Positive Health Online

Introduction

Bloatedness has got to be one of the commonest reasons for consulting a nutritional therapist. Tightness and discomfort in the abdomen with the accompanying feelings of heaviness and sluggishness often become so familiar for many people that they come to accept them as the norm.

Getting to the cause of the problem depends on each individual case.

An important place to start is to look at the balance of intestinal bacteria. A healthy gut contains around 3 lb of micro- organisms, some beneficial and some less so. Too many 'unfriendly' bacteria lead to a build up of toxic substances in the gut, which can cause gas and bloating. Acidophilus is a well-known strain of 'friendly' bacteria found in 'live' yoghurt and there are many other species. Such bacteria play an important role in protecting us from infections and they help crowd out the unwanted, disease-causing bacteria. Giving a supplement of bacteria (known as a probiotic) can be very helpful.

This will contain many more times the amount of organisms present in live yoghurt and can be taken for a period of one to two months until the bacteria begin to colonize and multiply in the gut. Choose your probiotic carefully though. A Which? report some years ago denounced many products because much of the bacteria were no longer 'live' due to poor storage or manufacturing conditions.

Factors that negatively influence the balance of bowel flora are stress, smoking, poor diet and certain pharmaceutical drugs, particularly antibiotics and steroids.

Case Study

When Sarah first came to see me, she had been to see her GP and a range of tests had all come up negative. She was waiting for an appointment with a gastroenterologist. The bloating she was experiencing was so severe that it was interfering with her day-to-day life and it was making her feel quite low. Her case showed some familiar patterns. She had taken frequent courses of antibiotics since the age of 16 and she had been on the birth pill for ten years, which also compromises the gut flora. Her diet, whilst not as bad as some, contained a lot of sugary snacks and alcohol, which she found she needed to cope with her very stressful job. All these factors are classic in the creation of an unhealthy gut environment in which yeasts such as Candida albicans thrive in. In fact a simple saliva test confirmed that Candida was a problem for Sarah. I gave her some natural substances including lavender oil, grapefruit seed extract and berberis, known for their antifungal properties. I also advised Sarah to eliminate yeast and simple sugars from her diet. She also replaced all her breads and cereals with rye- and oat-based foods.

As is often the case with abdominal bloating, I found that Sarah had low levels of stomach acid, which is needed for breaking down protein (and it also acts as a first line of attack against unwanted bacteria).

Lack of stomach acid can lead to partially digested food entering the intestines, which will putrefy and give off gases, causing bloating. There is a simple experiment that you can perform at home to determine whether you are producing enough stomach acid. Mix a level teaspoon of bicarbonate of soda into some water and drink it on an empty stomach. If your stomach acid levels are sufficient you will experience significant burping about 5-10 minutes after taking the mixture. Sarah showed an absence of these symptoms so I gave her a supplement of hydrochloric acid and pepsin to be taken just before meals.

I did not see Sarah for a few weeks whilst she put my dietary suggestions into practice and began supplementing her diet with probiotics, flax oil to soothe the gut, minerals to help reduce the desire to binge on sugary foods and flower essences to calm the nervous system. Then she started to experience intense vaginal itching, soreness and discharge. This type of reaction, known as 'die-off', may occur as the body throws out toxins and usually only lasts for a few days. Unfortunately Sarah's GP wrongly diagnosed pelvic inflammatory disease at this point, and Sarah was given some heavy-duty antibiotics which in fact turned out to be unnecessary.

This set back her progress a little but after some more probiotics, vitamin C and fluid extract of Echinacea she started to get back on track. She also realized the limitations of orthodox medicine!

When Sarah came to see me for her follow-up appointment two months later there had been, in her words, a "complete transformation". She had more energy, her skin was clearer, she had lost weight (a lot of which was excess fluid) and most importantly for her she had a flat, unbloated stomach!

General Advice

With problems such as bloating, how you eat is as important as what you eat. It is no use eating wonderful healthy food if you don't provide your body with the right conditions for digestion! If you are stressed when you eat, digestive functions slow down as the body goes into 'fight or flight' mode as if it were preparing for an emergency. It really is vital to take time over your meals and I don't deny this can be a real challenge in our 24-hour society. Here are some tips:

* Being around the food for a few minutes before tucking in stimulates the production of your digestive enzymes;
* Always sit at a table to eat;
* Focus fully on the taste of the food;
* Chew thoroughly. Try putting your knife and fork down after each mouthful and don't pick them up again until full chewing has taken place;
* Don't overeat. Aim to stop before you feel full;
* Leave around three hours between meals so that food has been fully digested before you start again.

A lot of people ask me whether it is worth food combining. Not including carbohydrates and proteins at the same meal can involve a lot of planning and when coupled with other dietary restrictions it can be impractical. Dr Peter Mansfield[1] suggests that it is the order in which foods are eaten that is important. According to his theory, different food groups can be eaten at the same meal but they should be eaten in sequence. Fruits and vegetables should be eaten first, followed by protein, with carbohydrates being eaten last. For people with persistent bloating this may be a more practical alternative to traditional food combining.

Reference

1. Mansfield Peter. Stop Bellyaching. Souvenir Press. 2001.