This is the second part in a series of posts. The first article covered What causes bloating, and this one follows up with how to get rid of bloating.
Though relieving the symptom of bloating is important, as with many chronic health concerns to make a permanent improvement, it is necessary to find the underlying causes of the problem. In the first part – what causes bloating – I gave a list of conditions that are linked to the symptom bloating. If your doctor has ruled out any serious medical conditions as the cause of your bloating, and you continue to have symptoms, then you could speak to your local qualified herbalist to help you find the underlying cause. Then it could simply be a matter of making some dietary or lifestyle changes. Along with some herbal remedies or supplements to help relieve symptoms.
For example, bloating commonly occurs after a meal which might suggest a food trigger. Or, if stressful times make your bloating worse you might need to focus on some stress management techniques. Bloating is also more common in women than men, especially in relation to a woman’s menses, which could suggest a hormonal link.
In the previous article I suggested using a food diary to help identify possible trigger foods. Following up with an elimination diet that removes potential trigger foods. An elimination diet is a simple yet powerful way to confirm whether a particular food is problematic.
In my series of articles about a 4R program I discuss an elimination diet that removes fermentable carbohydrates, called a low FODMAP diet.
Gluten and bloating
If you think that gluten containing foods such as bread, pasta and some breakfast cereals are a potential trigger food for you it is a good idea to ask if your doctor will check for coeliac disease. I talk more about coeliac disease here. It is likely that coeliac disease is under diagnosed at present. it is certainly true that many people do not realise they have this autoimmune disease. If coeliac disease is confirmed then it is crucial to avoid gluten containing foods completely. Even if coeliac disease is ruled out, gluten can still be a problem as it can cause another issue called non-coeliac gluten sensitivity.
Fermentation and bloating
Certain foods that are rich in carbohydrates such as sugars or starches can cause bloating due to fermentation in the gut, that leads to gas production. This can be linked to an imbalance or alteration in the population or location of microbes in the gut, sometimes called our microbiota. An altered microbiota may also be responsible for production of different fermentation gases, or an increase in the volume of gas produced. Which can also be affected by the type of foods eaten, and specifically the type and amount of dietary fibre.
However, many studies do not support the theory that the sensation of bloating is linked to an increase in the total volume of gas in the bowel. The suggestion is that the problem is instead related to poor transit or distribution of gas along the bowel. Food the moves slowly through the bowel, such as occurs with constipation, may make fermentation in the bowel more likely. Plus, the gases may be trapped in certain areas of the bowel causing discomfort.
Another theory is that some people, particularly those that have bloating without distension, may be more sensitive to the sensation of stretching of the bowel caused by gas production. Thus they are more sensitive, or have a lower pain threshold to the sensation of bloating, feeling discomfort even without an actual increase in abdominal girth.
Increasing dietary fibre may either improve or worsen bloating. In theory, dietary fibre reduces constipation, helping the bowels to move more easily. Yet, dietary fibre can also be a substrate for gut microbes, producing fermentation gases and more bloating. It is also possible that dietary fibre such as bran may increase the bulk of the bowel contents while decreasing the motility of the gut, which could be yet another cause of bloating. Furthermore, studies show that constipation slows the transit of the contents of the small intestine, further aggravating bloating.
How to get rid of bloating
By now I am sure it is clear that there is not one size fits all answer to the issue of bloating. Having said that, and having ruled out any serious medical conditions with your doctor, in many cases bloating could be linked to poor digestion causing fermentation. Food needs to be broken down properly during a healthy digestive process. Good digestion demands an adequate amount of stomach acid and digestive enzymes and other digestive juices. Sometimes people just don’t have enough. Following a 4R approach might be what you need to get your digestion back on track.
A balanced and healthy population of gut microbes helps to complete the digestive process. Whereas an imbalance or altered microbiota can lead to fermentation and bloating. It is possible to modify the gut bacterial population, yet probiotics are often not enough for a long term solution. Studies show that prebiotics are more reliable for improving microbial balance than probiotics. Whether that is by supplementation with prebiotics or by eating a prebiotic rich diet. Yet, this needs care as prebiotics selectively feed the gut bacteria, and at least to begin with, can be a cause of bloating. Starting with tiny amounts of probiotics or prebiotics may be necessary.
Check for food intolerances either using a food diary, appropriate food intolerance testing or a careful elimination diet. If you suspect a certain food or foods try eliminating them for a period of at least four weeks. Re-introduce foods one by one, leaving a gap of a couple of days before adding a new food, and noting any symptoms in your food diary. If a re-introduced food causes symptoms then it is best to leave this out of your diet for several months before trying again.
Constipation and bloating
As I mentioned before, studies show bloating with distension is often related to constipation. This meta-analysis found that probiotic supplements reduce intestinal transit time and improve stool consistency. Another study confirms that probiotic supplements significantly reduce bloating.
Ginger is a prokinetic herb, which means that it lowers the amount of time it takes for stool to pass through the intestines. Improving the wave like motion of the gut, or making the movement stronger. So, this herb can be helpful to prevent bloating and other digestive problems. Ginger is also a carminative herb, a medicinal property that I discuss later in this article.
Bloating and diarrhoea
As I mentioned before bloating can be related to constipation or to diarrhoea. Bloating that is linked to diarrhoea needs a different remedy to that of constipation related bloating. The herbal remedy peppermint may be more helpful for the symptom of bloating that occurs with diarrhoea. The essential oil of peppermint is another traditional remedy for digestive problems. Peppermint reduces spasms and relaxes the muscles of the gut, slowing the wave like motion of the gut. Research suggests peppermint may also reduce the sensitivity of the gut, which may be helpful for people that have a lower pain threshold.
In a study lasting four weeks, treatment with enteric coated peppermint oil capsules reduced the symptoms of IBS, including abdominal bloating.
Abdominal gas and bloating
In this study, activated charcoal significantly reduced the symptoms of bloating and abdominal cramps related to too much gas in the intestines, compared to placebo. Another study found that activated charcoal that was given after a typical gas-producing meal reduced the expected flatulence.
Carminative herbal remedies to relieve bloating
A carminative is a herb that helps to prevent the production of gas, or helps the removal of gas from the digestive tract. So, carminative herbs have a tradition of use to reduce symptoms of bloating.
Examples of carminative herbs include angelica root, aniseed, cayenne pepper, chamomile, cinnamon, dill, fennel, fenugreek, ginger, hyssop, lemon balm, peppermint, rosemary and yarrow. Many of these herbs can be included in cooking or may be taken as herbal teas. Their carminative property explains why many of these herbs are traditional favourites included in meals or after dinner beverages.
Aniseed is a traditional herbal remedy used for the treatment of digestive problems. One study found that enteric coated capsules of anise oil were helpful for treating symptoms of irritable bowel syndrome. Three capsules per day, for four weeks of encapsulated anise oil was better than an encapsulated peppermint oil or placebo for relieving symptoms of irritable bowels syndrome including bloating. What’s more 75% of the patients receiving anise oil were symptom free after the treatment period.
Fennel and dill are traditional herbal ingredients of gripe water. A classic remedy used to relieve colic pain and flatulence in babies and young children for generations.
A nice carminative blend to make is a decoction of equal parts of the following seeds: dill, fennel, caraway, coriander and aniseed.
In summary, there are several remedies that might help to reduce or prevent bloating. Yet if you suffer from chronic bloating finding the underlying cause and addressing that is preferable to just repeatedly treating symptoms.
If you need further advice or help with finding the underlying causes of your bloating why not discuss this with your local qualified herbalist.