As a leading gastroenterologist with an integrative approach to gut health, Robynne Chutkan M.D. is one of our favorite experts on all things digestion. In this adapted excerpt from her new book, The Bloat Cure: 101 Natural Solutions for Real and Lasting Relief, Dr. Chutkan tackles a topic that has plagued many of her patients and explains how to cure a few common causes.
If you're bloating and looking for solutions, you've come to the right place. In my gastroenterology practice, the Digestive Center for Women, I've helped deflate thousands of women and get them comfortably back into their skinny jeans.
Understanding all the different factors that conspire to bloat you—and having a toolbox of integrative solutions to deal with them—is the key to banishing your bloat for good.
Here are a few common factors that could be the cause, and how to fix them:
1. Birth-control pills
Birth control pills (BCP) contain various forms of estrogen that can cause bloating. If you’re on a high-estrogen BCP, deflating your midsection may be extremely challenging due to fluid and salt retention, as well as weight gain.
These pills can lead to some degree of insulin resistance, a condition that can interfere with your ability to lose weight, especially if you eat a lot of carbohydrates. If you already have a tendency toward insulin resistance or are prediabetic, you may be more likely to become bloated and gain weight from BCP.
The cure: Weight gain of more than 5 percent of your total body weight after starting BCP may be a sign of insulin resistance and should prompt a discussion with your doctor about a glucose tolerance test to diagnose it.
Using an alternative nonhormonal form of birth control or choosing a BCP with the lowest amount of estrogen possible makes sense if bloating, weight gain, or insulin resistance are issues. Ironically, going off BCP can lead to temporary bloating and constipation due to ovulation starting again, especially if you’ve been on the Pill for a long time.
Since caffeine has diuretic properties that help you get rid of excess salt and water through the kidneys, you might think it would help with bloating—but caffeine can actually contribute to your bloat. Its diuretic effect can lead to dehydration, slowing the movement of food through your intestines and causing backups and bloating.
Caffeinated beverages, especially coffee, can also overstimulate your digestive system and lead to bloat-causing spasms, as well as worsen some of the conditions associated with bloating, such as stomach ulcers, gastritis, and irritable bowel syndrome (IBS).
The cure: There’s only one way to do this, and it’s not pretty—give up the joe! Going cold turkey will get you there faster, but reducing your intake a little at a time (¼ cup per day) over a few weeks will lead to fewer withdrawal symptoms such as headache, irritability, and sleepiness.
There are lots of healthy alternatives to caffeine, including caffeine-free herbal teas, hot water with lemon, green juices, and, of course, just plain water.
3. Cruciferous vegetables
All gas and bloating is not created equal. Beans and cruciferous vegetables such as cabbage, cauliflower, kale, and broccoli contain potent cancer-fighting compounds and lots of healthy fiber, but they also contain a starch called raffinose that your body can’t fully break down and digest.
Bacteria in your colon ferment raffinose and produce methane, which you may experience as bloating accompanied by smelly gas. This is what I consider good gas, though, because it’s accompanied by the health benefits that eating those foods confer.
The cure: I never recommend completely eliminating the “good gas” foods because they contain lots of nutrients, but here are some things you can do to cut down on your gas when eating them:
- If you haven’t been eating foods like broccoli, kale, and cauliflower, start with a small amount and gradually increase your serving size to let your body get acclimated to them.
- Add lemon juice to your good-gas veggies to stimulate digestive enzymes.
- Soak dried beans overnight before cooking.
- Avoid canned beans, which tend to cause more gas and may also contain a chemical called bisphenol A (BPA) in the can lining, which has been linked to cancer and other conditions.
- Take Beano or Bean-zyme at the start of a meal; both contain a plant-derived enzyme that breaks down raffinose.
- Eat a pinch (about ⅛ teaspoon) of fennel seeds or chew on a stalk of raw fennel at the end of a meal to benefit from its gas-reducing oils. You can also make fennel tea by steeping a teaspoon of crushed seeds or fresh fennel bulbs in a cup of boiling water for 10 minutes, or you can add it to salads or cooked dishes.
4. Late-night eating
You may not realize that your stomach has a bedtime. Its muscular contractions are tied to the light-dark cycle, also known as the circadian rhythm, so it’s most active during the day, when the sun is up, and least active at night, after it sets—which is unfortunately when you’re probably consuming the majority of your calories.
To make matters worse, after filling your sleepy stomach with food at night, you may be reclining on your sofa or bed, so you don’t have the benefit of gravity and movement to help transport things from north to south. Eating large meals at night is a sure way to feel bloated, and it can also cause or exacerbate acid reflux.
The cure: Calorie shift by eating your largest meal early in the day when your stomach is most active and your smallest meal at night: Breakfast like a queen, lunch like a princess, and eat dinner like a pauper. Impose a dinner curfew: Stop eating at sunset, or shortly thereafter, and if you’re going to eat out, make it lunch or brunch rather than dinner, since studies show that people eat much more when they eat out compared to when they eat at home.
5. A sedentary lifestyle
If you’re not moving, neither are your bowels! A sedentary lifestyle is a major contributor to slow transit through your GI tract, which means bloating tends to be endemic in places like nursing homes and other chronic-care facilities where the residents get little or no exercise.
Sitting is the new smoking as far as your health is concerned, and that’s especially true for your GI tract, where sitting at a computer all day can slow your transit to a crawl.
The cure: Regular exercise is important to stimulate peristalsis and keep your products of digestion moving efficiently through your gut. You don’t have to run a marathon; even a walk around the block can help, and twisting yoga poses are especially good for dispersing gas pockets and moving things along.