How to get Rid of Bloating-the 7 Steps

No matter what the cause, to stop bloating symptoms, you will need to identify the root cause and then have to do a maximum of “seven things”, depending on what is truly wrong. I’ll get into the most common “root causes” of bloating and some more specifics of what you’ll need to do , but first, here is the “gist of things” of what you’ll be taught about how to reduce bloating and even, in many cases; how to get rid of bloating once and for all. This, after you get yourself an accurate diagnosis of your GI issues, if needed.

  1. You’ll be changing your diet (sometimes-dramatically) and will be very careful about consuming pharmaceuticals
  2. You’ll increase fluids, insoluble and soluble fiber consumption
  3. You’ll manage your stress (cortisol) and make sure you exercise regularly
  4.  You’ll use good prebiotic foods and take good probiotic supplements
  5. You’ll (perhaps) take products to clear up toxic bacteria and/or yeast
  6.  You’ll (perhaps) take products to heal your gut lining
  7. You’ll (perhaps) need to have your hormones balanced

So now, let’s get started by discussing first, what we actually mean by bloating.

What Exactly is Bloating?

Bloating is caused by gas, not by fluid retention. You might have a bloated belly but have some fluid retention in other parts of your body (such as your ankles and feet) if you have a condition that’s causing both problems.

how to get rid of bloatingWhy the excess trapped gas?

It’s a combination of issues caused by clinical syndromes which will be described below.

To simplify what’s going on look at your gut as a digestion and bacteria factory.

You have inadequate protein, sugar and/or carbohydrate digestion which then causes  foods to ferment. You likely also have an imbalance in your gut bacteria.

In the digestive tract, there are trillions of healthy and unhealthy bacteria which compete for space. When “bad bacteria” outweigh the good bacteria, the imbalance can lead to abdominal bloating and excessive gas.

It is unusual but possible for or any gastrointestinal bloating to indicate that there is fluid collecting inside your belly. Actually this is not bloating, it’s a potential medical emergency and what you think is bloating, we’ll call simply “distension.” It could mean an infection such as hepatitis or even cancer. It could mean bowel obstruction from scars caused by prior surgery or “adhesions” from ongoing inflammatory bowel disorder. If you have sudden gastrointestinal distention please see a doctor ASAP!

 Does bloating occur without other GI tract symptoms?

Not usually. If so, it is usually due to SIBO or food sensitivities which will be discussed shortly. I’ll be talking about all sorts of GI issues including gas and constipation; two other symptoms commonly associated with bloating. Lower intestinal gas is the primary symptom associated with bloating. Constipation is #2 and often helped with  proper “GI hygiene” measures which will be outlined below. Note that toxin issues (biotoxins like mold or lyme or heavy metals) are beyond the scope of this article, but toxin issues are associated with a host of GI ailments.

General “Gut Hygiene” Measures: How to Reduce Bloating:the Basics

Chewing is the first stage of  the digestive process. This is when enzymes first kick in from your salivary glands, making it easier on your stomach. After a certain age or if you have even minor reflux disease (heartburn AKA “GERD”) can cause bloating and you will need good digestive enzymes- and sometimes betaine too. I’ll get more into this in the next section. Anyway, chew your food well as “job one.”

Eat enough soluble and insoluble fiber to keep your colon “moving along”. This works out to 25-30 grams per day. No, I can’t keep up with this, either- so I personally take a multi-fiber supplement powder and add it to my morning reds/greens drink. You want to consume both soluble and insoluble fiber. What I mean by that is you want to eat a combination of “roughage” or soluble fiber (such as sprouted amaranth), and insoluble fiber (such as organic apples with their skins) on a daily basis. Cruciferous vegetables are not only high in fiber, they aid in the detoxification process, so they should be part of each day’s intake.

You want to hydrate well-meaning just make sure your urine is clear. Too much fiber added all at once will cause constipation. Add fiber slowly and make sure you add more water or fluids to your diet, too. The combination of hydration & fiber keeps the rhythm of the GI tract moving correctly.

Exercise regularly. This activity will also help with the  GI tract’s peristalsis or proper movement/propulsion forward.

Eat a healthy diet. Junk food causes gut issues galore; from leaky gut to dysbiosis issues. If you are following this blog you know that means you should be eating either Anti-inflammatory, Mediterranean, Keto or Paleo. So, let’s get started where digestion actually starts- with chewing and “upper tract” enzymes.

If bloating is due to insufficient stomach acid

Although it seems counter-intuitive, heartburn is the result of insufficient stomach acid. Yes, it is sometimes caused by the H. pylori bacterium, but a short course of antibiotics and proton-pump inhibitor medication (or the natural alternatives) are warranted only in these cases. Usually, people are continued on PPI medication for prolonged periods of time. The bloating for this one condition tends to be around or above the belly-button whereas everything else covered here shows up below the belly button.

Anyway, regarding the PPI- this is not how the drug was intended to be used–ever! In these cases and in the instances where people take over-the-counter PPI medications for their symptoms, the low stomach acid impedes the digestive process, making those individuals “set up” for leaky gut and a multitude of other health issues. To correctly treat run-of-the-mill heartburn, you need digestive enzymes containing pancreatic enzymes and bile acids.

If that isn’t enough to totally quiet down your symptoms, you need to add betaine (HCl) capsules; all taken 15 minutes prior to meals. If you still have bloating (especially below your belly-button), you have lower gut issues. You might have developed food sensitivities, for instance.

If bloating is due to Food Sensitivities

First of all, let me remind you that food sensitivities are not food allergies- where you have an immediate allergic reaction such as a rash and/or throat tightening and hives. The foods which cause the majority of food sensitivities are (in approximately this order) gluten, dairy, eggs, corn, soy, shellfish, peanuts, citrus and lectins (namely beans) and nightshade vegetables (eggplant, tomatoes, and peppers.) Because  75% of our immune system is located in the gut, eating these foods can contribute to inflammation and then an autoimmune responses such as skin rashes, migraines, weakened immunity and even autoimmune disease.

If you feel that the following foods are giving you “GI symptoms”, they might not be actual “systemic sensitivities” in which case you can experiment. Sometimes gas and bloating caused by milk is due to lactose intolerance in which case, cut out milk products and/or use lactase.

Sometimes GI symptoms are caused by a mild wheat or gluten sensitivity so see what happens when you remove gluten from your diet. This probably has something to do with the fact that just about all U.S. wheat is GMO and added to seemingly “everything.” It is estimated that a minimum of 30% of the U.S. population has some sort of gluten sensitivity. If “this one” is causing problems, there is a much greater chance that it is causing problems outside your gut as well. I have gone so far as to remove gluten from my “allowed foods” list in my basic anti-inflammatory diet.

Lastly; GI symptoms can be caused by beans;so either eliminate them or use beano. If you have inflammatory bowel disease or are lectin-sensitive, you’ll want to eliminate them.

Please note that there are sophisticated tests (Doctor’s Data labs, etc.) that can detect specific food sensitivities if you have eliminated the “frequent offenders”, fixed your gut, and other issues to be discussed below. However to kick things off, most people find that eliminating the foods discussed in this section and then slowly adding them back will pinpoint the foods you need to avoid. This doesn’t account for FODMAPS foods which will be discussed below. Specific strains of probiotics will be discussed at the end.

If bloating is due to Leaky Gut

This common condition is often caused by antibiotics and/or anti-inflammatory medications which don’t differentiate between “good” and “bad” bacteria when they are killing off organisms in your gut. It is also potentially caused by just plain eating a good old American sugar, starch and processed diet. It can even be caused by dust mites! Healing a leaky gut isn’t that hard and if you have one, you are likely not just miserable- you’re a set-up for autoimmune disease.

So: you need to heal your gut. This entails changing your diet to a gluten-free (preferably grain free for 2 months) and dairy-free diet. The rest of the specifics are in this blog, but you’ll be eating what amounts to a Paleo diet for a good couple of months. You’ll need good gut-lining healing leaky gut supplements such as l-glutamine and several herbals such as DGL and slippery elm. You’ll need to add prebiotic fiber (such as fermented foods) to your diet. You’ll need to take high quality probiotics. As you heal your gut over 2 months time, your food sensitivities and therefore your bloating will diminish. If it doesn’t, it generally means that you have SIBO, which is not uncommon in those with leaky gut.

If bloating is due to SIBO

Small intestinal bacterial overgrowth (SIBO) is caused by high levels of dysfunctional bacteria living in the small bowel-which is supposed to be sterile. It is associated with anything that disrupts intestinal mucous, the microbiome and is a common, undetected cause of chronic constipation. It is a common result of chemotherapy, is associated with leaky gut and with CIRS (biotoxin illness).

It is treated with antibiotics that are not absorbed by the gut (specifically: rifaximin as the most highly researched antibiotic) or with natural substances such as berberine, olive leaf, garlic or caprylic acid. Often, FODMAPS are problematic. We’ll discuss FODMAPS when we get to inflammatory bowel disorders. Note that the usual leaky gut diet and supplements are helpful in cases of SIBO. A special probiotic is helpful for the bloating associated with SIBO-and we’ll get to specific probiotics at the end.

If bloating is due to a diagnosis of IBS

Many people with a diagnosis of IBS (irritable bowel syndrome) actually have a treatable disorder. For instance, diarrheal-type IBS just might be BAM (bile-acid malabsorption) OR leaky gut, for instance. It might be a chronic parasite infection. If you have a diagnosis of IBS, you are best served to find a Functional Medicine practitioner and see what your real diagnosis is; because it just might be curable! Constipation-type IBS is quite often undiagnosed SIBO. In fact, some studies indicate that up to 80% of those diagnosed with IBS have SIBO!

Combination diarrhea-constipation-bloating IBS is often leaky gut. You get the picture-now get the correct diagnosis! If no one can find a diagnosis other than IBS, a low-FODMAP diet has been found to be helpful. This, plus the usual pre and probiotic “routine” which will be discussed at the end of this article. We’ll discuss FODMAPS in the next section.

If bloating is due to Inflammatory Bowel Disease

If you have an inflammatory bowel disorder, you started out with a leaky gut, didn’t have treatment and it progressed. It’s not your fault- leaky gut can be asymptomatic (no symptoms) or come with minimal symptoms you might dismiss as “eating the wrong things.” If you have a diagnosis of Crohn’s disease or Ulcerative colitis I suggest that you read my article on autoimmune diseases referenced earlier. If you want to get these issues under control, it takes work, but it’s possible to get them under control and also wean off of toxic pharmaceuticals. Don’t do this if you’re not under a doctors’ supervision please.

It takes a Paleo-type diet, digestive enzymes, pre and probiotics, probably treatment of SIBO, and supplements to mimic TNF-alpha, IL-6 and or IL-7 suppression. I have found that the addition of stool-bulking modified citrus pectin has been helpful for patients. Recently, it has been discovered that eliminating high-FODMAPS from your diet will help with symptoms; specifically bloating. Fermentable Oligo, Di- and Monosaccharides and Polyols sensitivity is what the FODMAPS acronym stands for. Foods containing glucose, fructose, polyols and lactose can be “problem” foods for the IBS and inflammatory bowel crowd. Details of specific dietary restrictions are contained in the references section below.

The basics of your diet plan are in what I recommend for autoimmune patients anyway, but specific foods which are “rather odd” which can be problematic include foods we think of as GI-friendly such as additive-free coconut milk.

If bloating is due to yeast overgrowth

Yeast overgrowth often occurs with SIBO. It occurs in slow-transit-time GI issues such as chronic constipation, leaky gut or can just occur because you’re eating an unhealthy standard American diet. You’ll practice good overall GI hygiene, eat the “quasi-Paleo” diet and use either medications (nystatin) or natural substances to kill the yeast. It is very important that you seriously exclude all sorts of sugars from your diet as this is what feeds the yeast. Natural yeast-killers include oregano oil and caprylic acid, amongst other things.

If bloating is due to Chronic Stress

Yes, indeed-the mind and the gut are intimately connected. It makes perfect sense; physiologically. When you have chronic stress, you have a high cortisol levels. High cortisol impacts the integrity of the mucous lining of the gut and the gut’s microbiome as well. Stress can actually cause leaky gut! See how? High cortisol also slows intestinal motility, causing constipation, which; as you’ve read, can cause SIBO! So getting your stress under control is something you must do for optimal health.

As you find your way towards stress-management techniques, you can take supplements to lower your cortisol levels. These are known as adrenal fatigue supplements. A more proper name would be HPA axis dysfunction supplements but everyone knows the term adrenal fatigue, so please; no comments about why I use this term. Simply put “stress” in the search bar at the dn of this blog and find a whole ton of articles on stress management.

If bloating is due to Hormone Imbalance

Low progesterone symptoms include lower abdominal bloating. The way to tell that it’s from low progesterone rather than a GI ailment is that the symptoms are usually accompanied by other low-progesterone symptoms such as irritability, sleep disruption, brain fog and are generally (but not always) cyclic. In fact, when you’re perimenopausal, symptoms tend to be more global; occuring much of the time.

how to stop bloatingSince progesterone helps gut motility, low levels will cause some constipation, so don’t let this symptom fool you.

Can chronic low progesterone lead to SIBO?

Or leaky gut? Interesting questions which haven’t been studied but I would say “yes.”

Treatment is simple.

Bioidentical hormone replacement with progesterone will clear things right up.

A stop-gap measure is to use pregnenolone (non-prescription) which partially breaks down to progesterone. Progesterone creams sold over-the-counter are ineffective.

How to Stop Bloating once and for all

Diet

Everyone with any sort of gut ailment needs to “clean up their diet.” Common food sensitivities include (again) gluten from wheat and other grains such as rye and then; dairy, corn, lectins (beans) and nightshade vegetables (eggplant, peppers, tomatoes). Common gut irritants include caffeine, alcohol and high FODMAP foods. When in doubt- cut it out. Your gut needs 2 months (on average) to heal so cut out potentially toxic foods for 2 months to feel markedly better and get rid of your bloating once and for all.

Supplements

Any time the GI tract is “stressed” I advise patients to chew food more carefully, cook meat and veggies more thoroughly, and take digestive enzymes to decrease the GI tract’s workload. The leaky gut “cocktail” I recommend helps anyone with GI lining issues. Prebiotics and natural prebiotic fiber are a good addition to anyone’s diet. An example of good prebiotic fiber food I enjoy is lots of asparagus and an occasional Jerusalem artichoke. Other supplements I reference in this article can be found in more depth in this blog. A special shoutout, however, for good probiotics; an area of increasingly positive research.

Probiotics

The only healthy yogurt is yogurt you make yourself with live cultures. Even then, experts including me suggest that you don’t use dairy-based yogurt until your gut is healed so initially, your probiotics should be from a capsule (or 2,3,4,5 or more) and here’s why.

If your gut microbiome is out of whack you need to use prebiotic fiber to feed a lot of good bacteria (and a little “good yeast”) to then overtake the bad bacteria. You want 50 to 100 billion totally probiotic CFU’s per day which is a lot. You’ll want a mixture (in your main probiotic) of Lactobacillus species and Bifidobacterium species. You’ll want to add in some friendly yeast called saccharomyces boulardii ( by prescription:Florastor). The latest research supports the use of sporulating probiotics for most conditions. What’s that?

These are species of bacillus with b. subtilis and b. coagulans being the most studied. If these give you diarrhea, cut back on the dose and even open up and dump out 1/2 of a capsule if needed.

If you have inflammatory bowel disease, L. casei has been demonstrated to decrease your symptoms. Finally;eureka; if you have (the most common variant of) SIBO, your gas and bloating will respond almost immediately to 10 billion units of L. plantarium (best one is made by Jarrow) daily.

Food testing

The vast majority of people find that their food sensitivities start reversing in concert with the reversal of their GI symptoms. However if you have “tried all of this” on your own, it’s more than time to seek the help of a Functional practitioner who is well versed on clearing up a GI tract. That doctor will have the right lab connections (e.g. Doctor’s Data). There just isn’t enough information to either recommend or not recommend the popular Cyrex labs. To get my two cents in-IMHO, if you are “at this point”, I strongly believe you need a doctor “in on your treatment plan.”

 References:
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Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy

Uday C. Ghoshal, Ratnakar Shukla, and Ujjala Ghoshal
 2016 Feb;18(2):8. doi: 10.1007/s11894-015-0482-9.

How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach.

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Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis

Emma Altobelli, Valerio Del Negro, Paolo Matteo Angeletti, and Giovanni Latella
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Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review.

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 2017 Nov 23:1-6. doi: 10.1080/00365521.2017.1397736. [Epub ahead of print]

Persistent symptoms in patients with Crohn’s disease in remission: An exploratory study on the role of diet.

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