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Bloating is one of the most commonly reported digestive symptoms. It is estimated that anything between 11 % and 30% of people may be regularly suffering with the sensation that their abdominal region is distended and uncomfortable. This may or may not be related to eating.

 There are four distinct patterns of bloating

1. The intestines are filled with gas; this may or may not be accompanied by flatulence or/and belching
2. Peristalsis (intestinal movement) is dysfunctional preventing healthy evacuation of gas and stools. This is referred as dysfunctional intestinal obstruction
3. The intestines are hypersensitive and feeling bloated even though they may not be particularly distended
4. The abdominal area is retaining water making it feel heavy and uncomfortably bloated

Let’s examine further what may cause each of those particular patterns and how to improve them.

Intestinal gas

The gut is a complex system made up of many communities of microbes. They colonise every nook and cranny of our intestines and coexist in relative harmony. Together they make the changing landscape of our gut from mouth to anus. Some produce gas, others can utilise that gas to power their own requirements. Some can function in the presence of oxygen other can’t; some like an acid environment others are killed if the PH drops below a certain level and, of course, all those organisms are dependent on the food we care to eat.

In an ideal world, the interactions between us, our food and our microbes should be harmonious and produce comfortable amount of gas. It should be easily passed and dealt with either via our lungs/skin or simply expelled. A certain amount of gas is normal and the sign that our flora is abundant and doing its job. Gas only really creates bloating if it is excessive. As a point of reference passing gas 20 times in a day is not excessive.

Food that is poorly digested, and allowed to reach the large intestine where most of our bacterial colonies live, will create excessive fermentation/gas. This can be due to meals that are too large and too dense compared to our digestive capacity, a physiological deficiency in digestive enzymes (which can be compensated with a digestive enzyme supplementation) or an inability to digest a particular food (lactose is typically a food that some of us do not have the ability to digest while gluten cannot be digested by celiacs).

Sometimes bacterial overgrowth can occur in the small intestine. Under normal conditions, the bacteria that produce gas are limited to the colon but can spread back into the small intestine where they will come in contact with partially digested food and create excessive fermentation. This condition  is called small intestine bacterial overgrowth (SIBO). It may be responsible for the more sever digestive symptoms of Irritable Bowel Syndrome (IBS).

You can test for bacterial overgrowth of the small intestine using a hydrogen/methane breath-test. This is done following ingestion of a fermentable sugar (lactulose, fructose, and sorbitol). Colonic bacteria will naturally form hydrogen and/or methane which is absorbed into the blood and eliminated in the breath where it can be measured. In normal individuals, there is one peak of hydrogen or methane when the lactulose enters the colon. In individuals who have SIBO, there are two peaks of hydrogen or methane: When the lactulose passes and is exposed to the bacteria in the small intestine and again when it enters the colon.

Depending on the state of an individual gut flora, some foods will create excess fermentation. Dairy, wheat, specific vegetables (i.e. onion, cabbage, red peeper, etc.) contain fermentable sugars that can react with gut bacteria. Limiting those foods can keep symptoms under control. Finding out exactly which foods are the worst offenders can be painstakingly slow and may require keeping a food diary. Colonic hydrotherapy can help manage and reduce symptoms of excessive gas, IBS and SIBO

Functional intestinal obstruction

A functional obstruction is not an actual physical blockage, but results from the muscles of the stomach or intestines that propel the intestinal contents not working functionally. This causes the content to accumulate and distend the abdomen. It can be caused by a nutritional deficiency such as magnesium, an emotional issue, a physical/neurological issue or an inability to handle fats. Fats can directly affect bowel peristalsis and slow it right down if poorly digested fats reach the small intestines. Typically this is because of liver/gall bladder congestion reducing bile out-put in the duodenum and poor fat digestion. Functional intestinal obstruction can lead to SIBO, further contributing to bloating. Kinesiology is an excellent tool to assess the cause and treatment of a functional intestinal obstruction.

Intestinal hyper-sensitivity

In some individual the gut itself feels boated and uncomfortable but there is no evidence of excessive fermentation or muscular dysfunction. This reflects a neurological state. Gut neurotransmitters such as GABA and serotonin may play a part and sensitivity can be accentuated by chronic low grade inflammation of the gut as evidenced by mucous in the stools and a tendency to diarrhoea. Butyric acid is helpful in controlling low grade inflammation as is a detox diet and probiotic supplements

Water retention

This can affect the abdominal area and is usually influenced by hormonal variations. Generally sugar, alcohol and excess salt (sodium chloride) contribute to water retention. Trace minerals and quality water is important in regulating kidney function. Food sensitivity and low grade cellular inflammation can lead to bloating. A detox diet combined with Dandelion leaves tea and colonic can effectively reduce water retention