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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 are just a few things you can think about to get on top of your bloating.


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!)

  • Imbalance of microbes in the large intestine as a result of a poor diet, stress, antibiotics and more.

  • Food intolerance

  • Stress on the gut-brain axis (sometimes called the microbiota-gut-brain axis)

  • Structural issues such as lumbar lordosis

  • Constipation (going to the toilet less than 3 times per week as a rule of thumb)


Okay, so 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.

Now let's get into the tips to help you overcome 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: improve possible dysbiosis


Dysbiosis is often defined as an “imbalance” in the gut microbial community that is associated with various diseases such as obesity, diabetes and much more. Dysbiosis may also be the underlying cause to your bloat.


Here are some things you can do about it:

  • Gradually work up to 30 different plants per week. This has been shown to improve the diversity of different bacteria we have in our gut, which in turn helps to up skill our bacteria and improve our gut function and health in return. When I say plants I am referring to fruits, veg, whole grains, herbs, spices, legumes, nuts, seeds and extra virgin olive oil.

  • Add in some fermented foods such as kefir, live yoghurt, kimchi, kombucha and sauerkraut (not in vinegar). These can help to increase the numbers of helpful bacteria in the large intestine and reduce inflammation. In turn improved the overall balance of our gut microbial communities.

  • Swap some animal protein for some plant-based protein such as tofu, beans, pulses, edamame, tempeh.

  • Add in some omega 3 rich sources of food such as oily fish (trout, salmon, mackerel, sardines etc) or plants such as chia seeds, hemp seeds, walnuts.

  • Don't go too hard on alcohol and refined sugar rich foods


Tip 4: 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 me 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

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