Bloating is quite possibly one of the most annoying digestive symptoms one can experience. Not only is it uncomfortable, it is unsightly and embarrassing. But more importantly, it is a major sign that there is something wrong with the digestive tract. No amount of bloating is considered normal! 

Bloating seems to come in two different forms. The first is your classic “I look like I’m pregnant”, style and the other is “I look fatter for no apparent reason”. Differentiating between types of bloating can help determine what is causing it.

The “pregnant bloat” or what I call “gas bloat”, is normally caused by the fast creation of gas in the intestines. If you tap on your belly, it has a hollow resonance. You may have flatulence or burping later as that gas makes its way out of the intestines. Much of this gas will also be absorbed into the bloodstream and exhaled through the lungs.

To accelerate this gas diffusion process, naturopathic doctors (and wise grandmothers) recommend carminative herbs. Carminative herbs tend to be fragrant because they are high in volatile oils, and include peppermint, fennel, cardamom, caraway, chamomile, and lemon balm. Many of these accelerate gastric emptying and bowel motility, as well as relieve crampy bowels. Fortunately, most carminative herbs are tasty and make wonderful teas. 

For the “fat in the middle” bloat, there is less air involved but often more inflammation. Inflammation is an immune process, and when the immune system rushes into an area, a lot of fluid comes with it. In our joints and extremities this is recognized as swelling, but in the intestines we call it bloating. 

To help relieve this style of bloating, we can still use carminative herbs, but it may also benefit from soothing herbs like licorice, and anti-inflammatories like turmeric, greens, and digestive rest (fasting).

These things can help relieve occasional bloating, they are merely palliative. The challenge is to get the bloating to go away and never come back. To do this, you must understand all the things that cause bloating, and then address these underlying causes.

The first common cause of bloating is insufficient digestive enzymes. We need enzymes to break down the carbohydrates we eat. If they are not properly digested, the carbohydrates feed bacteria, who then make tons of gas as they process the sugars. This style of bloating tends to get worse as the day wears on, and resolves overnight.

Carbohydrates may also feed yeast, which is another cause of bloating. Yeast overgrowth may present with some combination of bloating, constipation (usually), sugar cravings, brain fog, anxiety, waking with a coating on the tongue, and yeast overgrowth in other places, like athlete’s foot or vaginal yeast infections.

Unfortunately, yeast is not the only way that the microbiome, the bacteria that live in your intestines, can be imbalanced. There may also be bad flora residing in your intestines that cause bloating. Klebsiella and citrobacter are two species that can be dysbiotic causes of bloating and inflammation. Lack of good flora is also correlated with bloating, with lactobacillus, streptococcus, and bifidobacterium strains all seen in the research to decrease bloating. Microbiome related bloating tends to feel very random, with a few good days followed by a few bad days. 

Bloating may also happen in the presence of a good microbiome if you are eating foods that you are sensitive to, even perfectly healthy foods like almonds, coconut, or broccoli, are unhealthy if you have a sensitivity to them. Sensitivity means that every time you eat that food your immune system goes after it. This can be a huge source of inflammation and subsequent bloating. This presents very differently from person to person, it may be headaches, fatigue, joint pain, gut pain, high blood pressure, and more.

Some individuals have a good microbiome but it migrates from the colon into the small intestine where it gets early access to sugars before they have been fully digested. This is called small intestine bacterial overgrowth, or SIBO. SIBO is a huge cause of bloating, and it is at its heart a motility issue. It often presents with bloating, cramping, and constipation or diarrhea. It will seem like the person has food allergies, but really it is the carbohydrate types in the food that are the issue, not an immune response.

With all the different causes of bloating, no wonder it is so hard to resolve! The most certain way to figure out bloating is to test for food allergies and sensitivities and to do a comprehensive stool analysis to evaluate all of these causes. Because often, it’s not just one thing, but 2 or 3 that are an issue. For instance, it is very common to have low digestive enzymes and food sensitivities along with some dysbiosis.