This week I’ve had a number of patients come in complaining of abdominal bloating and cramping. It seems a good time to talk about bloating!.
This is a very common symptom that we see. The symptom generally consists of the abdomen feeling larger than usual. Pants fit too tightly, there is an uncomfortable sensation of pressure and sometimes cramping and pain. Sometimes the abdomen actually IS larger than usual, but sometimes not.
There are three ways that the abdomen can actually GET bigger. I’m not talking about weight gain, because abdominal fat mass doesn’t fluctuate from day to day. The intestinal contents can increase, the fluid around the intestines can increase, and there can be more intestinal gas content than usual.
- Constipation – This is often the cause of bloating and cramping. If you feel bloated and have not had a good BM in a day or two, take a stool softener or a gentle vegetable laxative like senna and see if that resolves the problem in a few days. (Note: Shaklee’s HerbLax is my favorite to recommend, it is very gentle and reliable.)
- Water retention – Ladies who notice bloating as part of PMS symptoms usually have this to blame. Hormones can also cause constipation so both can play a role. Avoiding salty snacks and processed foods can help. Dandelion tea has diuretic properties and can help relieve the water retention naturally as well. If you take water pills for any reason, make sure to discuss supplements with your doctor.
- Gas – There are two sources of intestinal gas. One is air that you swallow as you eat and drink. The other is gas that is produced in the intestine as bacteria ferment carbohydrates in the food you eat. The best known is beans (the musical fruit!). Beans contain carbohydrates like stachyose and raffinose, which humans can’t digest. Your intestinal bacteria, however, CAN digest them and happily go to work, creating intestinal gas. There are several ways to decrease the bloating and cramping from gas. Don’t chew gum, drink carbonated beverages or talk while eating (all of these increase the swallowing of air/gas). Decrease your intake of foods that create a lot of intestinal gas like beans, broccoli, cauliflower, Brussels sprouts, etc. If you’re lactose intolerant you should avoid dairy foods. There are enzyme supplements like Lactaid and Beano that can help.
Gas, bloating and cramping are very common symptoms of irritable bowel syndrome. IBS is a poorly-understood problem where the movement of the intestines (called peristalsis) is not coordinated properly. Instead of an orderly progression of contraction moving food contents through the intestine, IBS causes disorganized contraction which results in cramping and pain. Often peristalsis happens too quickly (causing diarrhea) or too slowly (causing constipation). The most frustrating situation is where one person has BOTH problems depending which day you ask! IBS generally responds very nicely to probiotic supplements. If you choose a probiotic make sure it is a coated capsule to protect the bacteria from the stomach acid. The one I use is Shaklee’s OptiFlora.
To summarize, if you find yourself suffering with gas, cramping and bloating, here are a few things to try. Avoid foods that cause gas like dairy foods, beans, etc. Use an enzyme supplement like Lactaid or Beano if you suspect one particular food is a bad actor for you. Don’t chew gum or drink carbonated beverages. Try to eat slowly and quietly. Address constipation with a stool softener or gentle vegetable laxative. Try a good probiotic supplement, especially if you have alternating constipation and diarrhea. If all this fails, check in with the doctor. Sometimes further testing is needed. Good luck!