Why do I feel bloated?

As a nutritional psychologist, much of what I do looks at the overlap between food and mental health and the role of food and nutrition on brain function, disordered eating, and our psychological relationships with food. In the last few years, I’ve noticed a striking pattern in the descriptions of a particularly worrying thought about bloating after eating, that seems to occur in patients with a range of different disordered eating habits. Most of these patients are in their twenties, making them members of a generation that has had access to the internet from a young age.

Time and again my patients talk about the distress of feeling “bloated after eating.” When I ask them to explain, our conversation usually goes something like this:

I’ve had clients, in their frustration, stand up, lift their shirts, and show me the post-meal “bloating” that was making them feel so bad. I look. I don’t see any signs of bloating. Over time, I’ve come to suspect that what my clients find so troubling are the results of the process of eating and digesting food—you know, the mild distention from the presence of foods and liquids, gurgling, maybe some gas. I believe this is linked to the medicalization of food and the body, as well as strong social stigma around fat and fatness, but more on that shortly. First I want to talk a little about what healthy digestion looks and feels like.

A reminder: bloating is a normal part of the digestion process.

As Rudolph Bedford, M.D., director of gastroenterology at Providence Saint John’s Health Center in Santa Monica, California, explains, after you eat, your stomach breaks food down into digestible-sized pieces, so that the food can then start to flow through the small intestine, where most of the digestive action takes places. The breakdown of carbohydrates and the fermentation of dietary fiber may produce gas, which expands (think of balloon filling with air), which in turn causes bloating. This bloating generally passes after a bit of time or after gas is passed, and is often simply part of your body working effectively to turn food into fuel.

It’s important to note that there are certain conditions that are associated with uncomfortable, persistent, severe bloating after eating. Dr. Bedford says that the bloating that comes with conditions like irritable bowel syndrome, Celiac disease, or gluten sensitivity are accompanied by discomfort and cramping, and aren’t likely to be confused with mild post-meal bloating (that doesn’t come with any other symptoms or cause more than minor discomfort).

As a professional in the nutritional world, I’ve seen a worrisome increase in the amount of my patients who think any bloating at all is bad. I’m not alone.

I’ve asked colleagues (in nutrition and mental health) whether they have experience with clients who complain in particular about bloating, and many reported clients and patients asking for ways to “avoid the bloat.” Time and again—even after digestive disorders have been ruled out—clients remain convinced that if their stomachs are not flat at all times, there is something (or they had done something) wrong.

Are gastroenterologists noticing any similar trends? When asked about patients at his practice, Dr. Bedford said he experiences what I described above “all the time.” (Actually he put it more emphatically: “All. The. Time.”) He says that in the last decade he’s seen an increase in patients who come to his office complaining of bloating; patients who, most of the time, don’t have other symptoms that would indicate anything besides normal digestion.

11 Ingenious Ways to Avoid Bloating After Eating

Don’t you just hate it when you look yourself into a mirror post lunch and a bloated stomach stares right back at you? As if it is mocking at your misery of not even indulging in a sumptuous meal and yet acquiring a post-feast ballooned belly. Bloating is a prevalent inflation of stomach especially after a meal. It is a common symptom of excess gas production in your stomach. Common causes of bloating include overeating, intolerance to a certain food or dairy product, constipation, change in environment, etc. But the good news is that bloating is only a temporary side effect of above mentioned causes, and subsides in a matter of time. However, you can take these essential lifestyle and dietary tips to avoid bloating permanently.

1. Take Minimum Drinks with Your Meal
Liquids are said to dilute stomach acid which is essential to break down the food, thereby hindering the digestive process. Experts suggest that a person should observe a minimum of 15 to 20 minutes gap before the meal and after, to avoid formation of gas.
(Also read: How 30 Minutes of Walking After Meals Can Help You Stay Fit)

2. Chew Your Food and Eat SlowGulping down the food in a jiffy is the worst invitation call to bloating. By not taking enough time to chew your food, you not only hinder the disintegration of food particles which will further upset your digestion, but also end up swallowing a lot of air, which contributes significantly to gas retention in your belly.
(Also Read: The Best and Most Popular Food Articles of 2016)

3. Exercise
This one is obvious. A significant portion of gas build-up can be prevented by exercise especially before breakfast. This would also facilitate your bowel movement. A short walk after a meal is said to deliver great results in avoiding bloating.
(Also read:Two-Minutes of Intensive Exercise Can Help Prevent Diabetes)
4. Cut Down Your Salt Intake
Too much of salt consumption is said to aggravate the water retention in your stomach, which contributes to bloating. When extra sodium is pushed into the body fluids, it stalls the process of pushing water out of the cells, which makes the stomach feel full with cells packed with water. Salts can be substituted with other flavourful herbs, pepper and vinegar. This would not only cut down on the excess sodium content but also prevent bloating.
(Also read: What’s Your Daily Salt Intake? Even 5 Gram Can Put You at Risk of Heart Attack)

5. Avoid Carbonated Beverages
Carbonated beverages and sodas act as a major carrier of carbon dioxide gas build-up in your body, which leads to bloating. This excess gas if not released in burping adds up to the bloat. Drink plenty of plain water instead or as an alternative, flavor it with lime or cucumber. Avoid regular tea or caffeine and opt for ginger and peppermint teas to steer clear of indigestion.

6. Monitor Your Fiber Intake
While whole grains are essential for healthy digestive system, their high fiber content is often a common cause for bloating. Therefore it is recommended that you slowly increase their amount in your diet, and give your body the time to adapt to the change. Else the upheaval in the gas levels is sure to call for bloating.
(Also read:5 Fiber-Rich Foods You Should be Eating Everyday)7. Avoid Dairy
For the ones who are lactose intolerant, it is advisable to stay away from dairy products such as cheese, milk etc. Your body lacks the enzymes necessary to break down lactose, which causes excessive gas formation in the Gastrointestinal(GI) Tract leading you to bloat. Opting for soy milk as a substitute to normal milk has proven to be an effective measure against bloating.
(Also read:A Daily Glass of Milk Can Save Your Heart)
8. Cut Down on Legumes
Love rajma? This might break your heart, but beans, along with peas and lentils, are significant contributors in causing gas. They contain sugars and fibers that are difficult for the body to absorb easily. It is quite a task for your large intestine to push them for smooth digestion, which causes bloating. However, if they are had regularly especially with rice or quinoa, your body adjusts to it, and bloating is prevented
(Also read:10 Best Matar (Peas) Recipes)
9. Broccoli, Cabbage and Other Cruciferous Vegetables
For its high content of raffinose, a kind of sugar which is possible to digest only once the bacteria in your gut acts upon it, cruciferous vegetables produce immense gas. But experts also suggest that a regular intake of the greens leads to a stronger and healthier digestive system that’s less prone to bloating. So maintain a balance. Having the vegetables cooked or steamed softens the fibers and shrinks the portion as some of the water cooks out, so it takes up less space in the GI tract, which also prevents bloating to a great extent.
10. Eat Papaya and Pineapple
Fresh papaya and pineapple have natural digestive enzymes that aid digestion and help break down proteins in your GI system.
(Also read:8 Amazing Benefits of Papaya for Health and Skin)
11. Eat Asparagus
CommentsAsparagus contains plenty of prebiotics which helps in the growth of ‘good bacteria’, thereby maintaining a healthy balance in your digestive system and reducing gas. The vegetable’s soluble and insoluble fibers further promote overall digestive health.

About Sushmita SenguptaSharing a strong penchant for food, Sushmita loves all things good, cheesy and greasy. Her other favourite pastime activities other than discussing food includes, reading, watching movies and binge-watching TV shows.

Seriously Bloated: Warning Signs You Shouldn’t Ignore

By Robynne Chutkan, MD, FASGE, Special to Everyday Health

We’re seeing a virtual epidemic of bloating these days. The causes range from benign yet bothersome conditions like lactose intolerance to serious diagnoses like cancer. But how do you know whether your bloating is a nuisance or a sign of something more worrisome? You’re seriously bloated when your symptoms are caused by a condition that requires immediate medical attention. It’s important to be familiar with the warning signs and symptoms that might indicate something ominous, as well as the nine diagnoses associated with serious bloating, and what to do about them.

Warning Signs and Symptoms

Weight loss is one of the main warning signs for serious bloating. If you find yourself losing more than a few pounds without changing your diet or starting a new exercise regimen, that should be cause for concern, especially if it’s 10 percent or more of your body weight. Weight loss can be caused by tumors that press on the intestines, making you feel full after just a small amount of food, or from substances secreted by tumors that suppress your appetite.

Ascites is an abnormal buildup of fluid in the abdomen or pelvis. It can cause bloating, weight gain, and a rapidly expanding waistline. Ascites is usually caused by liver disease, but cancer is the culprit about 10 percent of the time. A large amount of fluid can make you look and feel like you’re several months pregnant. The combination of bloating and jaundice, which turns the eyes and skin yellow, can be a sign of cancer that’s spread to the liver, although it can also occur with more benign forms of liver disease like hepatitis.

Severe abdominal pain and bloating that occur suddenly, especially if you also have nausea and vomiting, may be a sign of a bowel obstruction from scar tissue or a tumor pressing on the bowel. Immediate medical attention is a must to avoid complications like bowel perforation that can be fatal. Obstructions are painful, because the bowel above the blocked area stretches as it fills with food and digestive juices. The pain is intense and may occur in waves as the bowels try to push their contents through the obstructed area.

Blood in your stool, vaginal bleeding in between periods, or postmenopausal vaginal bleeding can all be associated with serious bloating. Fortunately, the most common causes of these symptoms (hemorrhoids, an irregular menstrual cycle, fibroids, endometrial atrophy) aren’t the most serious, but bleeding should always be evaluated because it can be a sign of cancer, particularly colon or uterine cancer.

Fever that accompanies bloating is usually due to infection or inflammation. If there’s also an elevated white blood cell count, infection needs to be immediately excluded — particularly from a pelvic, urinary, or gastrointestinal source.

9 Causes of Serious Bloating You Need to Know About, and What to Do About Them

1. Ovarian cancer isn’t the most likely, but it is one of the most lethal. Although ovarian cancer is only the fifth most common cancer in women, it causes more deaths than any other reproductive cancer — mostly in women over 50. Risk factors include never having children or having them late in life, obesity, a family history of ovarian cancer, certain genetic abnormalities, and long-term treatment with hormone replacement therapy. Persistent bloating, feeling full faster, and pelvic pain are typical symptoms.

What to do if you’re concerned about ovarian cancer:

A thorough pelvic exam or transvaginal ultrasound is the best way to diagnose ovarian cancer. The blood test CA-125 isn’t a reliable screening test, but it can be helpful for following the course of treatment after diagnosis.

2. Uterine cancer. In addition to bloating, uterine cancer can cause abnormal vaginal bleeding, a watery or blood-tinged vaginal discharge, pelvic pain, or pain with intercourse or urination. But it’s important to know that sometimes bloating or a change in bowel habits (new onset of constipation) may be the only initial signs of uterine cancer. Important risk factors include taking tamoxifen; taking estrogen supplements that don’t also contain progesterone; radiation therapy; a family history of uterine cancer; or a family history of a form of inherited colon cancer called Lynch syndrome.

What to do if you’re concerned about uterine cancer:

Combinations of the above symptoms, especially if you have a strong family history or additional risk factors, may point to a more serious diagnosis like uterine cancer. This calls for immediate further investigation with a pelvic exam, and imaging tests like an ultrasound or CAT scan. Fortunately, even aggressive cancers, when caught early enough, can be treated and often cured.

3. Colon cancer can block the inside of the colon, causing progressive bloating. If the cancer is located at the end of the colon in the rectum or sigmoid, there is usually bleeding and a history of worsening constipationColon canceris the second most common cause of cancer deaths in non-smokers in the United States.

What to do if you’re concerned about colon cancer:

Colon cancer is mostly preventable through lifestyle changes and regular colonoscopy screenings. Some studies have shown that switching to a plant-based, nutrient-rich diet can cut your risk of colon cancer in half. If you think you may be at risk or experiencing symptoms, a colonoscopy is worth pursuing.

4. Pancreatic cancer tends to be very aggressive with low survival rates. The combination of bloating associated with jaundice (yellowing of the eyes and skin), weight loss, poor appetite, and upper abdominal pain that radiates to the back is a worrisome constellation of symptoms and may indicate pancreatic cancer. Newly onset diabetes, in association with bloating, weight loss, and abdominal pain, may also be a sign of pancreatic cancer.

What to do if you’re concerned about pancreatic cancer:

Fortunately, pancreatic cancer is not a common cause of bloating. But if you do have it, early diagnosis is the key to ensuring a good outcome. Seek immediate medical evaluation if you are experiencing the above constellation of symptoms.

5. Stomach cancer is usually asymptomatic early on, or causes vague symptoms like bloating, indigestion, and a feeling of fullness in the upper abdomen. Like pancreatic cancer, it may have already reached an advanced stage at diagnosis, in which case there will likely be additional symptoms of weight loss, nausea, and abdominal pain.

What to do if you’re concerned about stomach cancer:

Infection with the bacteria Helicobacter pylori is probably the most significant risk factor for developing stomach cancer, so it’s a good idea to be tested for H. pylori if you think you may be at risk. Nitrates and nitrites in smoked and processed meats are also risk factors for stomach cancer, and in a small number of patients, stomach cancer is genetic.

6. Liver disease is often benign. But cancer from distant organs can spread to the liver. When cancer cells get into the bloodstream, they eventually get filtered through the liver. Bloating that’s accompanied by ascites and jaundice may be a sign of cancer that’s spread to the liver or of primary liver cancer, which can develop in people with a history of hepatitis or heavy alcohol use.

What to do if you’re concerned about liver disease:

If you think you may have liver disease, seek medical attention for a thorough physical exam, an ultrasound of the liver and abdomen, and a blood test that evaluates liver function to confirm the diagnosis. Some liver disease can be treated through dietary changes: more green leafy vegetables, legumes, and other plants, and less animal protein and starchy, sugary foods. Some cases require prescription medication.

7. Diverticulitis refers to infection or inflammation of small pothole-type lesions that can develop in the colon called diverticulae. Diverticulitis usually occurs in people over age 50, and is often accompanied by abdominal pain and tenderness, loss of appetite, fever, and constipation or diarrhea.

What to do if you’re concerned abut diverticulitis:

Bouts of diverticulitis can be treated in a number of ways: bowel rest (nothing to eat or drink), a liquid diet, antibiotics (if severe pain, fever, or an elevated white blood cell count are present), and analgesia (pain management). Severe tenderness may prompt a CAT scan to exclude an abscess. Worst-case scenario includes drainage of any abscesses, or surgery to remove a severely affected area. The longer your stool sits in the diverticular orifices, the greater the risk of developing diverticulitis — so constipation is definitely to be avoided. Once the acute episode of diverticulitis is over, a high-fiber diet can help keep you regular and avoid future complications.

8. Pelvic inflammatory disease (PID) occurs when the uterine lining, fallopian tubes, or ovaries become infected, usually from sexually transmitted diseases like chlamydia or gonorrhea.It can also occur during childbirth, abortion, or miscarriage, or with insertion of an intrauterine device. Bloating accompanied by fever, pain, and tenderness in the pelvic area, plus a vaginal discharge, is very suggestive of PID.

What to do if you’re concerned about PID:

A careful pelvic exam and treatment with antibiotics are essential for PID. Untreated, it can lead to infertility and ectopic pregnancies (a pregnancy that implants and grows in the fallopian tubes rather than in the uterus and can cause life-threatening tubal rupture). If you’re having bloating, vaginal bleeding or discharge, and lower back or pelvic pain and think you may be pregnant, you should seek immediate medical attention to exclude PID.

9. Crohn’s disease is an autoimmune disorder that affects the GI tract, usually in the small intestine or colon. The lag time between initial symptoms and diagnosis can be years, and bloating is one of the early symptoms. Crohn’s can cause narrowing of the intestines and ultimately lead to a bowel obstruction, resulting in severe bloating, weight loss, and nausea and vomiting after meals. Diarrhea with blood is typical when Crohn’s occurs in the colon. There may be other symptoms present outside of the GI tract, including mouth ulcers, joint pain, skin lesions, and inflammation in the eyes.

What to do if you’re concerned about Crohn’s disease:

Diagnosis is often the most challenging aspect of Crohn’s disease. X-rays and even colonoscopy may not show the inflammation, which usually occurs at the end of the small intestine (the ileum), an area not within easy reach of the endoscope. More sophisticated imaging techniques such as a CAT scan, MRI, or video capsule endoscopy (a tiny ingestible micro-camera in a pill) may be required. Like its sister disease ulcerative colitis, dietary changes, supplements, and more potent prescription drugs all play a role in getting the inflammation and bloating associated with Crohn’s under control.

The good news is that most people with bloating don’t have cancer, infection, or inflammation. If you’re not sure whether your bloating is serious, it’s always better to err on the side of seeking medical attention rather than ignoring it and hoping for the best.

Robynne Chutkan, MD, FASGE, is the author of The Bloat Cure: 101 Solutions for Real and Lasting Relief, The Microbiome Solution, and Gutbliss. Dr. Chutkan has been on faculty at Georgetown MedStar Hospital in Washington, DC, since 1997. In 2004, she founded the Digestive Center for Women, an integrative practice that incorporates nutritional optimization, exercise physiology, biofeedback, and stress reduction as part of the therapeutic approach to digestive disorders.

Why Your Diet Can Make You Bloated (Even With Good Nutrition)

As a contest prep coach and figure competitor, I’m seeing more and more competitors walk around in a constant state of bloat, as well as hearing more and more complaints of discomfort due to digestive issues during a contest prep diet.

I feel lucky that I can throw almost anything at my body and have no negative effects in terms of bloating, gas, or discomfort even after months of strict dieting. But many athletes become sensitive to different variables during a contest prep diet (or any diet for that matter) and it can be difficult to pinpoint the culprit.

I hear many coaches and athletes recommending “solutions” such as laxatives. This is a misguided recommendation that amounts to putting a temporary bandage on the symptom of a real digestive problem. These symptoms are the body’s way of letting you know something isn’t working. Any time a natural process such as digestion becomes compromised, I view that as a warning sign.

I like to think I’m as hard-core as the next competitor, but suffering through pain that’s being induced due to something or somethings within your diet isn’t hard-core. It’s silly and unnecessary.

First Things First

Are you really bloated? For many competitors, lower abdominal fat is the last thing to go, and often I hear clients complaining of “bloat” when it’s more likely to just be a stubborn and isolated fat deposit. If you’re not experiencing any discomfort and your digestion is normal, it’s possible bloating isn’t the issue.

“During a contest prep diet, many competitors transition to a lower-carbohydrate diet and increase their fiber with more vegetables. This can often lead to bloating if the body isn’t prepared for this influx”

But if you’re having discomfort, pressure, constipation, and/or strained bowel movements (or lack thereof), then there’s likely a problem. It’s usually easy to see when someone is bloated during contest prep due to the low levels of body fat and the isolated look of a bloated belly. I have seen my fair share of bikini competitors who are completely lean everywhere else, but look three months pregnant due to digestive issues. Not a cute look, and bloating is more commonly experience in women than in men.2

Potential Culprits for Bloating

When you’re eating a number of different food groups and taking a handful of different supplements every day, it can be a challenge to pinpoint what is causing your issues (and potentially stopping you from proper nutritional absorption and hindering maximum performance). This list describes the most common dietary factors I see in relation to digestive issues in bloating during a contest prep diet:

Fiber

Too much or too little fiber can lead to the build up of gas in the stomach, which then leads to bloating.3 The American Dietetic Association recommends we get 25-40 grams of fiber daily, but most of us get markedly less. On the other hand, they also say too much fiber may lead to symptoms such as, “diarrhea and other gastrointestinal symptoms such as flatulence, bloating, and abdominal discomfort.”1

Finding a happy medium is key, as well as avoiding any dramatic increases or decrease in fiber intake at one time. If you are making large increases or decreases to the amount of fiber you consume in a day, make these changes slowly to let your body adjust and avoid potential problems.

“In switching to a contest prep diet, you may discover sensitivities to certain foods that you didn’t notice before. ”

During a contest prep diet, many competitors transition to a lower-carbohydrate diet and increase their fiber with more vegetables. This can often lead to bloating if the body isn’t prepared for this influx in fiber-rich vegetables. Other athletes struggle for the opposite reason – not getting enough fibrous vegetables in their diet, focusing on consuming adequate protein levels, keeping carbohydrates low, and not meeting daily-recommended values.

Diet Soda and Artificial Sweeteners

For many, diet sodas may be a double-whammy as they include artificial sweeteners, which are not fully absorbable in the digestive process. This can cause bloating, especially in conjunction with the high levels of carbonation, and can produce gas build up in the stomach.2 Unfortunately, if you find yourself sensitive to artificial sweeteners, then low-calorie condiments, flavored supplements, and protein powders may all irritate your digestion and be best left for after the show, if at all.

Too Little Fat and Too Much Protein

A diet too low in fat can lead to problems with constipation and bloating, as fats aid in the stimulus of healthy bowel movements.4 The list of functions and benefits of a diet with adequate fat levels goes way beyond proper digestion, and I encourage all competitors to ensure their fats are at a healthy level during a contest prep diet, women especially.

On top of that, too much protein (all those egg whites!) has been shown to cause issues in regards to gas, bloating, and constipation. This is based on my experience, and each individual’s ability to process high levels of protein may vary.

Sensitivities

In switching to a contest prep diet, you may discover sensitivities to certain foods that you didn’t notice before. In eating a limited number of food sources, you may consume several meals of the same foods each day and realize some foods cause you more discomfort than others. In addition, if you are cutting out certain foods, such as dairy, from your daily diet, you may develop a certain level of sensitivity as your body may stop producing the digestive enzymes needed to comfortably consume lactose.5

In my experience, certain food sources can become irritants to different athletes after extended periods of consumption at higher than normal levels. I like to rotate my food sources in order to avoid potential sensitivities developing. As well, I include things like small amounts of dairy in my weekly cheat meals to ensure my body remains able to easily digest all foods.

Food Volume, Sodium, and Water

When it comes to dieting, everyone knows volume is king. So, when we are on “poverty calories,” who of us doesn’t want to eat the most amount possible for the limited calories allotted? But bloating can occur if we are accustomed to small portions or mostly protein- and fat-based meals and we suddenly increase our volume of non-starchy vegetables or other low calorie add-ins. Doing this leads to large portions the stomach isn’t used to and potentially to stomach distension.

“Any time a natural process such as digestion becomes compromised, I view that as a warning sign.”

Similarly, changes in water levels (higher or lower) can cause stomach bloating and distention, especially in combination with influxes of sodium that can cause water retention. Consistency is key when it comes to water and salt intake throughout your contest diet, with the exception being any manipulations made strategically before taking the stage in the days leading to the show.

Digestive Support

If upon manipulating these variables and attempting to find the reason behind your digestive issues you’re still experiencing regular bloating, you may find relief using a combination of the following digestive aids:

  • Digestive Enzymes: Used to aid in the breakdown of foods upon consumption. Make sure your digestive aid includes protease, lipase, and amylase as needed based on your diet. Consume with meals to help digestion.
  • Probiotics: Ensure your probiotic includes lactobacillus acidophilus and bifidobacteria bifidum to aid in a healthy gut flora. I recommend getting a refrigerated brand or eating raw sauerkraut for a similar effect.
  • Fiber Supplement: if you’re not reaching your daily fiber intake through your diet, then consider bringing in a supplement to get adequate intake. Psyllium husk is cheap, tasteless, and makes a great pancake when mixed with egg whites (as long as the egg whites don’t give you bloat!).

Note: If you’re experiencing regular pain and constipation with no relief using any of the above recommendations or the pain is severe, please see a doctor in order to rule out any digestive disorders.

Check out these related articles:

  • If You Want to Win, Face Your Fears (Contest Prep Athlete Journal)
  • How I “Cheat” My Way to Shredded
  • Orthorexia – When “Clean Eating” Goes Too Far
  • What’s New On Breaking Muscle

2. Azpiroz, F., & Malagelada, R. Abdominal bloating. Gastroenterology. 2005, 129 (3): 1060-1078. doi:10.1053/j.gastro.2005.06.062

3. Mayo Clinic. Bloating, belching and intestinal gas: How to avoid them. 2014.

4. Monastyrsky, K. The ingredients of longevity nutrition.

6. Smeets, A., Margriet., S., and Westerterp-Plantenga. Acute effects on metabolism and appetite profile of one meal difference in the lower range of meal frequency. British Journal of Nutrition. 2008, 99: 1316-1321. doi:017/S0007114507877646.

Photos courtesy of .

Time Spent In Nature Will Save $6 Trillion Globally In Mental Health Care Costs, Claim Australian Researchers

Bloating is the single most common digestive complaint afflicting people today, with millions around the world suffering from it, yet it is also one of the least understood. We try to do all the right things — avoid common allergens and inflammatory foods like gluten, sugar, and dairy, limit processed foods, exercise regularly — and yet still find ourselves with uncomfortably swollen abdomens after virtually every meal.

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It has certainly plagued my life for as long as I can remember, and I worry about it constantly. It’s stressful, it’s embarrassing, and it often leaves me feeling utterly defeated — all of which, of course, only exacerbates the issue. I have tried everything to rid myself of this seeming curse, but unless I’m depriving myself and eating like a bird, very little seems to help.

Fortunately, gastroenterologist Robynne Chutkan has taken some of the guesswork out of this unwelcome visitor by compiling the most common bloating culprits into her latest book, The Bloat Cure. “I wanted to create a guide for women to be their own medical detectives,” says Dr. Chutkan. “Bloating is absolutely is the number one thing I see in my practice. It’s sort of that common, non-specific way for the GI tract to let you know it’s unhappy.”

“To a layperson, our digestive tract can feel like this empty tube, but people don’t appreciate how specialized it is,” she continues. “There are so many different things happening in different parts, and so many things that can go wrong.” This complexity is what makes identifying and treating the root cause of bloating so difficult.

So if you’ve taken care of the diet piece and are still struggling with bloating, the following list of 8 common mistakes may help you banish this digestive demon for good.

1. Distracted Eating

The Problem: Do you scroll through your Instagram feed while eating? Reply to work emails, text your friends, or read the news? Then you are among a growing population of people for whom multitasking has become an essential, habitual part of life. As our lives get busier and our attention spans shorter, we begin to treat every moment as an opportunity to be entertained, productive, or both. Eating lunch while sitting at our desks and continuing to work has become standard practice in many offices, and sit-down family dinners, where people connect with one another and reestablish bonds over a leisurely meal, have almost disappeared entirely.

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The loss of this important social ritual has obvious implications for our psychological well-being, but its impact on our digestion, while less immediately apparent, is no less profound. According to Dr. Chutkan, aerophagia — aka swallowing air — is becoming more common as we become less mindful of the process of eating. “A lot of people with aerophagia feel like they have acid reflux, but they’ve been on drugs for months and aren’t any better,” she says. “There’s often a waxing and waning to it; they don’t necessarily start the day feeling full.” Essentially, the faster we eat, the more air we gulp down, and the more bloated and gassy we feel.

The Solution: Eat slowly and mindfully, paying attention to the taste and texture of every bite. This not only prevents the ingestion of excessive air, but also inhibits overeating. The more we pay attention to what we’re eating and the more slowly we eat it, the more time the brain has to receive the “I’m full” message from the gut, and the less food we consume overall.

You should also sit down for your meals rather than eating while standing or on the go, and take several deep, calming breaths before beginning your meal to allow your autonomic nervous system to leave the “fight or flight” state and enter its “rest and digest” state.

2. Depression

The Problem: Only recently have we discovered that a healthy microbiome is essential for good mental health, and how strongly the two are linked. Eve Kalinik, a UK-based certified nutritional therapist, explains that “recent research has directly the microbiome influences neurotransmitters in the brain, affecting the way that we think and feel,” and “certain strains of beneficial bacteria can themselves produce many of the same mood-positive chemicals used in brain signaling, such as dopamine, serotonin, and GABA.” Researchers are even experimenting with replacing antidepressants with probiotics, with promising results thus far.

We have also discovered a link between low serotonin levels in the gut and depression, with constipation and bloating being the result, and unfortunately, many antidepressant medications themselves cause bloating, making this mental illness a double digestive whammy.

The Solution: To combat the bloating effects of depression, Dr. Chutkan recommends both talk therapy and exercise, a well established and potent mood booster. “Movement helps to lift the mood, and it doesn’t have to be intense to get a little bit of an endorphin rush,” Chutkan says.

Have trouble motivating yourself to exercise? Check out these seven ways to banish those excuses for good.

3. Dehydration

The Problem: Despite the pervasiveness of the ‘eight glasses a day’ myth, the amount of water we need to stay hydrated varies widely from person to person and from situation to situation. You might know that caffeine, a diuretic, saps your water reserves, but did you also know that spending too much time in air conditioning or even taking antihistamines has the same effect? As far as our digestion goes, when we get dehydrated our intestines become less lubricated, resulting in stagnation and then, of course, bloating.

The Solution: The easiest and most effective way to ensure your fluid intake is adequate is not to tally up your glasses of water each day but to monitor the colour of your urine — the paler the better. And the best way to stay hydrated throughout the day is to keep water with you at all times and sip steadily, even if you’re not thirsty. This also helps prevent overeating, since hunger is often thirst disguised. The next time you feel hunger pangs, try drinking a glass of water first and see what happens. You might be surprised to find out it was water you wanted, not food!

4. Skipping Meals

The Problem: You’ve probably experienced this before: You went all day without eating, becoming ravenously hungry in the process, then scarfed down an enormous meal when you finally found time to eat. From there, you promptly felt as if your belly were about to explode.

Skipping meals is a surefire way to ensure that your stomach bloats when you do finally eat. “If there are long periods of time where nothing’s moving through the gut, it becomes a little bit inactive,” says Dr. Chutkan. So not only are you eating too quickly and not chewing your food sufficiently, your digestion itself has slowed down, all of which is a recipe for major bloating.

The Solution: The best way to avoid this is to fuel up regularly, eating both meals and snacks throughout the day, and eating well before you get to that desperate, hangry, empty-the-fridge level of hunger.

5. Haywire Hormones

The Problem: Estrogen dominance in women is becoming increasingly common, thanks largely to artificial hormones like the birth control pill and hormone replacement therapy, and it’s making us more bloated than ever before.

The Solution: To combat this problem, Dr. Chutkan recommends avoiding xenoestrogens, like those found in conventionally-raised produce and meat, plastics, and cleaning supplies, as well as considering alternative methods of birth control.

6. Post-Workout Pain Meds

The Problem: Sometimes even the most well-intentioned and well-informed personal trainers give poor advice, and the most common I’ve heard is recommending pain killers to combat muscle soreness. Aside from their questionable effects on our physical and mental well-being, they can also wreak havoc on our gut, particularly if it has already been compromised by chronic inflammation. Multiple studies have shown that pain killers worsen intestinal permeability, or leaky gut, as well as inflammation. “NSAIDS are super toxic to the GI tract, but because there’s so much marketing of these drugs, there’s this perception that they’re benign,” says Dr. Chutkan.

The Solution: She advices using over-the-counter pain meds sparingly and, more importantly, to opt for holistic options, like epsom salt baths or active recovery. “Every time you take something, you have to do a risk-benefit analysis,” she says. “There’s nothing you can take with no side effect. And the place you’re most likely to see a side effect is in your gut.”

7. Desk Jobs

The Problem: Is there no end to the ills of desk jobs? We know sitting all day wreaks havoc on our health, causing neck and back pain, decreasing blood flow throughout the body, and even accelerating the aging process. Sitting has also been linked to higher blood glucose levels and blood pressure, so the more we sit, the larger our waist circumference becomes.

Decreased blood flow also means that all your biological processes are slowed down, including digestion. When your GI tract is moving at this reduced speed, bloating is almost inevitable. “A lot of the people I see are lawyers—they’re literally at their desk for 14 hours in a row, five days a week, and then sitting even more at home,” says Dr. Chutkan. “It’s horrible for the gut, because we’re meant to be on the move,” she adds.

The other problem with sitting is that most people don’t eat less to make up for how few calories they’re expending. Indeed, many people graze at work or eat treats and fatty foods to either alleviate their boredom or get through the post-lunch slump. (I’ve been there.) Thinking still makes us hungry, but it doesn’t burn calories the way movement does. So not only are we eating too much compared to how little we’re moving, but our body is processing that food at a glacial rate.

The Solution: Fortunately, taking frequent breaks throughout the day can mitigate these harms. You should be out of your desk for a minimum of five minutes every hour. Use this time to do some stretches and restore blood flow to your limbs, or to walk a few laps around the office. If you need to speak with a coworker, get up and physically meet with them rather than emailing — I’ve seen people who were sitting two feet away from each other exchange emails, all to avoid getting out of their chairs!

Bonus: If you’re staying hydrated the way I described earlier, you’ll have to go to the bathroom more often, which means more opportunities to get up and stretch your legs!

8. Stress

The Problem: The only thing worse for our health (and bellies) and more endemic to modern society than sitting is stress.

As I mentioned previously when describing mindful eating, when our nervous system is fired up as a result of stress, our bodies enter the ‘fight-or-flight’ mode, halting digestion and releasing cortisol, the stress hormone linked to increased abdominal fat.

Evolutionarily speaking, says Dr. Chutkan, “when a T-Rex is upon us and we have to get away from it, it shunts blood flow away from the digestive tract to the big muscles in the legs and the heart so you can run.” These days we aren’t running from tigers or bears, but our lives are stressful in other ways, and unfortunately, our bodies can’t tell the difference. This means that for many of us, that stress state is constant. This not only slows down gut movement, but also affects the pH of our digestive tract and our enzyme and acid secretion. The Solution: Aside from exercise, meditation is your complete well-being panacea, and it can alleviate anything from stress and anxiety to digestion and pain. I personally challenged myself to meditate every day for one month last year, and it changed my life. Within the first few days I saw my IBS symptoms improve drastically, going from having a bowel movement once or twice a week to one every day. Meditation is now an essential part of my self-care routine, and it has helped me to become happier, healthier, and calmer. Unsure of how to get started? Try this short guided meditation, or visit headspace.com and download their meditation app. The first 10 meditations are free, and serve as a wonderful introduction to the practice. I use the app every day and cannot recommend it enough. You can also check out some of these other natural anxiety fixes. Source: http://www.wellandgood.com/good-advice/bloating-causes-beyond-diet/

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