Why am I BLOATED?!

After writing my blog on how I cured my chronic bloating I received a ton of questions and stories from girls experiencing similar pain and discomfort so in this blog I will answer all the questions they have sent to me, AS WELL as what I've learned about the possible causes of intestinal gas (which is probably the reason why your belly swells up like you're 6 months pregnant).


So let's dive right into it!


What is boating?

Abdominal bloating occurs when the gastrointestinal (GI) tract is filled with air or gas. Most people describe the feeling of being bloating as feeling full, tight, or swollen in the abdomen.


How to know if you are bloated?

Your abdomen may look be swollen (distended), feel hard and painful.

You may experience cramps, stinging pain, obstipation (constipation), diarrhoea, heartburn, nausea, or fever (when the bloating is caused by an infection).




What are the most common causes of bloating?

I will divide this answer into 7 categories, listed in a random order.


1. Mal digestion

  • Indigestion: A functional disease in which the gastrointestinal (GI) organs, primarily the stomach and first part of the small intestine function abnormally and produce a lot of gas that increases the size of your intestines and abdomen.


  • Dysbiosis: a term for a microbial imbalance, making it impossible to digest and process the food properly and absorb nutritions.


  • Low stomach acid (very common cause of heartburn) this means that your stomach isn't acidic enough to digest your food properly.


  • Pancreatic insufficiency: impaired digestion because the pancreas cannot produce enough digestive enzymes. People with EPI cannot properly digest the food they eat. Mal digestion due to EPI can lead to gas, bloating and stomach pain.


This is linked to stress and the use of birth control.


2. Birth control (hormonal + copper IUD)

When it comes to birth control, every body reacts differently. Some of your friends might feel completely fine, you might unknowingly suffer from the side effects. (click here for more info on birth control).


  • That nagging bloated feeling or persistent gas you’re feeling? It’s not necessarily a symptom of your period or even a side effect of birth control. It could be a red flag that your contraceptive is throwing your gut out of whack and in the process disrupting your overall wellness.


  • You have hormone receptors everywhere in your digestive tract and the added hormones in your body from the pill can affect those receptors. This causes all sorts of pain and discomfort, such as: irritable bowel syndrome, gas, bloating and constipation. These can all be signs of 'dysbiosis' or a microbial imbalance within the digestive tract. So are acne and eczema.


  • For women who take birth control for more than five years, there is a three-fold increased risk of Crohn’s disease (see point 6).


  • Bloating is often times linked to the use of birth control because it causes your cortisol levels to become chronically high. Causing your body to constantly be in the fight/flight mode and therefore, causing mal digestion and intestinal gas (see point 4).


  • Women taking 'the pill' are 37.5% more likely than other women to suffer from low-grade inflammation, according to a study in PLoSONE. (see point 3).


bloated stress women stomach bloating

3. Infection

Stomach infections can cause gas, which may cause bloating or other symptoms.


  • These are often due to bacteria such as Escherichia coli or Helicobacter pylori or even a viral infection such as Norovirus or Rotavirus.


  • Stomach infections usually go away on their own after a few days. However, can lasts for years when the cause isn't being treated.


  • Intestinal parasites produce a variety of symptoms in those affected. Most of which manifest themselves in gastrointestinal complications such as inflammation of the small and/or large intestine which can lead to bloating.


This is linked to bacteria, parasites, birth control, stress and nutrition.


4. Stress

To keep it short our body has two states:

Homeostasis: rest, digest and maintain body systems.

Allostasis: act, fight/flight and altering physiologic parameters to counteract challenges.


Cortisol is a hormone our body processes when we are stressed. This hormone causes your body to go from homeostasis to allostasis, meaning that the blood flow shifts from your digestive organs to your muscles. When you eat when you have high cortisol levels your body isn't able to digest the food properly which on can cause bloating.


This is linked to lifestyle, trauma, nutrition and birth control.


5. Food intolerances


There is a difference between an intolerance and an allergy. An allergy is something that is genetic and can be tested easily, whereas an intolerance is temporary (however can be chronic) which makes it a lot harder to test.


Therefore, it is up to you to find out what food (groups) cause intestinal gas and which don't.


Having had your allergies tested doesn't mean you don't temporarily suffer from intolerances. The symptoms of an intolerance are similar to those of an allergy.


Very common foods people have intolerances to:

  1. Dairy. Lactose is a sugar found in milk and dairy products.

  2. Gluten. The general name given to proteins found in wheat, barley, rye and triticale.

  3. Caffeine .

  4. Salicylates. Can be found in fruit, vegetables, nuts, seeds, herbs, spices and honey.

  5. Amines. Can be found in fermented foods, cured meats, dried fruits, citrus fruits, avocados, aged cheeses, smoked fish, vinegar, soured foods like buttermilk, fermented alcoholic beverages like beer and wine.

  6. FODMAPs. Short-chain carbohydrates found naturally in many foods such as apples, cauliflower, beer, wheat, dairy products and honey.

  7. Eggs and fish.

  8. Fructose. Found in fruit and fruit based products.



bloated why women stomach bloating

6. Medical condition


  • Pathologic fluid accumulation in the abdominal cavity (ascites) as a result of cancer (e.g. ovarian cancer), liver disease, kidney failure or congestive heart failure.

  • Celiac disease or gluten intolerance.

  • Pancreatic insufficiency which is impaired digestion because the pancreas cannot produce enough digestive enzymes.

  • Perforation of the GI tract with escape of gas, normal GI tract bacteria and other contents into the abdominal cavity.

  • Intestinal disorders, for example, IBS (irritable bowel syndrome), IBD(inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis) and SIBO (small intestinal bacterial overgrowth).

  • Indigestion (chronic mal digestion).

  • Low stomach acid (often causes heartburn or a feeling of acid in your esophagus after eating.

  • Parasite. Intestinal parasites produce a variety of symptoms in those affected. Most of which manifest themselves in gastrointestinal complications and general weakness. Gastrointestinal conditions include inflammation of the small and/or large intestine, diarrhea/dysentery, abdominal pains, and nausea/vomiting.


7. You're (almost) on your period.


Normal periods:

Changes in progesterone and oestrogen levels cause the body to retain more water and salt. The body's cells become swollen with water causing the feeling of bloating.


In combination to that progesterone decreases muscle strength and the muscles that help digest your food are weaker. Meaning that digestion goes slower and some foods can't be digested at all.


So now you know: you're bloated on your period due to a mix of excess water and full bowels.



bloated endometriosis women period bloating

Endometriosis:

An often painful disorder in which tissue similar to the tissue that forms the lining of your uterus grows outside of your uterine cavity.


There are several reasons why endometriosis may cause abdominal bloating:

  • Buildup of endometrial-like tissue can cause inflammation in the abdomen. This can result in swelling, water retention and bloating.

  • The endometrial-like tissue can cover or grow into the ovaries. When this happens, trapped blood can form cysts which may cause bloating.

  • Those with endometriosis are more prone to small intestinal bacterial overgrowth (SIBO) and fibroids which may also lead to bloating.

  • Endometriosis often causes issues with digestion such as constipation and gas.


8. Eating/ drinking too much too fast

I know every site says this as the number one reason and if you're like me you'll probably thinking: " why are they even going into this?"

Well, because this is probably a part of the solution.

I don't think this is the main cause of your bloating because, if you eat too much food too fast: you'll know.


However, I assume that it's in combination with one of the causes mentioned above.

No matter what the cause is, your body isn't digesting the food properly and that causes bloating.


Meaning that there's something not 100% functioning in your digestive organs. So why not help yourself a little by starting the process of digestion in your mouth?


Your month contains essential enzymes to get the digestion process started. In order to give the enzymes the time and opportunity to get to the food, you need to chew properly.


By 'properly' I means more frequent and slower then you do now.

I'm not telling you to chew every bite 150 times because ain't nobody got time for that.

However, chew your food into really fine bits (fine enough to get it down your esophagus doesn't count) before you swallow.


Advice to follow

Talk to your doctor or another health care professional you trust, if lifestyle changes and dietary interventions don’t relieve your abdominal bloating. If your doctor finds a medical cause for your bloating, they may recommend medical treatments. Always listen to your body when it comes to finding a treatment that suits you.


 

Resources used

Crohn's & Colitis Foundation. "Inflammatory Bowel Disease and Irritable Bowel Syndrome Similarities and Differences." July 2014.

<http://www.crohnscolitisfoundation.org/assets/pdfs/ibd-and-irritable-bowel.pdf>.


Abraczinskas, D., et al. "Intestinal gas and bloating." Sept. 12, 2018. <https://www.uptodate.com/contents/intestinal-gas-and-bloating?source=search_result&search=bloating&selectedTitle=1~150>.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166604/


International Foundation for Functional and Gastrointestinal Disorders. "Understanding Bloating and Distension." Sept. 6, 2015. <https://www.iffgd.org/symptoms-causes/bloating-and-distension.html>.


NIH; National Center for Complementary and Integrative Health. "Probiotics: In Depth." October 2017. <https://nccih.nih.gov/health/probiotics/introduction.htm> .


https://www.healthline.com/health/abdominal-bloating


https://www.health.harvard.edu/newsletter_article/stress-and-the-sensitive-gut


 

Written by Evi Maalcke

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