimulate the growth of yeast.

The bacteria and yeast ferment sugar or starch that is eaten, producing gas. Many people with this condition feel worse when they try to eat more healthfully by having a lot of starchy, high-fiber carbohydrates and reducing fat in their diets. One example of gut fermentation is lactose intolerance, when a person lacks the enzyme needed to digest lactose. The lactose in milk, ice cream or even yogurt is fermented by intestinal bacteria, which leads to bloating, gas, pain or diarrhea.

Most doctors will not diagnose gut fermentation syndrome, but you can test it on your own by eliminating certain foods from your diet and seeing how your body reacts. Gut fermentation syndrome occurs when the fermentation produces so much gas that there is discomfort. Try eating a diet that is free of lactose, wheat and other starchy foods like corn, rice, oats, potatoes and beans and sugar for about a week. Instead, eat poultry, fish, meat, eggs, cheese and vegetables.

To prevent constipation, eat a lot of vegetables and have some fruit, about two pieces a day. If your bloating improves, start adding back foods to see what you can tolerate. Over-the-counter products like Pepto-Bismol, raw garlic capsules or oregano oil capsules kill bacteria and yeasts and may diminish gut fermentation. Using a Lactobacillus preparation, also called acidophilus, may help by building up some of the healthier bacteria.

Food Allergy: A food allergy or "specific food intolerance." Some people get bloating, usually with other intestinal symptoms, or symptoms suggestive of allergy when they have specific foods.

Intestinal Motility Disorder, a form of Irritable Bowel Syndrome. Disturbed motility in the intestines, often related to stress or genetic factors, can cause bloating as a direct symptom. Disturbed motility can also cause an imbalance of bacteria and lead to gut fermentation syndrome. If your main problem is just a motility disorder, you may be helped by eating more fiber because high-fiber foods (like bran) stimulate healthy intestinal motility; herbs like peppermint may also help (peppermint tea). If you get worse with a high-fiber diet, then, even if you have an underlying motility disorder, gut fermentation has probably developed as a result of it.