Bloating 101: What Is Bloating & What Causes It?

Board-Certified Internist By Vincent M. Pedre, M.D.
Board-Certified Internist
Dr. Vincent M. Pedre is a board-certified internist in private practice in New York City since 2004. He serves as medical director of Pedre Integrative Health, president of Dr. Pedre Wellness, and is the author of Happy Gut.
Woman Resting on the Beach with a Hat on Her Stomach

For some people, bloating is mildly uncomfortable. For others, it's absolutely miserable. It can make you feel gassy, "stuffed," heavy, or uncomfortable, especially after meals. As a medical doctor who specializes in gut health, I can tell you bloating is one of the most common complaints I hear. "I want to take off my pants, put on my sweatpants, and watch Netflix on my couch alone," one patient recently told me.

In fact, around 15 to 30% of Americans regularly experience bloating. It can be visible or simply a feeling. For most, the reason for bloating is too much intestinal gas, and it can be caused by a number of things.

Why do you feel bloated?

Many times, helping patients beat bloating requires a bit of digging to find what's creating this symptom. It's also important to acknowledge that bloat is frequently a symptom of conditions like irritable bowel syndrome (IBS), inflammatory bowel disease, and other functional gastrointestinal disorders.

That said, after helping hundreds of patients, I've pinpointed a few lesser-known culprits of bloat you'll probably want to note:

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1. You might be eating irritable foods.

Many bloating problems come down to food. Overeating can certainly create bloating, along with consuming fried foods, too many carbs, and processed foods.

Overdoing fiber can also create bloating. While dietary fiber is great for your gut, increasing the amount too quickly can be a problem. If that's the case, slow down and add fiber gradually. 

Certain foods including dairy and legumes can also create bloating. And many people have intolerances to these foods, or the inability to fully break down that food with digestive enzymes, which further leads to irritation. For these patients, I use an elimination diet to remove potentially problematic foods. We then carefully reintroduce those foods, one at a time, to pinpoint what creates the bloating. 

2. You could have an imbalance of bacteria.

Underlying many of these gut disorders is dysbiosis, an imbalance between favorable and unfavorable microorganisms in the gut. Your gut contains about 500 to 1,000 species of bacteria. And the tiniest shifts in the relative predominance of these bacteria can affect how your gut works.

Small intestine bacterial overgrowth (SIBO), for example, is a type of dysbiosis caused by an overpopulation of bacteria in the small intestine. This can increase fermentation of sugar in the carbohydrates you eat, and bloating often occurs from this excess gas production. As a result, people with SIBO often can't tolerate carbohydrates, including starches, sweets, and sugars. To address SIBO, I use a carefully designed nutrient plan and implement an elimination diet, which cuts out all sugars, including sneaky sweet sources.

In a different case, small intestinal fungal overgrowth (SIFO) can occur when your small intestine becomes overpopulated with too much yeast or fungi. One type of fungus, a yeast called candida, can especially become a problem when it gets out of hand in your small intestine. This yeast can wipe out other friendly, symbiotic bacteria, and the imbalances in your gut bacteria may lead to gas and other digestive issues. Similar to SIBO, a diet rich in sugar and simple carbohydrates is often the culprit here.

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3. You could have low stomach acid.

Sometimes, patients complain about bloating within minutes after eating a meal that contains protein. They may also find they belch a lot. "After I eat, it feels like I've got a brick sitting in my stomach for an hour," one told me. 

Many believe acid reflux is the problem here. But the opposite is often true: Low stomach acid–not too much—can masquerade as acid reflux after eating. When you don't have enough stomach acid to break down protein, food sits undigested in the stomach longer.

The most common sign of low stomach acid is a feeling of bloating or stomach expansion after eating a protein-rich meal. If you experience this on a regular basis, you might benefit from supplementation. I often recommend hydrochloric acid supplements, but be sure to consult with your doctor before giving this a try.

4. Your gallbladder may be having trouble.

Your liver creates bile, which gets stored in your gallbladder. Your gallbladder releases that bile to help break down dietary fat. In some situations, compounds from bile build up in your gallbladder, a condition called gallbladder sludge.  

This can eventually lead to gallstones, collections of solid material in the gallbladder. Gallbladder sludge can also cause swelling and inflammation of the gallbladder, called cholecystitis, that can result in severe pain (especially in the upper right side of your abdomen), vomiting, and bloating. 

A digestive enzyme that contains sufficient amounts of lipase might help break down and emulsify these fatty foods to facilitate their absorption, but you also want to get to the root of these problems. Talk with your doctor if you suspect that you experience gallbladder-related pain and bloating on a regular basis.

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How to beat the bloat.

Sometimes pinning down what creates bloating can require some trial and error. Carefully tracking what you eat, when you eat it, and any accompanying symptoms in a food-symptom journal can help better pinpoint the problem. This is an important step in developing food-gut intuition—your ability to tell which foods disagree with you and which ones lead to a happy gut.

Once you identify what creates bloating, I adjust a patient's diet to address specific problem foods and create a plan that supports gut health. I often recommend lifestyle modifications, including stress management and regular exercise.

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Choosing the right foods can go a long way toward eliminating bloating. But so can how you eat. I encourage patients to slow down while they eat. So many of us are conditioned to speed through meals, eat while working, and not give mealtime its due consideration. Instead, try to be mindful during meals—it might help to start off with deep breaths, prayer, gratitude, or whatever helps you be more present while you eat. 

At times, I also recommend incorporating a high-quality probiotic. Among probiotics' numerous health benefits, research shows the microorganisms improve bloating and other uncomfortable GI symptoms.* Specifically, one study found a combination of Lactobacillus and Bifidobacteria improved symptoms of bloating in patients who had functional bowel disorders.

Finally, consider intermittent fasting. Giving your gut a break can do wonders for bloating and other gut issues.

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Bottom line.

There are a number of reasons you may be feeling bloated. Being mindful of when you experience symptoms can help you get a better understanding of the root cause. If you experience chronic bloating, speak to your doctor about your best options.

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Vincent M. Pedre, M.D.
Vincent M. Pedre, M.D.
Vincent M. Pedre, M.D., medical director of Pedre Integrative Health and president of Dr. Pedre...
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Vincent M. Pedre, M.D.
Vincent M. Pedre, M.D.
Vincent M. Pedre, M.D., medical director of Pedre Integrative Health...
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