Dietitian cheat sheet: feeling bloated?

Bloating is a common condition, with up to 25% of people without gut conditions complaining of abdominal bloating and up to 96% with irritable bowel syndrome. Whilst some bloating is a normal byproduct of digestion, it can become issue if it becomes frequent and uncomfortable.

Sounds like you? Don't worry, there is plenty you can do about it. Here is our Dietitian's Cheat Sheet including a few starting points for you to consider to beat the bloat.

What is bloating?

Bloating is a condition where your belly feels full and tight, often due to gas. Bloating can lead to discomfort, pain, poor body image and have a negative impact on the quality of life. The symptoms may be linked with other gas related complaints, such as burping or belching, swallowing air and flatulence.

What causes bloating?

There are several proposed explanations for bloating. Here are just some of the possible triggers and underlying causes for belly bloat:

• Too much gas in the gut

• Abnormal levels of bacteria in the small intestine (they usually reside in our large intestine!)

• Food intolerance

• Stress

• Structural issues such as lumbar lordosis

• Constipation (going to the toilet less than 3 times per week as a rule of thumb, or struggling to fully evacuate)

Okay, what can I do about my bloat?

The best thing you can do to overcome your bloat is get to the root cause of why this is happening. Carrying out a good old fashioned food and symptom diary can help you re-trace your steps and pinpoint any causes. Do this for a week or two and review it, ideally with the help of a dietitian.

Let's get into a dietitian's cheat sheet for beating bloat

Tip 1: Address your constipation

If you are going to the toilet less than three times per week, or you're struggling to open your bowels, or you feel that you are not fully completing a bowel movement - then this could be a sign that you are constipated. The great news is that there is so much you can do with diet and lifestyle to get the motion going.

Reflect on your diet now and identify what is missing from the list below, then gradually introduce more of these foods and review your symptoms in a few weeks:

• Whole-grains such as oats, wheat, rye, barley, buckwheat, bulgur wheat and otherwise can help to reduce the time it takes for bowel movements to occur

• Don't go too low fat. Fat can help to stimulate muscle contraction of the bowel. Keep a moderate intake of fat overall from sources such as avocado, nut butter, nuts, yoghurt and extra virgin olive oil

• Eat regular meals to help stimulate regular bowel muscle movement

• Hydrate! Fluids help to push food along the bowel. Everyones needs will be different but aim for around 1.5-2.5L per day as a rule of thumb

• Be patient. Are you always in a rush in the morning? Try setting aside an extra 10-15 minutes to relax with a drink and let your bowel do its thing.

Tip 2: Soothe your gut-brain axis

Scientists have known for years about the gut-brain axis. This is the two-way communication between the central nervous system (CNS) and the enteric nervous system (ENS). Essentially, the gut-brain axis links the emotional and cognitive centers of the brain with intestinal functions. One example of this communication is when we have "a gut feeling" or "butterflies in our stomach".

Changes in this communication between the gut, brain and gut microbiota may lead to the development of gut symptoms (such as bloat) and disorders (such as IBS). Such changes can occur when we are stressed, due to the dialling up of the "fight or flight" part of our nervous system that puts our "rest and digest" on hold.

Think about it: if you are being chased by a tiger, the last thing your body needs to do is perfectly digest that burger from lunch time, instead it needs an increase in blood flow to your other muscles.

Here is what you can do about it:

• Meditation

• Yoga

• Breathing exercises

• Making time for yourself to do the things that you enjoy and keep your mind happy. Movement you enjoy, have a bath, schedule a coffee date - whatever makes you tick. Do this regularly.

• If you have IBS you could also consider gut-directed hypnotherapy

Tip 3: peppermint oil capsules

Peppermint oil is a type of medicine called an antispasmodic. It helps relieve bloating. It works by helping the muscle of the bowel wall to relax. These can be bought in capsule form from various different health food shops or online.

Here's how to take:

• The usual dose of peppermint oil is 1 or 2 capsules, taken 3 times a day. It’s best to take it around 1 hour before meals.

• Wait at least 2 hours between taking a dose of peppermint oil and taking an indigestion medicine. This allows the peppermint oil capsules to work properly.

• It will start to work within a few hours but it could take up to 1 to 2 weeks to take full effect. Keep taking peppermint oil until your symptoms improve.

• Common side effects include heartburn and indigestion.

• If you've bought peppermint oil from a pharmacy or shop, do not take it for longer than 2 weeks without checking with a doctor.

There are a number of people that shouldn't take peppermint oil capsules or should speak to their doctor first, for example:

• have ever had an allergic reaction to peppermint oil or any other medicine

• have liver disease or gall stones

• weigh less than 40kg (around 6st 5lbs) or are losing weight

• are allergic to peanuts (some brands contain arachis oil, so it would be best to avoid those brands)

• are 40 or over and have IBS, but have not had an attack for a while

• have noticed that the symptoms you were taking peppermint oil for have changed

• have noticed blood when you poo

• have suffered abnormal vaginal bleeding or discharge

• difficulty or pain when peeing

• feel sick (nausea) or are being sick (vomiting)

• look paler than your usual skin tone, and feel tired

• recently had a high temperature

• are pregnant, or think you may be pregnant

• have digestive problems such as reflux disease, severe constipationor ulcerative colitis

Summary

Hopefully this has given you some food for thought and will help you make meaningful steps to improve your bloat and health. If you are still struggling, there are plenty of other things that can be explored.

Feel free to get in touch with us at The Dietitian Method for a bespoke assessment plan to help you get back into the drivers seat of your gut function. Of course, if you are struggling with severe symptoms then you should always speak to your doctor or GP for further investigations.

Good luck!

J