Janice Oh, MD
Janice Oh, MD, a resident physician within the Division of General Internal Medicine at Cedars-Sinai, Los Angeles.
One in seven Americans experience an uncomfortably swollen, tight feeling in the abdomen at least once a week—and most of them never mention it to their physicians. But if they did, they could likely find relief for this common symptom, called bloating. Bloating occurs when a person’s gastrointestinal tract fills with air or gas. It can be caused by diet or an underlying condition, such as irritable bowel syndrome, carbohydrate enzyme deficiency, chronic constipation, or small intestine bacterial overgrowth. It’s much more common in women, but men can also experience it.
There are several strategies you can try at home to reduce discomfort:
Exercise. A study published in the Journal of Gastrointestinal and Liver Diseases found that moderate-intensity aerobic exercise (such as jogging or brisk walking) reduced symptoms of bloating in people with irritable bowel syndrome. A study published in the journal Gastroenterology found that yoga may also provide relief. Finally, strengthening the muscles of the core can increase circulation, improve bowel regularity, and promote healthy digestion, which may reduce bloating.
Make dietary changes. Keep a food diary to see which foods trigger your symptoms. If it’s unclear, try cutting out the common culprits: dairy, gluten, and a group of foods called FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). These are difficult-to-digest sugars found in some fruits, vegetables, grains, dairy products, and sweeteners (see sidebar).
In some people, the carbohydrates in high-FODMAP foods don’t get digested in the small intestine. They advance to the large intestine, where bacteria feast on them, causing cramping and gas.
Treat constipation. If you’re not having regular bowel movements, eat more high-fiber foods (fruits, vegetables, whole grains, and legumes—look for low FODMAP options). Drink plenty of water to soften stools, and get some exercise, which stimulates the muscles in the digestive system and promotes bowel movements.
Listen to your gut. Some, but not all, studies have found that certain strains of probiotics may be effective in reducing symptoms of bloating. Probiotics contain live bacteria that may help to regulate the balance of bacteria in the gut. They may improve the digestion and absorption of nutrients in the gut, which can reduce the buildup of gas and other byproducts that contribute to bloating. Some strains of probiotics may have anti-inflammatory properties, and they may help to regulate the contractions of the muscles in the digestive system, which can promote more efficient movement of food and waste through the intestines.
To get more probiotics in your diet, try yogurt (look for nondairy options to lower FODMAPS); miso; kombucha, a fermented tea; and fermented vegetables, such as sauerkraut, kimchi, and pickles.
If you follow these suggestions and still have symptoms, talk to your primary care doctor, who can suggest medications as a next step.
While not an exhaustive list, the following foods are particularly high in bloat-triggering FODMAPs.
Fruits: apples, pears, mangoes, cherries, figs, pears, watermelon dried fruit, apples, blackberries, peaches and plums.
Vegetables: artichoke, garlic, leek, onion, spring onion, mushrooms, cauliflower and snow peas.
Grains: wholemeal bread, rye bread, muesli containing wheat, wheat pasta, and rye crispbread.
Legumes and pulses: red kidney beans, split peas, and baked beans.
High-lactose dairy: soft cheeses, milk and yogurt.
Sweeteners: sorbitol, xylitol, erythritol, honey, and high-fructose corn syrup.
