Banish the bloat naturally

By Dr Marissa Kelaher

If you experience bloating, know you're not alone! 

Bloating and distention are two of THE most frequently mentioned gut symptoms we see in clinic, affecting up to 1 in 5 people, and are more common in women.

They can be due to a number of factors, ranging from benign to serious, but diet and lifestyle are by far the biggest causes - and fortunately the easiest to change.

Bloating is defined as a feeling of fullness or pressure in the abdomen, and often gets worse as the day goes on. While it's super common, it's also often a sign that things aren't quite right with your digestive system, so it's worth paying attention to. 

Let's cover the main causes, and more importantly, what you can do to help 😊

Please note - if you have new onset bloating, especially if it's associated with pain, weight loss, altered bowel habits, or rectal bleeding, ALWAYS see a doctor first to rule out more serious causes. 

COMMON CAUSES OF BLOATING:

Constipation

This is one of the leading causes of bloating in the Western world, due to our meat and dairy-heavy diet lacking in fibre. Many people are so used to constipation they think it's normal! 

Constipation means passing less than 3 stools per week, or small, hard stools - we should ideally pass at least one soft stool a day 😉

Constipation leads to stool sitting and fermenting in our large bowel, causing more gas-producing bacteria to grow - cue bloating and distension.

It also makes it harder to pass wind, and can even cause nausea and back pain!

The best natural ways to help improve constipation are increasing fibre in your diet, staying hydrated, and adding some movement to your day - see tips below. 

We also cover gut health and fibre in depth, and include lots of gut healthy recipes in our Reboot and Transform your Nutrition courses - and some of the most frequent feedback we get from people who've done our course is how much their bowels have improved!

Even chronic constipation can be helped a huge amount with the right strategies 😊

Irritable Bowel Syndrome (IBS) 

This is a common condition affecting how the gut functions (how the gut muscles and digestion work). 

People with IBS have digestive systems that are more sensitive to stimuli than usual, and also often have an 'over' or 'under' active gut wall.

IBS results in bloating, pain, and constipation or diarrhea, with bloating affecting around 90% of people with IBS. 

IBS is complex and thought to be due to a combination of genetics, an altered gut microbiome, and changes in the signals sent between the brain and gut.

Evidence based strategies that help IBS include dietary changes, improving the health of thr gut microbiome, stress reduction, movement, diaphragmatic breathing, and techniques to 'rewire' the gut-brain axis, such as gut-directed hypnosis or cognitive behavioural therapy.

It often takes a multifaceted approach, which is why lifestyle medicine is the perfect answer!

We cover many of these strategies in more depth, plus the science of how they work, and ways to start using them, in our Reboot and Take Control of your Stress courses.

FODMAP foods

Many foods can lead to bloating, but some of the main culprits are what are known as high FODMAP foods. 

FODMAP stands for ‘“fermentable oligosaccharides, disaccharides, monosaccharides and polyols’ - these are all types of carbohydrates.

The carbohydrates in high FODMAP foods aren't broken down or digested in our small intestine, but instead pass into the large bowel where they are digested by our gut bacteria.

While this process is very normal (our good gut bacteria feed on undigested carbohydrates and fibre, helping them to thrive), in some people this can cause bloating, discomfort, and gas.

High FODMAP foods are particularly common triggers for IBS, and low FODMAP diets have been shown reduce IBS symptoms by around 70%. 

Some high FODMAP foods include garlic, onion, legumes, certain nuts, and apples. You can find full lists easily available online.

Unfortunately, high FODMAP foods include a lot of foods that are also very good for us, and are recommended as part of a Mediterranean-style plant-focused diet!

It's actually the very fibre contained in them that gives them many of their health benefits, yet also causes bloating - so its a catch 22 for many people until they find the right approach..

While low FODMAP diets reduce bloating, they are highly restrictive and not intended to be used long-term for the above reasons - plus foods high in FODMAPs are also some of the best foods for our gut microbiome, as it’s actually often our good bacteria doing their job that causes gas 😳

The recommended way to approach FODMAP foods is to try a short-term low FODMAP diet to improve symptoms, then systematically reintroduce high FODMAP foods one at a time to figure out which ones are causing the issues, and how much of them you can tolerate.

As this is complex and time consuming, it's best done in conjunction with a FODMAP trained registered dietician.

The other less intensive way to approach it is to keep a food diary, and cross-check when symptoms occur against the list of FODMAP foods, to identify what is triggering them.

This can be useful to try initially if you don't have ready access to a dietician, or have mild symptoms.

A cool fact - our gut bacteria can actually adjust within days to weeks to deal with different foods, meaning many people with IBS can eventually tolerate high FODMAP foods if they optimise their gut microbiome and lifestyle!

But as its easy to flare up IBS, doing this in a slow structured whole person approach works best, as well as keeping your diet as diverse as possible, and ensuring you're also looking at the full picture (such as stress triggers for IBS) ❤️

Sugar, Fat, and Salt

These are major but often little-known causes of bloating, and typical Western diets are unfortunately high in all three of them! 

High-salt diets can increase bloating by up to 30% due to causing fluid retention in the gut, while high-fat foods move through our digestive system slower, causing bloating, indigestion, and reflux. 

High-sugar foods (especially artificial sweeteners) can also cause bloating due to their effect on the gut microbiome, and how they are fermented. 

Try to cut down on these wherever possible, and aim instead for mostly whole plant foods in your diet; as these are naturally low in sugar, salt and fat, and are also high in fibre to promote a healthy gut microbiome - your body and gut will thank you for it.

If you'd like to learn more about the health benefits of plant foods, the effects of ultra-processed foods, and discover lots of whole food plant-based recipes to try for yourself, why not check out our Reboot and Transform your Nutrition courses.

Malabsorption

This is when our small intestine has a hard time digesting certain nutrients in food. 

Many conditions can cause malabsorption, but one of the most common is lactose intolerance (inability to digest the lactose in dairy).

Malabsorption causes bloating due to unabsorbed nutrients passing into our large bowel and being fermented by our gut bacteria, resulting in excess gas. It often also causes diarrhoea, nausea, abdominal pain, and less commonly constipation (in the case of lactose intolerance).

In more severe cases of malabsoption (such as undiagnosed coeliac disease), this can even result in nutrient deficiencies, due to damage to the gut lining affecting its ability to absorb these.

In general, malabsorption should always be diagnosed by your doctor or a registered dietician, due to the range of potential causes.

Once you've ruled out more serious causes, trialling off dairy can often be done at home, due to how common it is, and the wide range of dairy free alternatives now available.

Plant-based diets are also naturally dairy free, and we cover easy alternatives to dairy, and simple swaps for common dairy foods in our Reboot and Transform your Nutrition courses (plus over 60 original dairy free recipes!)

HOW CAN YOU GET RID OF THE BLOAT? 

Now we've covered common reasons for bloating, let's explore what you can do about it!

1) Keep a Food Diary

This is one of the best ways to identify what's causing bloating, and its easy to do at home.

Use three columns: one for the food you’ve eaten, a second for your stress levels/emotions, and a third for your symptoms.

Try tracking for a week or two, until you start seeing a pattern - it's time consuming but can give really valuable insights! 

If you need extra guidance with this, then registered dieticians are experienced in helping identify and manage food intolerances.

2) Avoid Processed Food

These are full of fat, salt, and refined or artificial sugars, which can all cause bloating. They also have very few health benefits, and may even be harmful.

Minimising processed foods won't just help your bloating, it will improve your overall health, reduce your risk of health issues such as heart disease, diabetes and cancer, and even help you live longer, as by default you'll be eating more whole foods!

Try to eat as little of these as possible, aiming instead for whole or minimally processed, mostly plant foods instead.

As the famous quote goes, ‘Eat whole foods, not too much, mostly plants!’

We have loads of whole food plant-based recipes, ideas on how to swap out processed foods, and tips on how to introduce more whole foods into your diet, in our Reboot and Transform your Nutrition courses.

3) Drink enough water

Many people are chronically dehydrated without realising it...

Water can help bloating by flushing out excess salt in our bodies, as well as making our stool softer and improving constipation.

Plus its important to include when you're increasing fibre in your diet, as many high fibre foods (especially high FODMAP foods) draw water into the bowel, so we need enough to help digest them.

Aim to drink enough that your urine is clear, not dark when you pee. 

Contrary to popular belief, tea also counts as water (and herbal tea is even better)

If you don't like the taste of water, try adding some herbs, a splash of lemon, carbonated water, or making up a jug of cold herbal tea to sip on.

Taking a water bottle around with you can also help remind you to stay hydrated throughout the day!

4) Cut Out the Dairy

While not everyone has lactose intolerance, it’s extremely common, and more so in certain ethnic groups, so is always worth considering as a cause for bloating. 

While there are laboratory tests for lactose intolerance, they are expensive, time consuming, and not widely available.

Allergy tests are NOT useful for dairy intolerance, as they check a different pathway (IgE) to the one that causes gut intolerance, and should generally only be used for hives, anaphylaxis, and allergic rashes).

IgG testing or hair analysis tests are also not recommended, as they've been shown in clinical trials to be unreliable - and do not correlate well with actual food intolerances.

The easiest (and recommended) way to check for lactose intolerance is to just cut all dairy (ie milk, cheese, butter, yoghurt and ice cream) out of your diet for 2 weeks, keep track of symptoms, and then reintroduce it. This is considered ‘gold standard’ testing for dairy intolerance.

Dieticians can also help if you need extra guidance and support (especially in young children) , or try the dairy-free recipes in our Lifestyle Lounge, Reboot course, and Transform your Nutrition courses.

5) Try spices

Most herbs and spices contain a variety of antioxidants, flavonoids, and other beneficial phytonutrients, so they're great to include in your diet.

There are also several herbs and spices that can specifically help with bloating, including cumin, fennel seeds, turmeric, peppermint, asafoetida, ginger, and mint.

Try adding them to your meals regularly, or have in a tea (peppermint, ginger, mint).

You can also get peppermint oil capsules from the pharmacy, although be careful with these if you suffer from reflux, as they can potentially worsen it (they also relax the oesophageal sphincter - the muscle at the entrance to the stomach). Peppermint oil is proven to reduce bloating and cramps in IBS in particular.

6) Add some fibre 

Fibre is what keeps food moving through our gut, and also feeds our good gut bacteria.

Most people in western societies are fibre deficient, meaning we don't eat enough, and our bowels suffer!

It takes time for your gut to adjust to more fibre though, and if you increase it too quickly it can actually make bloating worse, so slow and steady is the key. 

Soluble fibres such as psyllium husk or ground linseed are often the best ways to start - add a small amount to your breakfast each day (or dissolve in water) and slowly build up the amount over a week or two.  

One of our favourite DIY fibre mixes is a tablespoon each of ground linseed, psyllium husk, and chia seeds daily - these are also packed with healthy omega 3!

7) Tips for legumes

Legumes have countless health benefits, and are amazing foods for our good gut bacteria, however they're also foods people may struggle with the most due to their high fibre content.

When introducing legumes to your diet, the best approach is to start low and go slow so your gut bacteria can adjust to the increase in dietary fibre.

Start with a tablespoon at a time and build up the amount you eat over the course of a few months.

Small lentils are often easier to digest than larger beans, so try 'work your way up' the size ladder of legumes.

Rinsing and thoroughly draining canned legumes can also help, as this removes the water that contains some of the indigestible carbohydrates (aquafaba).

While these carbohydrates are also great for our gut bacteria, when you're starting out they can cause gas and bloating.

Canned beans are sometimes also high in salt (if this has been added to the water - check the ingredients panel), so rinsing can help remove excess salt. It's a good idea to choose canned beans with no added salt if possible.

If you have time, cooking legumes from scratch is great as it saves money and creates less waste.

If you are able do this, try soaking them overnight before cooking them, as this helps make them more digestible, and reduces cooking time. Aim to soak for 6 -10 hours in room temperature water, and ensure you discard the soaking water for the same reason you discard the water from canned legumes.

Sprouting legumes before cooking them is also great (if you have time), as this helps to increase nutrient absorption and protein digestibility.

When you cook beans and lentils from scratch, aim to cook them until soft and easy to mash with a fork. This helps to break down compounds called lectins that are naturally present in legumes, and again makes them easier to digest.

Certain herbs and spices can also help as previously mentioned and are often used in traditional dishes for this reason (as well as to taste great and for the health benefits!).

For example, cumin seeds or ground cumin helps with digestion and is perfect in a soup, curry or dal (lentil dish) - we use these combinations in many of the recipes in our Reboot and Nutrition courses.

Cooking beans with a large strip of dried kombu, Japanese dried kelp, may minimise their gas-producing properties too.

8) Time-restricted eating

This can be a great way to protect against bloating, it also helps improve metabolic health weight, and your gut health. 

Aim for 10-12 hours a day with no food in your stomach, water and unsweetened herbal tea are fine. 

The easiest way to do this is to eat dinner by around 6-7pm, then wait 12 - 14 hours before eating breakfast.

Avoiding food for the few hours before bed also helps you sleep better too! 

You can shift these hours to fit around your schedule, the key is giving your digestion a break for at least 12 hours. 

9) Eat Mindfully

Our lives are busy, and many of us tend to gulp down our food in a hurry without even realising it. This might mean you get back to work faster, but it can also result in swallowing large chunks of food and lots of air along the way! 

The old advice of chewing your food well before swallowing is backed up by science, as digestion actually begins in our mouth.

When we take the time to eat slowly and chew our food well, it helps to start breaking down our food before it even gets to our intestines, moving it through our digestive system faster, and producing less gas.

Slowing down and paying attention also helps stop us from swallowing air, and even improves how well our gut muscles work (plus we're less likely to overeat). Try to sit down and try to eat slowly without distractions (such as phones and television screens).

Focus on enjoying the experience of eating and take a moment to savour the textures and flavours of your meal. Your gut will thank you for it, and you'll get more enjoyment from your food too - so it's a double bonus!

We cover mindful eating in depth in our Reboot and Nutrition courses, and also have some tips in our blog post here.

10) Walking/Stretching

This is a simple trick, but surprisingly effective. Have you ever noticed that you feel more bloated if you move less?

Walking and stretching help stimulate your gut muscles to work better, and speed up how quickly food passes through. This in turn helps reduce bloating and gas and improves digestion. 

Learn more about the benefits of exercise, and tips to get moving in our Boost your Activity, and Reboot courses.

11) Abdominal Massage

If you're feeling bloated and can't manage a walk, this is the next best thing. 

To do it, place your hand on your right hip, and gently massage the abdomen as you make your way up toward your ribs. Then massage straight across the top of your tummy just below your rib cage to the left side, then continue down to the left hip. Keep massaging in this pattern as many times as you need to until you feel better.

It stimulates your gut muscles to help move food and wind through faster. 

12) Diaphragmatic breathing

The way we breathe can also affect digestion, as it impacts our mind gut axis, as well as on our digestion. 

When we take small shallow breaths into our chest, this stimulates our 'fight or flight' nervous system which shuts down digestion - slowing gut movements, reducing digestive enzymes, and reducing oxygen delivery to our gut muscles. 

Slow deep belly breathing activates our 'rest and digest' system, creating the opposite effect, and also massages our gut. 

To try it, lie on your back, with one hand on your belly and one on your chest. Inhale through your nose for about 4 seconds, feeling your abdomen expand - the hand on your tummy should move and the one on your chest should stay fairly still.

Hold your breath for 2 seconds, then exhale very slowly and steadily through your mouth or nose for about 6 seconds. The mouth should be relaxed. Repeat this cycle for 5-15min, but if you feel short of breath or lightheaded, reduce the amount of time you spend on each breath. 

We have breathing and meditation exercises, plus more info on the science behind these, in our Take control of your Stress and Reboot courses.

12) Probiotic Foods

Our digestive system relies on trillions of bacteria (our gut microbiome) to keep it functioning well. But when this gets out of balance (due to illness, diet, or lifestyle) it can affect digestion, resulting in bloating and discomfort. 

Studies show that probiotic foods can help improve our gut microbiome in as little as two weeks, so including them in your daily diet is a great idea! This includes yogurt with live cultures, sauerkraut, kimchi, kefir, kombucha, and miso

The science on probiotic supplements is less clear, so it's best to get those healthy probiotics from food wherever possible.

Hopefully this post has helped you learn more about common causes of bloating, and give you some practical tips to beat it!

If you've enjoyed it please share with others who may find it helpful.

And if you'd like to know more about any of the things mentioned, don't forget to check out our Reboot and Focus courses for a deep dive into better health today ❤️