Women's health
8 reasons we might be bloating (and what to do about it)
We’ve all been there: our stomachs slowly getting bigger during the day, or quickly expanding after a meal. Say hello to bloating — something almost 20% of us experience at least once a week.
Aside from causing jeans to feel a bit too snug, bloating can lead to pain and discomfort. It can also be embarrassing, with wind being a common side effect.
Although we can often tackle bloating at home, pinpointing the cause is key when it comes to finding the right treatment. Here, we chat to the experts who share their advice for beating the bloat.
8 reasons we might be bloating (and what to do about it)
Our hormones
Hormonal fluctuations can play a big part in bloating, and may explain why the condition is twice as common in women than men.
Prior to menopause, hormonal changes during the menstrual cycle can influence bloating.
“The womb will change in size and fullness in response to varying hormone levels,” says Dr Fionnuala Barton, specialist doctor and founder of The Menopause Medic women’s health clinic. “This can give rise to bloating, distension, and discomfort.”
And the issue doesn’t end at menopause, either. Hormonal shifts experienced during this time can impact our gut cells and the gut microbiome, says Fionnuala, in turn influencing digestive function. Hormonal fluctuations can also encourage water retention, making us look – and feel – fuller.
The solution? Moving regularly, drinking plenty of water and avoiding too much salt may help to ease symptoms.
Diet
Sophie Medlin, consultant dietitian at CityDietitians, says that one particular food group is commonly linked with bloating: fermentable carbohydrates. This food group includes ingredients such as pulses, beans, onions, apples, and garlic.
Unfortunately, they can be more troublesome once we hit our midlife years. “We can become more sensitive to these in midlife because of changes to the microbiome that occur with age,” Sophie explains.
Such changes involve a higher prevalence of gut bacteria that ferment foods more rapidly – leading to gas and bloating.
While our first instinct might be to cut out these foods entirely, Sophie says a more nuanced approach is best. “Work with a dietitian to restore your microbiome and tackle the underlying cause, so you don’t have to follow a restrictive diet in the long run,” she advises.
Eating habits
It’s not just what we eat but how we eat that can lead to bloating. If we’re not paying attention and eating too quickly, we can end up swallowing air as we chew, quickly leading to a balloon-like feeling.
“Being aware of how you eat and keeping your mouth closed, not chatting too much, and chewing food properly can help,” notes Dr Helen Wall, a GP partner at The Oaks Family Practice in Bolton.
Helen also recommends massaging the stomach if we feel gassy after eating, as this can help to release trapped air.
Anxiety
Our stomach doesn’t only churn when we’re anxious: it can also bloat up.
“When we’re stressed, rapid shallow breathing can cause the diaphragm to contract, which pushes our stomach down and out,” explains Sophie. “Studies show that when the diaphragm contracts, although there is no additional gas in the digestive system, the contraction compacts the gas, causing bloating.”
It doesn’t end there. The gut and brain are also closely linked, and research reveals that stress can negatively impact gut microbiota levels and activity.
To help counter stress-related bloating, breathwork can be highly effective in calming the mind and relaxing the diaphragm. “There are also specialist forms of cognitive behavioural therapy for irritable bowel symptoms if you recognise stress as a trigger,” says Fionnuala.
Gallstones
While bloating isn’t often cause for concern, it’s worth knowing that it can sometimes be the result of gallstones. And, as Fionnuala explains, it’s a surprisingly common issue during midlife.
“Gallstones develop when excess bile products accumulate into lumps in the gallbladder, which is tucked just under the liver,” she explains. “They can cause pain and can dislodge and block the ducts, which can cause more pain and impact digestion, causing more bloating.”
Treating gallstones usually requires surgery. We can minimise our risk of developing them, however. Fionnuala recommends following a healthy diet and maintaining a normal BMI.
She also notes that studies have found links between oestrogen and gallstone development, so it’s worth a chat with a GP if we’re taking HRT.
Constipation
There’s no such thing as a ‘standard’ bowel movement: some people empty their bowels several times a day, while others only do so a few times a week.
As such constipation is another common cause of bloating, says Sophie.
“This is often missed because someone might assume their bowel habit is normal,” she says. Stools should be soft and easy to pass, she states – so if we find ourselves straining, it could be a sign of constipation.
While not eating enough fibre is a common culprit, Sophie explains that body changes can also contribute. “Sometimes, especially in midlife, weakening of the pelvic floor can cause defecatory issues,” she says. “This makes it more difficult to pass stools, leading to constipation.”
Working with a dietitian or nutritionist can be helpful for understanding any causes of constipation.
Irritable bowel syndrome
Irritable bowel syndrome (IBS) is thought to affect 13 million Brits – with symptoms including stomach pain, diarrhoea, and (you guessed it) bloating.
Experts aren’t entirely sure what causes IBS, but potential triggers include medication, stress, and stomach bugs. All of these can then impact the sensitive balance of bacteria in the gut microbiome. Over-sensitive nerves in the digestive system – known as ‘visceral hypersensitivity’ – are also believed to be a factor in the condition.
Gynaecological cancer
In rare instances, certain cancers can be the cause of bloating. “Gynaecological cancer can present with vague symptoms, such as bloating, due to inflammation and fluid accumulating in the pelvis,” explains Fionnuala.
There are five types of gynaecological cancer – cervical, womb, ovarian, vaginal, and vulval – and around 22,000 new cases are diagnosed each year. Attending routine smear tests plays a vital role in the early detection of cervical cancer.
When to seek medical advice about bloating
Not all bloating is cause for concern.
“If you have bloating that builds up through the day and is noticeably worse after eating, this is normal, to an extent,” says Sophie. For instance, we might feel a bit bloated at bedtime after a particularly heavy dinner, then notice our tum is back to normal the following morning.
However, bloating can be a sign of a more serious condition, such as cancer or coeliac disease, that requires prompt testing and treatment.
“Please see a GP if you’ve been feeling bloated for three weeks or more and [are] unable to self-resolve it with diet, or if you feel bloated regularly (more than 12 times a month),” Helen says.
She states that it’s also essential to visit a GP if experiencing bloating along with sickness, diarrhoea, constipation, weight loss, pain, or blood in our faeces.
Words: Chantelle Pattemore
