Getting to the Bottom of Bloat

When it comes to the organ we think of as “in charge” of the body, Dr. Paul Ratte says we’ve got it all wrong. “You’ve heard of the concept of the second brain. You have brains in your gut, and I often wonder if that’s not the first brain,” explains the naturopathic doctor and assistant professor at Northwestern Health Sciences University. “There’s a lot of information that’s transacted in the gastrointestinal tract, and we completely take it for granted.”

Translation: If we actually took the time to listen to our gut, it may tell us why we’re so dang bloated all of the time.

According to a survey from the American Journal of Gastroenterology, bloating was one of the most commonly reported symptoms among the 60 percent of respondents who experienced GI discomfort over the course of a week.

The idea that more than half of Americans are bloated on a regular basis would have anyone scrambling for a box of Beano, but if you want to banish bloat for good, you have to dig a little deeper. “Bloating means that we’re ending up with more air in the digestive tract. Where is that air coming from?” says Ratte. “I’m trying to get at what the cause of the problem is. You can treat the symptom, but the bloat is there for a reason.”

A Byproduct of Western Civilization

Why is it that your Friday-night burger-and-fries habit doesn’t sit well with your stomach? Your body likely isn’t processing the fatty, greasy food properly because—surprise!—it’s not meant to. The cramping, constipation, and bloating you feel after scarfing down a Big Mac? That’s a “disease of Western civilization,” as Ratte calls it, the result of the standard American diet. 

So when Ratte’s patients complain about bloat, his first stop on the route to a diagnosis is the digestive system. The stomach, small intestine, and large intestine are crucial for the breakdown, absorption, and elimination of the food we eat, and when those organs aren’t functioning properly, “we call that digestive or pancreatic insufficiency,” says Ratte. “That just means you don’t have enough digestive enzymes to break down food, and if you don’t break that down properly, it can start to putrefy in the body.” (No wonder our farts stink.)

Another culprit of trapped gas has to do with our gut microbiome, where thousands of species of bacteria, fungi, parasites, and viruses set up camp. When this microorganism mecca is imbalanced, there is too much bacteria in the intestinal tract, a condition known as SIBO—small intestinal bacterial overgrowth. “Bloating is often the result of the bacteria over-fermenting,” says Ratte. “Methane is one of the byproducts of that, and methane creates gas that we either pass or that gets stuck in that intestinal tract, especially if the intestinal tract is not moving very well.”

If you’re tempted to shrug off these conditions as minor inconveniences, think again: Both pancreatic insufficiency and SIBO have been linked to more serious diseases like inflammatory bowel disease, irritable bowel syndrome, celiac disease, and obesity, so it’s important to get to the bottom of, well, what is (or isn’t) coming out of your bottom.

SUB: Beat the Bloat

Determining your particular brand of bloat might be a process of elimination—no pun intended. “If you’ve got bloat, the question is, when is it? How often is it? Is it related to what you eat? Is there any pattern you’ve noticed?” says Ratte, offering these tips to get rid of bloat and prevent it reoccurring.

  • Keep a food and stool diary. “Most people are semi-conscious eaters. We’re habitual; we don’t even pay attention until we start having symptoms,” says Ratte, who asks all his patients to start logging their meals and bathroom trips. “I’m a poop doctor. I want to know how often, what it looks like, what color it is, and what it smells like, because those are clues.”
  • Chew your food. Americans notoriously eat too much too fast, a result of our constant on-the-go lifestyle. “We swallow our food whole,” says Ratte. “When you eat a piece of meat and you don’t chew it properly, do you know how much more work that is for your digestive system to break down?”
  • Experiment with your diet. If fried, greasy food isn’t cutting it for you anymore, play around with your diet (with approval from your doctor). Increase your fiber intake; cut out common irritants like dairy, soy, and gluten; and try a low-sugar (FODMAP) diet, especially if you suspect you might be suffering from SIBO.
  • Consider digestive support. To help move things along, your doctor might suggest supplements that aid the digestive system, like digestive enzymes, peppermint oil, ginger, and probiotics.

In most cases, bloating subsides after a few hours or days at most, but if your stomach distension is persistent, you don’t have regular bowel movements—at least once a day, ideally more—or the bloating is accompanied by symptoms like bloody stool, vomiting, or unexplained weight loss, it’s time to make an appointment with the Poop Doctor, as Ratte refers to himself. “It’s kind of like being a food detective. If you reflect on your symptoms, you can figure out the problem,” he says. “You’re going to get constant feedback [from your body] as long as you’re paying attention to it.”

Located in Bloomington, Northwestern Health Sciences University is a premier integrative health institution that prepares the next generation of healthcare professionals deliver and advance healthcare, offering 11 areas of study. Its clinics and TruNorth Wellness Hub are open to the public to support healthier, better lives for all. Bloomington Clinic specializes in whole-family care, providing chiropractic treatment, acupuncture, Chinese medicine, massage therapy, naturopathic medicine, nutrition, and cupping. Sweere Clinic offers comprehensive care for complex pain conditions and trauma. The Biomechanics Lab and Human Performance Center support proper movement and recovery through gait analysis, rehabilitation, and strength and conditioning.

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