Wondering Why You're Always Bloated?

Photo: Susana Ramírez

Several months ago I saw a lovely young woman, 19 years old; let’s call her Amy. She talked to me mostly about her belly bloating and gas over the last three years, explaining how embarrassing and uncomfortable it was. Amy also complained about having social anxiety, and the combination of the two had become really difficult for her to handle—especially as a young person. I, of course, got her medical history, list of medications and allergies, and then we tackled the issue from five different directions, as I do with all my patients in my functional medicine practice:

1. Physical.

During our discussion, I found out that Amy was not exercising. This was a crucial piece of information because exercise has been shown to significantly reduce symptoms of anxiety. I asked her if she was willing to exercise. She said, "I like yoga, and if a doctor says I should do it, I will." We started with yoga two to three days a week, building up to three to five days a week.

2. Chemistry.

We did a full functional medicine analysis, which I do one of two ways: The first is a stepwise approach, in which we do several tests, then treat what we find. If that fixes the problem, then we’re done. If it doesn’t resolve the problems, then we do more testing. The second approach is to do everything at once. In other words, order all possible testing and see if we can find the biggest offenders and treat them. Amy chose the all-in-one approach.

We ordered stool, blood, urine, and saliva testing. I worked her gut up for SIBO (small intestinal bacterial overgrowth), dysbiosis, an overgrowth of candida (yeast), food allergies, leaky gut (increased intestinal permeability). In addition, we looked at nutritional deficiencies or excesses, amino acids, oxidative stress, heavy metal toxicity, neurotransmitters, glutathione levels, and mold toxicity.

While the testing was in process we started her on a regimen of herbs and probiotics to treat her gas and got her off gluten and dairy, which are common offenders. I also added a little bit of Inositol to help with her anxiety. There are a lot of approaches to herbs and supplements, and I am very careful not to overload people. I have found that changing too much at once overwhelms many patients, and then they won’t actually end up changing anything.

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3. Psychological.

Amy clearly had significant emotional issues, so we talked about how her fears had gotten the best of her, boxing her into a corner. I found out that she used computer or phone games for four to six hours a day to escape from reality. We talked about therapy, and for her I thought it was important to start with some kind of seminar to break her current patterns.

4. Social.

Amy’s relationship with her family was strained, and she had few friends. We discussed how social support is vital to one’s health. We discussed The Blue Zones by Dan Buettner and found that when they analyzed the five areas of the world where inhabitants commonly lived to over 100 years old, one of the most striking commonalities was a strong social network of friends and family. We discussed that having friends and family around isn't a luxury; it's vital to good health.

5. Spiritual.

When I speak about spiritual, I speak about a sense of purpose or deeper meaning in life. Why should you exercise or eat well if you don’t have a sense of purpose? All I asked of Amy was that she meditate every day for 10 minutes—for at least eight weeks. I've found that eight weeks of solid practice can create noticeable changes. Meditation apps like Headspace, Insight Timer, or Calm really help people stick with it.

With her assignments in hand, we wrapped up our session. I saw Amy back for a follow-up two months later. She was, quite literally, not the same person I had met two months earlier! She had reestablished ties with her mother and some friends. She was meditating every day. Her gaming time had gone down from four hours a day to one. Her gas was also much better. Even before the test results had come in, our intervention of removing gluten and dairy, putting her on powerful herbs for dysbiosis and candida, and recolonizing her gut with good bacteria through a probiotic had had a significant impact.

For me, this is what it's all about. Helping people on their personal journey to better health and happiness, by addressing these five aspects of health, is the "juice" of life.

Wonder what specific foods cause bloating? Here's a list.

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