What causes it?

It's a concern patients report almost daily in clinical practice and a symptom we're all familiar with. Whether it shows up after an overindulgent meal, with our monthly menstrual cycles, or has become a daily struggle, the discomfort is real and the cause is difficult to pinpoint.

 Most of us can relate to the symptom, but it's important to recognize that bloating is just that... a symptom. And while I'll give you some great tips to manage the bloating, the trick to banish it for good is to determine where it's really coming from. 
 

While excluding the more emergent or complicated causes of bloating, the uncomfortable abdominal distention is most commonly attributed to two overarching concerns: digestive dysfunction and/or hormonal dysregulation.

Digestive Dysfunction

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If your bloating happens following meals, or if you wake with a flat stomach in the morning, but feel like you're carrying a 3-month food baby by bedtime, it could be related to your digestion.

• low stomach acid: an acidic state is required to digest foods and absorb micronutrients. When the stomach lacks acidity, these foods do not get broken down and absorbed, but rather fermented by bacteria in the gut, leading to symptoms of gassiness, bloating, and sometimes even stool changes. 
   

• food intolerances:  much like any other inflammatory reaction, food intolerances create an inflammatory state in the gut, leading to fluid retention and ultimately, bloating.
  Learn more about food sensitivities here
   

• dysbiosis: an overgrowth of bacteria and yeast in the stomach can also be a cause of foods being fermented instead of digested. There may also be an association with bacterial overgrowth in otherwise sterile environments, such as the small intestine, referred to as small intestinal bacterial overgrowth (SIBO). It is suggested that up to 75% of IBS cases are actually misdiagnosed SIBO.
  Learn more about SIBO testing here

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Hormonal Dysregulation 

In females, if your bloating is present even upon waking, has no correlation to food, or has a cyclical pattern with menstrual flow, it could be your hormones.

• excess estrogen: breast tenderness, water retention, and swelling/bloating before menses with heavy bleeding are often attributed to too much estrogen in the body. Furthermore, hard, distended bloating that never resolves could be a sign of ovarian or uterine cysts and should be investigated further via ultrasonography.

• low progesterone: another cause of bloating before menses, that typically lasts anywhere from ~2 weeks before flow, with short cycles and long bleeding times (>6 days). Since progesterone produces a lovely calming effect on the body (the pregnancy glow), low levels cause be a source of premenstrual irritability.
  Learn more about comprehensive hormone testing here

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