Bloating is one of the most common complaints I treat in my patients. Because of the recent spotlight on SIBO, people automatically assume that bacterial overgrowth in the intestine is the only cause of bloating. In fact, there are many other causes. Bloating comes down to something taking up space. It can be gas, fluid, or solids. It can be inside the gastrointestinal (GI) tract or outside of it. It can show up as visible abdominal distention that makes you look pregnant, or simply as a sensation of feeling bloated.
Let’s start by looking inside the GI tract
Gas is a common cause of bloating. It results from fermentation, as bacteria or yeast feed on the food in your digestive tract. Bacteria thrive on undigested fiber, which leads to overfermentation and gas buildup. If you’re able to pass gas, the discomfort is usually mild and short-lived. For some people, though, the built-up pressure can be painful enough to send them to the ER.
On the other hand, you may not have an overgrowth at all, just too much undigested food sitting in your GI tract. This can happen because the body is missing certain digestive enzymes needed to break the food down properly, or because of an injury somewhere in the GI tract. Either way, food isn’t moving through the digestive tract at the pace it should.
The other common cause of bloating is constipation. Most people assume that if they have a bowel movement every day, they can’t be constipated, or that loose stools rule it out. A healthy bowel movement should actually happen about twice a day, with stools that are formed, soft, and easy to pass. The evacuation should feel complete and easy to wipe. If you’re passing pebble-like stools, large lumpy stools, or even mushy stools that require pushing or leave you feeling incomplete, these can all be signs of constipation.
Now let’s move on to bloating caused by factors outside the GI tract
One cause is ascites, a condition where fluid builds up in the abdominal and pelvic cavities. This is usually related to liver or kidney disease and is a serious finding. Anyone with this condition needs immediate medical attention.
Another cause is a mass. This could be a cancerous tumor, a benign uterine fibroid, an enlarged uterus before menstruation, or adipose tissue between the abdominal muscle and skin.
A third cause is abdomino-phrenic dyssynergia, a condition where the abdominal muscles and diaphragm fall out of coordination during digestion. This discoordination can lead to significant visible distention in the lower abdomen within 20 to 30 minutes of eating.
Because bloating can have so many different causes, it’s important to get guidance from your healthcare team so it can be properly assessed and treated. If you’re ready to get to the bottom of your own bloating, we are happy to help! You can schedule a consultation with one of our providers here.
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Dr. Sherry Su, ND, FABNG
Naturopathic Doctor San Jose
408-356-1364
Dr. Sherry Su is a licensed naturopathic doctor specializing in gastrointestinal disorders, women’s health, thyroid and adrenal imbalances, and anxiety. She earned her degree from Bastyr University and holds the prestigious FABNG certification for advanced expertise in evidence-based naturopathic gastrointestinal care. With a compassionate, integrative approach, Dr. Su uses minimally invasive therapies to help patients reclaim their health and well-being. She is passionate about empowering patients with sustainable lifestyle changes and personalized care.
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