Why am I bloated? Common causes and Natural Approaches

According to a study published in Gastroenterology in September 2023, almost 18 % of the global population suffers from bloating a minimum of once a week. Over 50,000 individuals in 26 countries took part in the research. The results showed that women appear to be more affected by bloating. Interestingly, the highest prevalence of bloating was reported by the youngest age group (18-34 years) whereas the oldest age group (65 years and above) reported the lowest occurrences [1]. But what exactly is bloating, what causes bloating and is it possible to relieve it naturally ?

Bloating is generally perceived as abdominal pressure and tightness, often accompanied by swelling. Several mechanisms may be involved in bloating including excess gas production, slow digestion and over-sensitive gut nerves.

Excess gas accumulation is primarily caused by swallowed air, technically known as aerophagia, and bacterial fermentation. Eating or drinking too quickly, talking while eating, smoking, chewing gum and consuming carbonated beverages can all lead to excess amounts of nitrogen and oxygen accumulating in your stomach.

Inadequately chewed food results in larger particles of food entering the gut. This slows down digestion and can lead to undigested carbohydrates fermenting in the large intestine. As a consequence, hydrogen, methane and carbon dioxide are produced. Physiological impairments in the digestive system could prevent gas from being evacuated efficiently.

Whilst excess gas production can contribute to bloating, recent studies suggest that bloating may result from the perception of a build-up of gas, rather than the physical build-up of gas [2]. Gut hypersensitivity means that an indvidual’s pain threshold is lower so they experience normal functions as painful.

Other factors, such as imbalances in the gut microbiome, constipation, hormonal changes and stress, may be worth exploring.

Natural approaches to bloating aim to relieve not only the symptoms but also the underlying causes of bloating and thus reduce its occurence. If the bloating is severe and frequent, you should consult your doctor, however, if you suffer from occasional, mild bloating, the following approaches might help provide relief.

- Eating slowly and chewing thoroughly allows the secretion of saliva and digestive juices to promote the digestive process.

- Limiting or avoiding certain food products, such as dairy and wheat, may diminish gas production, help to rebalance the gut microbiome and improve digestion. In the study mentioned at the beginning, frequent consumption of milk, bread and pasta was associated with more frequent reports of bloating [1]. Keeping a food journal where you note what you eat and how it impacts your body could help to identify problem foods.

-Gradually increasing fibre intake can improve the digestive process. Doing this slowly will allow the body to adapt to physiological and microbiological changes.

- Sufficient hydration will support the digestive process, assist in balancing hormones and reduce the probability of bloating caused by constipation. Water should be drunk consistently throughout the day to ensure the best results.

- Regular mild to moderate exercise stimulates the mecanical actions of the digestive tract, improves the gut microbiome, reduces stress and clears gas more effectively. You can find more information on the microbiome here.

A number of medicinal plants have been proven to effectively relief bloating.

Peppermint (Mentha x piperita), for example, contains menthol which relaxes muscles reducing contractions which cause cramping and spasms [3].

Chamomille (Matricaria recutita) reduces flatulence and soothes abdominal pain due to its antispasmodic and anti-inflammatory properties. It also calms anxiety and stress, which can be factors in spasms and hypersensitivity [4].

Both peppermint and chamomille can be prepared as herbal infusions. This involves covering a heaped tablespoon of the dried plant with boiling water and allowing it to infuse for 5-10 minutes. The herbal tea is generally taken 30 minutes following a meal.

Compounds in ginger (Zingiber officinale), such as gingerol, relax the intestinal walls and stimulate the movement of food through the digestive system [5]. One to two teaspoons of grated fresh ginger root in a cup of water can be brought to the boil and then simmered for 10 minutes to extract gingerol. This decoction is most effective if drunk 20-30 minutes before the meal.

Herbal infusions and decoctions should be covered during preparation to ensure that volatile aromatic molecules do not evaporate.

Fennel seeds can also be effective in reducing the symptoms of bloating and improving the gut microbiome. A recipe for a fennel herbal tea can be found here.

Herbalists approach bloating as a sign of imbalance and will seek to better understand an individual’s unique situation before proposing a personalised plan of action. Bloating may have a variety of causes and it may take time to pinpoint your own individual triggers. Human physiology is complex and you should alway seek professional advice if you are concerned about your symptoms.

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[1] Ballou S et al.Prevalence and Associated Factors of Bloating: Results From the Rome Foundation Global Epidemiology Study Gastroenterology, 2023; 165, 647-655.e4

[2] Seo AY et al. Abdominal bloating: pathophysiology and treatment. J Neurogastroenterol Motil. 2013 Oct;19(4):433-53. [3] Hawthorn M et al. The actions of peppermint oil and menthol on calcium channel dependent processes in intestinal, neuronal and cardiac preparations. Aliment Pharmacol Ther. 1988 Apr;2(2):101-18. 

[4] Wu KL et al. Effects of ginger on gastric emptying and motility in healthy humans. Eur J Gastroenterol Hepatol. 2008 May;20(5):436-40. 

[5] Asadi-Shahmirzadi et al. Benefit of Aloe vera and Matricaria recutita mixture in rat irritable bowel syndrome: Combination of antioxidant and spasmolytic effects. Chin. J. Integr. Med. (2012).