Here's why you are bloated - and how to finally stop it

Everyone gets a bloated stomach from time to time. You've eaten something that causes flatulence, such as onions or cabbage, and for a few hours afterwards you feel a lot of pressure in your stomach that somehow wants to come out. But there are also people who feel bloated almost all the time, even though they don't really have flatulence, so the air in their stomach doesn't get any less. This article explains why this happens and how you can get rid of your permanently bloated belly.

The intestine is a highly complex system

Our intestines are home to between ten and one hundred trillion bacteria and microbes. At least 500 different types of microorganism make up the intestinal flora of an adult human being. Each type and each bacterium has its own role to play in the digestive process. They break down the food that reaches the intestines into its individual components, so that the nutrients it contains can enter our bloodstream through the intestinal mucosa. The intestinal microbiome also uses the components that cannot be further broken down, such as fibre. These are fermented by the intestinal bacteria, which in turn produces important vitamins and nutrients. If the delicate balance between these countless microorganisms is disturbed, this can have significant consequences, not only for digestion.

The Gut-Brain Connection

There is a very close connection between our gut and the emotional centre of the brain. Many people therefore experience effects on their digestion when they are agitated, for example before an exam or a performance. There are also many people who cannot go to the toilet in unfamiliar surroundings because their gut literally goes on strike, which leads to constipation. It is therefore no coincidence that the term "gut feeling" has been used in everyday language for decades and that many people describe their emotions as being felt primarily in the abdominal region. A permanent bloated stomach is therefore often accompanied by chronic fatigue and mild irritability.

Researchers have also known about this connection for a long time and have found that the composition of the intestinal microbiome can even affect psychological aspects of health. For example, depressive moods and anxiety disorders are associated with the balance of the intestinal flora.¹ The microbiome could also play an important role in the development or treatment of sleep disorders.²

How an unbalanced gut flora leads to bloating

The composition of the various bacteria in our gut is as individual as a fingerprint. However, there is always a balance between bacteria that produce gases when food is digested and those that need gases for metabolism. It is quite possible that a meal may require certain types of bacteria and more gas is produced in the gut. However, this condition normalises within a few hours. Should the bloated stomach persist, however, this means that something fundamental in the diet or the intestinal flora is not right. Possible reasons for a persistent bloated stomach are

• high-sugar diet
• low-fibre diet
• high-fat and high-protein diets
• stress
• Taking medication (e.g. antibiotics)

Of course, there are other, illness-related reasons why someone may have problems with flatulence. To be sure, you should definitely describe your symptoms to a doctor. In otherwise healthy people, these three aspects, i.e. diet, stress and medication, are the main causes of a bloated stomach. The good news is that these are all factors that can be influenced.

How to restore the balance in your stomach

So you have the means to get rid of your bloated stomach once and for all. These four tips provide you with efficient tools to optimise your digestion and your gut microbiome.

1. A balanced, high-fibre diet

As mentioned above, fibre is an important aspect of nutrition because it is fermented by various bacteria in the gut. This process produces lactic acid and other substances that serve as food for many gut bacteria and maintain the environment in the gut. Fibre is particularly found in psyllium husks, flax seeds, dried fruit and legumes. Fresh fruit also contains fibre, but it is important to eat it whole and not as a smoothie or juice. The daily amount of fibre recommended by the WHO is at least 30g per day.

2. Reducing sugar, alcohol and cigarettes

Researchers have identified a diet that is very high in sugar and simple carbohydrates as a factor in increased inflammation.³ Sugar also creates an environment in the gut that makes it impossible for various good bacteria to survive and promotes the proliferation of harmful bacteria.

3. Include more fermented foods

The same bacteria that thrive in our gut flora are also produced during the fermentation of vegetables or drinks. When you consume these foods, they settle in your gut and help to maintain a balanced gut flora. However, since fermented foods with live bacteria continue to ferment on the supermarket shelf, producing gases in the process, they are usually pasteurised. This involves heating them to such an extent that the bacteria are killed. This means that they can be stored for longer without the jars running the risk of exploding. That's why you should make sure that fermented foods you buy are not pasteurised. Such "live" fermented foods are usually available in organic markets. These include sauerkraut, kimchi or drinks such as kefir and kombucha.

Yoghurt is also produced by the work of probiotic bacteria, which cause the milk to thicken. But here too, most products are pasteurised and therefore no longer probiotic. However, there is now "probiotic yoghurt" that is explicitly labelled as such, to which beneficial bacteria have been added. So to do your gut some good, you should opt for natural yoghurt or probiotic yoghurt. If you do not tolerate cow's milk well, there are also good alternatives made from sheep's or goat's milk.

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4. Taking probiotics

To be absolutely sure that you are getting enough of the most important gut bacteria, it is also recommended that you take probiotics regularly. This means that you don't have to worry so much about getting enough probiotics in your diet and you will regularly get the same amount of lactobacillus and co. This will help you to restore your gut flora balance and avoid intestinal unrest. There are a number of studies that attribute a positive effect to the targeted intake of probiotics. Lactobacillus acidophilus and Bifidobacterium lactis in particular have been shown to have a positive effect on flatulence.⁴
With a probiotic in your daily routine, you have one less thing to worry about and know that your gut flora is well cared for and in balance.

Sources:

1. Wei L, Singh R, Ro S, Ghoshal UC. Gut microbiota dysbiosis in functional gastrointestinal disorders: Underpinning the symptoms and pathophysiology. JGH Open. 2021 Mar 23;5(9):976-987. doi: 10.1002/jgh3.12528. PMID: 34584964; PMCID: PMC8454481. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454481/
2. Wang Z, Wang Z, Lu T, Chen W, Yan W, Yuan K, Shi L, Liu X, Zhou X, Shi J, Vitiello MV, Han Y, Lu L. The microbiota-gut-brain axis in sleep disorders. Sleep Med Rev. 2022 Oct;65:101691. doi: 10.1016/j.smrv.2022.101691. Epub 2022 Aug 31. PMID: 36099873. https://pubmed.ncbi.nlm.nih.gov/36099873/
3. Satokari R. High Intake of Sugar and the Balance between Pro- and Anti-Inflammatory Gut Bacteria. Nutrients. 2020 May 8;12(5):1348. doi: 10.3390/nu12051348. PMID: 32397233; PMCID: PMC7284805. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284805/
4. Mari A, Abu Backer F, Mahamid M, Amara H, Carter D, Boltin D, Dickman R. Bloating and Abdominal Distension: Clinical Approach and Management. Adv Ther. 2019 May;36(5):1075-1084. doi: 10.1007/s12325-019-00924-7. Epub 2019 Mar 16. PMID: 30879252; PMCID: PMC6824367. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824367/
5. Järbrink-Sehgal E, Andreasson A. The gut microbiota and mental health in adults. Curr Opin Neurobiol. 2020 Jun;62:102-114. doi: 10.1016/j.conb.2020.01.016. Epub 2020 Mar 9. PMID: 32163822. https://pubmed.ncbi.nlm.nih.gov/32163822/
6. Socała K, Doboszewska U, Szopa A, Serefko A, Włodarczyk M, Zielińska A, Poleszak E, Fichna J, Wlaź P. The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders. Pharmacol Res. 2021 Oct;172:105840. doi: 10.1016/j.phrs.2021.105840. Epub 2021 Aug 24. PMID: 34450312. https://pubmed.ncbi.nlm.nih.gov/34450312/