The most common digestive symptom that brings women to my office is bloating. Most women know the exact feeling when they hear the word “bloated” – that bothersome feeling of air trapped in your stomach, feeling “6 months pregnant”, sometimes associated with abdominal cramping and discomfort.

Perhaps you’re already aware of some of your bloating triggers. Maybe you’ve tried cutting out various foods in an effort to figure out what the problem is, to no avail. Sometimes it’s as simple as cutting out a food item, but more often than not, there are a few factors going on that are contributing to that discomfort you feel.

That’s why women come in to speak to me about this annoying symptom – they’re frustrated with trying to figure it out on their own, without success.

In this article, I’m going to delve into the 8 steps that you can take to lessen bloating WITHOUT cutting out any foods.

These are the digestion tips that you can do at home help reduce bloating and improve digestion BEFORE you come in to see a Naturopathic Doctor. I’m going to teach you the “Digestion 101” that I always explain to my patients when we delve into their bloating and digestion concerns. These are the most common, and yet least known, causes of bloating.

I’ll note here that this article on bloating is not exhaustive – there are various other causes of bloating, some benign and others serious, that I will cover in other articles. Today, I will focus on the most common mistakes that people make when it comes to eating that contribute to bloating symptoms.

What’s the big deal? Why does my digestion matter so much?

Your digestive function is incredibly important. In my eyes, your digestive system forms the very foundation of your health.

Our ability to digest and absorb nutrients from food is integral to the function of every other organ and organ system in the body. The amino acids, vitamins and minerals we obtain from our diet are transformed into the hormones, neurotransmitters and cells that we require for every single bodily function.

Your mood actually does depend on the B vitamins you get from your diet. Your hormones are formed from dietary fats and cholesterol; if you’re not eating or absorbing those fats, it can affect your hormone balance. Your thyroid and metabolism depend on the specific minerals you get from foods – as long as you’re absorbing them adequately.

When our digestive system is compromised by overt disease (ex. inflammatory bowel disease), or functioning poorly (ex. “irritable bowel syndrome” or indigestion), we may not be extracting the nutrients from food optimally, despite eating a “healthy diet.”

Symptoms of poor digestion or absorption

Here are some of the clues that your body is telling you that you’re digestive system needs some extra support:

Nutrient deficiencies. If you have been told that you have low iron, vitamin B12, vitamin D, or other minerals and vitamins, this may indicate that you’re either not eating enough of that nutrient, or that you’re not absorbing it effectively from your food. Simple blood tests can help inform you of this.

Digestive symptoms. Symptoms such as low appetite, nausea, bloating, diarrhea or loose stools, flatulence, stomach cramping or pain all indicate that you may not be digesting and absorbing optimally.

Abnormal bowel movements and stool. If you’ve met me, you know that we are going to talk about your poop. It’s the window to the… digestive system. It really is! The “perfect poop” should be 1-2 pieces, in the shape of a banana, medium brown, easily passed, occurring 1-3 times a day. Symptoms of poor digestion can include:

• visible bits of undigested food in the stool
• floating or greasy stool
• blood or mucus in the stool
• unusual stool colours like grey or black
• stool that is loose or watery
• stool that is in multiple hard pieces that is painful to pass.

Signs of vitamin deficiencies, such as:

• Hair loss
• brittle nails
• bleeding gums or cracked corners of the mouth
• red/swollen tongue.

Low energy or fatigue. Be careful to dismiss fatigue as being due to poor sleep or stress – oftentimes, testing reveals a nutrient deficiency is part of the problem. For women, low iron is the most common nutrient deficiency I see in practice.

Most common reasons why we may not be breaking down and absorbing food properly

There are certain medical conditions that can cause nutrient deficiencies due to poor absorption, or “malabsorption”. For example, Inflammatory Bowel Disease (such as Crohn’s Disease) or celiac disease are a few common examples. It’s important to discuss your symptoms with your MD or ND to ensure that appropriate testing is performed (I’ll delve into those conditions in other articles).

Here, I’m going to focus on the most common and most frequently-missed causes of bloating and poor digestion that I see in many of my patients.

Stress. Your brain and nervous system need to be in the “rest & digest” state to release the saliva, stomach acid, and digestive enzymes needed for optimal digestion and absorption. However, in this day and age, most of us don’t spend a lot of time in “rest and digest” mode.

During periods of stress, the body goes into “fight or flight” mode. In this state, the body mobilizes resources to help you run away from a perceived “danger” – your heart rate and breathing rate increases, pupils dilate, you sweat, and blood is shunted towards your muscles. During this time, body systems that are non-essential to your immediate survival (including the digestive system!) are effectively “shut down”, in order to conserve energy and prioritize more immediate demands. When we rush meals, eat on the go, eat at our work desk while checking emails, or are generally stressed, the body is in this “fight or flight” state and is less able to “rest” and digest food optimally.

What does this mean for us? It means that when we’re stressed, we’re not producing adequate digestive juices, therefore we are more susceptible to feeling bloated.

Eating quickly and inadequate chewing. The first and most important step in the digestion process is to see and smell your food, which triggers your brain and gut to start releasing saliva and enzymes to prepare your stomach to receive food. When we’re on the go or eating to quickly, we miss the step, resulting in suboptimal release of enzymes. This can be a contributing factor to bloating and indigestion.

Insufficient stomach acid. High stress can result in decreased stomach acid secretion, as can certain autoimmune diseases. Lack of stomach acid means that protein isn’t broken down adequately before it enters the small intestine. This can result in bloating, indigestion, flatulence, heartburn, or suboptimal nutrient absorption.

Gallbladder surgery or fatty liver. The liver produces bile, which is stored in the gallbladder until it’s stimulated to release upon eating a meal. People who’ve had their gallbladders removed often have difficulty breaking down and absorbing fat. This means that they may also have problems absorbing fat-soluble vitamins (vitamins A, D, E, K), as well as feeling severely bloated after greasy or fatty meals.

Unhealthy balance of gut bacteria. Bacteria play a vital role in not only our digestion, but in our overall health, including mental health. In the gut, certain bacteria help us produce vitamin K, breakdown certain nutrients, train our immune system, and form a first line of defence against pathogenic bacteria, yeast, and parasites.

Unhealthy bacteria can predominate the gut in a variety of circumstances, such as in: food poisoning or gastroenteritis, post-antibiotics, C. difficile infections, inflammatory bowel disease, a highly processed or high sugar diet. Your gut bacteria balance can also vary depending on your genetics and how you were born (vaginal versus cesarean section birth). An overgrowth of unhealthy bacteria or yeast can alter our ability to absorb nutrients from our food, and is, in my experience, one of the more common causes of bloating.

Leaky gut. A leaky gut occurs when the tight junctions between intestine cells become excessively permeable, allowing substances to pass through the intestine into the bloodstream, which can trigger an immune response. It is hypothesized that leaky gut is a contributing factor to a variety of autoimmune disorders, such as inflammatory bowel disease, celiac disease, autoimmune hepatitis, type 1 diabetes, multiple sclerosis, and SLE (lupus), among others1.

Prescription for Healthy Digestion: Start with the Basics

Do you identify with one of the items above? Has bloating been an issue for you for a while? Start with these 8 simple steps FIRST, before you come see a Naturopathic Doctor!

1. Sit down, relax, smell and taste your food.

Avoid eating at your work desk; ideally, go for a walk outside or find a calm environment to give your mind and body a break. Be seated, as opposed to eating “on the go” or in the car.

Take a few minutes to interact with your food – the sight and smell of food triggers your gut-brain to start releasing digestive juices. Cook or prepare your food yourself whenever possible, or make it visually pleasing.

Take 5 deep, calming breaths before you begin your meal. Take a moment to appreciate your meal before you eat.

These small rituals help put your body in that critical “rest and digest” state to support healthy digestion, and is the first and most often ignored step in the digestive process.

2. Chew thoroughly and eat slowly.

Did you know that you should be chewing 20-30 times before swallowing? The mechanical breakdown of food by your teeth, tongue, and saliva is the second (most often missed!) step of digestion. Don’t underestimate the impact of simply chewing your food thoroughly on bloating symptoms!

3. Extra support your stomach acid and digestive enzymes.

Gastric acid is produced in the stomach to break down proteins. The pancreas and small intestine produce enzymes to break down carbohydrates, proteins and fats before they are absorbed through the small intestine wall into the blood. The gallbladder stores and secretes bile, which helps emulsify (break down) dietary fats. The first two steps mentioned above both help with supporting your digestive juices; here are a few additional tips:

• Try taking 1 tsp – 1 Tbsp apple cider vinegar in 1-2 oz. water, 10 minutes or immediately before meals.
• Check out my favourite Apple Cider Vinaigrette Recipe and add on your salads
• Incorporate fruits that naturally contain digestive enzymes, such as papaya and pineapple
• Speak to your Naturopathic Doctor about the right digestive enzyme for you and your particular symptoms.

4. Increase your intake of ‘bitter’ foods and herbs.

Our culture tends to favour sweet foods. The ‘bitter’ taste response has some interesting impacts on our nervous system and digestion. Have you ever noticed that when you eat something bitter, like a lemon, you salivate more? Have you ever partaken in a pre-dinner cocktail containing bitters?

When we encounter a ‘bitter’ flavour in the mouth, it triggers the the brain and the gut-brain (called the Enteric Nervous System) to in turn stimulate the release of gastrin (hormone that stimulates the release of gastric acid), pancreatic enzymes and bile. These hormones and peptides stimulate the appetite, help establish the “rest and digest” state, enhance digestion and therefore reduce bloating.

Here are some simple ways to incorporate ‘bitters’ into your regular dietary routine:

• Eat more bitter foods and herbs, such as arugula, apple cider vinegar (check out this recipe), dandelion leaves, coffee, dill, dark chocolate (80% or more), kale, radicchio, grapefruit, bitter melon, Brussels sprouts, and green leafy vegetables.
• Try a few drops of a bitter herbal tincture directly onto your tongue. A few drops of bitter herbs in liquid form helps to stimulate the above-mentioned functions. I can custom-formulate a tincture for you, or you can pick up “Swedish bitters” or “Canadian bitters” from a health food store and take a few drops before meals.

5. Consider taking a high-dose (20-50 billion CFU), multi-strain (8+) probiotic supplement.

This helps support the balance of healthy bacteria in the gut. If you buy one from a health food store, ensure that it’s been stored in the fridge, and keep it refrigerated at home. Be aware that “one size does not fit all” when it comes to probiotics. If you’ve ever tried to buy one, you likely quickly learned that there are plethora of options. Start with a basic one, or ask your ND for guidance when you see them.

6. Increase your probiotic-rich food sources.

These include fermented foods such as Greek yoghurt (plain), kimchi, sauerkraut, kombucha, kefir, miso, natto, or tempeh. These fermented foods help to build up your own healthy and helpful gut bacteria.

7. Increase your intake of “prebiotic” foods that feed your healthy bacteria.

Healthy bacteria feed on non-digestible plant fibres. They act as sources of energy to help build and maintain our good bacteria.

Examples of prebiotics include: raw chicory root, Jerusalem artichoke, raw dandelion greens, raw garlic, leeks, onion, asparagus, wheat bran, or banana.

8. Eat a variety of whole foods.

This may seem obvious, but the nutrient-depleted “foods” that come from highly processed foods are not doing you or your gut bacteria (or your bloating symptoms) any favours. Aim to incorporate more whole grains, 6-8 servings of vegetables per day, wild salmon and fish, healthy oils (such as olive oil), nuts, seeds and legumes. Reduce the food items that come in packages with long lists of ingredients and additives. Eliminate artificial sweeteners – these can be a bit culprit for bloating symptoms.

If you need more help…

Give these simple steps a try, and let me know how it goes for you – I’d love to hear from you!

If your bloating symptoms persist despite taking on the basic treatment measures listed above, further testing may be indicated to assess the root cause of the symptoms. Certain tests can be completed by your GP, others are exclusively performed through Naturopathic Doctors. I’ll delve more into these in future articles; stay in touch by signing up for my blog updates, below!

If you want help getting to the root cause of your bloating concerns and you’re ready to delve in beyond the basics, book in for a consultation so we can talk about what testing options are best for you.

Yours in Health,

Dr. Kathleen Mahannah ND

References:

Mu et al. (2017) Leaky gut as as danger signal for autoimmune diseases. Front Immunol, 8:598. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/