If you start the day with a flat belly but feel bloated by bedtime, there’s a good chance you’re a woman.
Why being female makes you more bloat-prone isn’t clear but shifting hormones could play a part – women surveyed recently by The Gut Foundation, for instance, reported that bloating is more common before a period.
But what’s almost as big a problem as bloating itself is that its symptoms are sometimes disregarded by doctors or lumped under the heading of Irritable Bowel Syndrome – which means the real cause may not be found, says gastroenterologist Terry Bolin, Associate Professor of Medicine at the University of NSW.
"Some women who have problems with bloating also mistakenly assume they’re overweight and go on restrictive diets. This can make bloating worse if it’s caused by constipation and they then reduce their fibre intake," he says.
While constipation is a common cause of bloating it’s only one of many possibilities unravelled in Bolin’s new book Understanding Gas and Bloating– why can’t I do up my jeans at night? Food intolerance, lactose intolerance and coeliac disease can be causes, as can excess gas generated by some sugars in food, including fructose, fructans and sorbitol, in some sensitive people.
But it can also be a problem with the muscular contractions in the small intestine.
In a well behaved gut, regular muscular contractions keep gas moving smoothly through your system, but sometimes things go wrong. Contractions can be disrupted, trapping pockets of gas and causing bloat.
In some people the muscles in the gut wall become more elastic and easily blown up with gas – and we humans do make lots and lots of the stuff. On average you produce around 25 litres daily most of which – thankfully - your body reabsorbs.
Even so, your small intestine could be carrying up to three litres of gas at any point in time – the equivalent of two party balloons. If things aren’t working well and gas becomes trapped there can be pain, discomfort and swelling, Bolin explains.
A number of things can disrupt the muscular contractions of the gut. Changing hormone levels before a period may be one. Fat and stress are others.
"Studies have shown that if you trickle fat into the small intestine it can trigger disordered contractions in some people. Any type of fat will do this whether it’s extra virgin olive oil or from KFC," he says.
With stress, the problem seems to lie with the complex connections between the brain and nerves in the gut that can affect muscular contraction, especially in people with IBS. For some people a tiny dose of tricyclic antidepressants – well below the normal dosage for depression – can help, Bolin says.
What helps prevent or improve bloating? It depends on the cause. Finding that can involve trial and error and expert help from a gastroenterologist, and possibly a dietitian too.
If the problem is constipation, increasing the fibre in your diet is a solution, but it’s important to do this gradually – too much too soon can make the problem worse.
Being physically active is good - it improves the movement of gut muscles.
Probiotics can help too, although it’s not clear yet which strains work the best, says Bolin, although the following are showing promise: bifidobacterum infantus, lactobacillus acidophilus , lactobacillus casei GG , bifidobacteria animalis lactis (HN019) and lactobacillus plantarum.
“But you can’t always rely on one single thing to improve bloating – you may need more than one approach,” he says.
Understanding Gas and Bloating – why can’t I do up my jeans at night? is published by The Gut Foundation, A$24.95 and is available online at www.gutfoundation.com.au.
When bloating can be a warning
For women, vague gut symptoms are sometime a sign of ovarian cancer – if symptoms like bloating, feeling full, pain in the abdomen or back, changes in toilet habits and unexplained weight loss or weight gain are persistent and unusual for you, Medical advice is to get them checked out.
- Sydney Morning Herald