Bloating - It's Not Always Digestive

Happy Almost Fall! While I LOVE summer I have to admit this one was so hot and dry that I’m not complaining about a cooling trend!
As I think about some of the most common health complaints I see, bloating is right there at the top of the list.
Bloating is described as retention of gas in the intestines. Some feel the pressure as high as in the stomach and central rib area while some have lower abdominal bloating. Some have entire abdomens swollen and puffy and describe it as feeling of being “pregnant”. Not all pass gas when they are bloated and sometimes it can be super-duper painful – like “take me to the hospital” painful. Some describe a gurgling sound while others experience no sounds at all.
Most people believe that their bloating is derived from the digestive tract, however there are multiple other causes of bloating that are important to consider. Although bloating is most commonly caused by digestive distress there are numerous other causes of bloating that are important/crucial to consider.
DIGESTIVE CAUSES
1. Gastritis – inflammation of the stomach – usually described as having a balloon high up in the abdomen right below the sternum
2. SIBO/IBS – one of the most common causes of bloating is bacteria (that shouldn’t be in the small intestine) eating your food and producing gas. Remember SIBO/IBS are symptoms and should never be the diagnosis!
3. Candida or Parasites – believe it or not Candida is not as common as one would think and is a symptom of a dysfunctional gut microbiome!
4. Food sensitivities – poor reactions to foods – usually though this is due to #7 below and not the food itself!
5. Undigested food – poor pancreatic enzyme and hydrochloric acid output so you’re left with partially undigested food which can ferment and is a burden on the small intestine.
6. Fermentable foods (those high in FODMaPs) – gas promoting foods such as beans, legumes, broccoli, cauliflower, cabbage, apples, avocado, etc.
7. Histamine – high levels of histamine in the gut due to a dysfunctional gut microbiome – namely low Bifidobacterium species or overgrowth of histamine-producing species
8. Slow transit – poor macro-motility – peristalsis – so foods sit giving a feeling of fullness
9. Over-eating – just putting too much food into a system that can’t work as fast as you are shoveling it in😊
OTHER IMPORTANT CAUSES
1. Reproductive System Problems – ovarian cysts, uterine fibroids
2. Liver Disease – sometimes it’s not air but fluid known as ascites
3. PMS – sometimes it’s that week before your period and you just feel puffy in the belly
4. High estrogen levels – this is a cause of a lot of bloating and most don’t realize it
5. Cancer – many cancers can cause the sensation of bloating – certainly digestive cancers can but there are some cancers caught late because bloating is dismissed by your doctor. Three cancers come to mind – ovarian, uterine and pancreatic. They are often missed early because they can first manifest with simple bloating and the feeling that you fill up with food fast (early satiety). The bloating experienced can be actual bloating or fluid build-up (ascites).
Now don’t go getting terrified on me because I mentioned the dreadful “C” word – cancer. Yes, it’s true that several cancers’ first symptoms are digestive and bloating tops the list. That’s why they are so overlooked and caught late – think ovarian and pancreatic. So many practitioners will brush off bloating when their clients express that symptom and quite a few have missed important, early diagnoses by doing this.
Here's a story for you – a heavier-set female client came to me after seeing several gastroenterologists for her distended belly, bloating and painless “spasms” in her belly – with no answers. Not one doctor bothered to get a true, full history. Once I heard her history, I asked her to immediately go and buy a pregnancy test. She did and it was POSITIVE and she gave birth `1 week later! She didn’t even know she was pregnant!! They were so determined to focus on her bloating that they missed she was full-term!
Can you see why conventional medicine breaking up into specialties is a problem. If you go to a gastroenterologist for your bloating but your bloating is hormonal in nature they cannot/will not help you or guide you properly because they aren’t always going to ask all of the questions necessary. Also, insurance (or their ego) can prevent them from running diagnostic imaging to verify that the cause isn’t something more obvious or ominous – like a pelvic and/or abdominal ultrasound to rule out pregnancy, ovarian, uterine or pancreatic causes. Always see a practitioner that sees you as a WHOLE – not a system.

It all comes down to this - never assume any symptom is what it seems. It takes a good diagnostician to fully work-up a client and think of all possible causes of symptoms and not just brush them off!
SO what to do?
First off see a practitioner who is willing to take your symptoms seriously! Don’t let them blow off your symptoms by diagnosing you with IBS (a complete made-up diagnosis) and offer you no real solutions or simply the medication that goes with that “form” of IBS.
The key is to find the source of your bloating – regardless of what system it is in.
You don’t have to live with bloating. It’s not always easy to find the cause but we owe it to our clients to fully assess each one as an individual and run appropriate and comprehensive testing.

ALWAYS LOOK FOR THE ROOT CAUSE!