Sarah’s Health Notes: Help to beat bloating

This week I have asked nutritionist Dr. Marilyn Glenville, my trusted authority for decades, to share her advice on bloating. This came about because a twentysomething friend Angela* asked me for advice on a long time problem with this very common digestive problem. As Dr. Glenville explains,  ‘you may feel fine when you wake up but, as the day goes on, you feel more and more uncomfortable with your clothes feeling tighter and tighter.’

Angela (not her real name) was diagnosed with IBS by her former GP but then basically left to get on with it. But, as Dr. Glenville comments, ‘IBS is often a “catch all diagnosis” for digestive problems’, which may or may not be the case here. Whatever, it really didn't help the patient.

Dr. Glenville’s advice below is to help over the holiday season when all the parties and Christmas goodies can overload your digestion with much too much food, often sugary and fatty. (I have a problem with Christmas cake and pud, both of which I love, mainly because of the sugary dried fruit.) According to Dr. Glenville, ‘it’s estimated we can consume up to 6,000 calories just on Christmas day alone (women are recommended to have 2,000 per day and men 2,500) so this overindulging can leave you feeling very uncomfortable’.

In the New Year, Dr. Glenville suggests Angela talks to her new GP about referral to a dietician and possibly trying the low FODMAP diet, which involves avoiding foods that are not easily broken down by the gut. However, Dr. Glenville recommends also avoiding too many sugary foods (which may still be ‘allowed’ with the low FODMAP diet), as these can exacerbate IBS and bloating.

If bloating continues, it is very important to consult your GP to exclude any underlying conditions.

Dr. Glenville’s Top Tips for managing bloating

Eat more slowly and chew, chew, chew. The first part of digestion starts in your mouth so take your time and your food will be digested more efficiently; this will stop it from stagnating and fermenting, which leads to bloating. 

Chewing not only helps with the mechanical part of digestion by breaking down your food into smaller pieces before it is swallowed but will also make you eat at a slower, healthier pace. When you eat too fast, you often eat too much but you probably won’t realise that because it takes your brain 20 minutes to register that you are full. Eating more slowly means you automatically end up eating less food.

Another big cause of bloating is swallowing too much air when you eat. That tends to happen if you snack on the run (see below) and eat too quickly, talk while eating, drink from a straw, or down a lot of fizzy drinks.  So: take more time for meals, skip carbonated drinks, eat smaller amounts of food at each sitting and chew with your mouth closed.

Chewing gum. This also makes you swallow too much air, so best avoided. 

Reduce stress. Relax more! Stress is a trigger for digestive upsets so try deep breathing, which can help relieve stress -related digestive problems.  The stress response was designed to enable you to either run or fight for your life.  During that time you‘re probably not digesting food so the natural flow of energy is diverted away from your digestive system to your extremities so you have the energy to run or fight. 

When you’re stressed, your body literally shuts down your digestive function so food stagnates and ferments, making you bloated and often giving you gas.

Try not to eat on the run, however short of time you are, because your body goes into the same run or fight mode.

The solution is to reduce stress, either by changing what is making you stressed or how your body copes with stress.  Use relaxation techniques starting with deep breathing.

Nutrients to help… There are certain nutrients that can help your body not react so quickly to stress and therefore not affect your digestive system so much. These include the B vitamins known as the ‘stress’ vitamins, magnesium – dubbed Nature’s tranquilliser, Siberian ginseng - the herb of choice for stress, and an amino acid called L-theanine, which has a relaxing, calming effect on both mind and body. In her clinic, Dr. Glenville uses NHP’s Tranquil Support, which contains all these nutrients and more.)

Constipation. Being constipated can also cause bloating because bacteria in the bowel ferment food in the digestive tract, leading to bloating.  The longer the food stays in there the more fermentation can take place. As well as bloating, this may also cause flatulence.

Foods to avoid… Certain foods may cause bloating, including and any of the beans (eg chickpeas, lentils, kidney beans) and some vegetables such as broccoli, Brussel sprouts, cauliflower, cabbage, onions and leeks. 

Broccoli, cauliflower and cabbage may also cause excess wind because they are not digested completely in the small intestines, possibly due to a lack of enzymes.  So when they reach the large intestines, bacteria in that part of the gut can cause gas and bloating as they set about breaking down those foods.  Too much sugar and wheat may also be culprits.

Reduce or eliminate carbonated drinks. The bubbles from fizzy drinks, even sparkling water and diet colas (see below), can cause bloating.

Avoid sugar substitutes. Sugar alcohols (a.k.a. polyols), which include xylitol, sorbitol and maltitol, can cause bloating, flatulence and IBS symptoms in people who are sensitive to them.

Explore whether dairy’s a problem. Some people – about 6% - don’t produce the enzyme lactase, which helps break down lactose, a sugar found in milk. If lactose is not broken down, it ferments in the gut causing pain, gas and bloating. [To find out if this affects you, NHS information advises avoiding products with lactose for two weeks to see if your condition improves. For more information, click here. Another cohort of people has problems with dairy but who are not lactose-intolerant may have a problem with another milk protein called A1. So-called A2 milk is free from this so may be worth trying.]

Probiotics may help. Probiotics can help with bloating because they control the levels of harmful bacteria and yeasts, which may be causing the symptoms.  An even better combination is to have a probiotic and prebiotic combined so that the prebiotic supplies the ‘food’ for the beneficial bacteria to colonise the gut.  It is important to have good levels of the lactobacilli species of bacteria as they are important in helping produce digestive enzymes, which also helps the breakdown and absorption of nutrients. In her clinic, Dr. Glenville uses NHP’s Advanced Probiotic Plus, which also contains a prebiotic.

Sip peppermint tea after a meal. A cup of peppermint tea can help prevent and ease bloating. [I love fresh mint tea or Pukka Teas Organic Three Mint teabags.]

Go for a stroll. If you feel bloated after a meal, take a short walk as this can reduce the feeling of fullness.

Dr. Marilyn Glenville PhD is one of the UK’s leading nutritionists.  She is the author of 17 internationally bestselling books including Osteoporosis – how to prevent, treat and reverse it. The Glenville Nutrition Clinics are all operating remotely at the moment so if you need any help nutritionally go to glenvillenutrition.com or phone 01892-515905.