By Denise Maher, AARP March 2023
How to change your diet to find relief, and learn when you need to seek treatment. Bloat sounds like it feels. Your belly swells, with gas and fluid pushing out from inside, making it feel as if you are wearing a heavy inner tube around your middle.
Bloating, a sensation of fullness in your abdomen, is a tricky topic, says Lin Chang, M.D., vice-chief of the Division of Digestive Diseases at the David Geffen School of Medicine at UCLA. “Bloating is such a common symptom that can be associated with multiple different diseases or disorders,” she explains, that it is often not used in diagnostic criteria, as it doesn’t help distinguish one condition from another.
What causes belly bloat?
The root cause of your bloat could stem from various issues, or a combination of them, including a lack of fiber in your diet, a food intolerance, irritable bowel syndrome (IBS) or small intestine bacterial overgrowth, or a serious condition such as colon cancer. If you’ve already gotten the clear from a colonoscopy — recommended starting at age 45 — it is likely that this disagreeable symptom comes from a classic gastrointestinal problem. Constipation, one of the main reasons so many people experience gas and bloating, gets more common as you age. According to the American Gastroenterological Association, about 16 out of 100 adults experience constipation symptoms. After age 60, that number rises to 33 out of 100.
Experts say there are a number of reasons digestive issues tend to plague more older people. “With age, we produce less stomach acid, which is responsible for activating certain enzymes that help break down foods,” says Sandra J. Arévalo Valencia, director of community health & wellness at Montefiore Nyack Hospital in Nyack, New York. “When these enzymes are not being activated and the food remains longer in the stomach, then there’s more gas that remains for a longer period of time in the digestive tract,” she says.
Every person is different, and not everyone will have trouble with every food, stresses Arévalo. But if you are curious about possible dietary causes of bloating, consider these seven types of food.
1. Milk, cheese or other dairy foods
Developing lactose intolerance later in life is very common, says Arévalo. With age, we produce less and less of the enzyme we need to digest the lactose (a type of sugar) in milk, she explains. Besides bloating, dairy digestion problems can cause gas, pain and diarrhea.
Luckily, there is an easy over-the-counter remedy. You can supplement the missing enzyme, lactase, with products such as Lactaid.
2. Beans, lentils, almonds, whole grains
The high fiber content in legumes and some other foods can cause bloating and pain with digestion, notes Arévalo, who is also a spokesperson for the Academy of Nutrition and Dietetics. Chang suggests that her patients use a tool, like a spreadsheet or food diary, to help correlate consistent patterns of gastro symptoms with what they ate. Check out free digital app diet trackers like Cara Care, Symple Symptom Tracker or Low FODMAP diet A to Z that can help you connect foods with your bloating symptoms. Also helpful are such patient-friendly resources as the International Foundation for Gastrointestinal Disorders and the Rome Foundation.
3. Foods with artificial sweeteners
Manufacturers use low-calorie sweeteners like sorbitol in foods and beverages to bring down the overall calorie count. But some sweeteners might not digest fully in the small intestine, leading to gas and bloating in the large intestine. More research is needed to learn how sweeteners affect GI function and the gut microbiome, according to Monash University, where researchers created the low FODMAP diet for people with IBS. Check the ingredients list for sweeteners such as sorbitol and mannitol. Gum and mints with warnings about excess consumption causing laxative effects are a good sign that the item is a sweetened food that may cause gastro symptoms.
4. Carbonated drinks, soda, sparkling water
Some people cannot tolerate bubbles and carbonation, according to Arévalo. Others need to start drinking it gradually, to get their system used to the fizzy beverages.
Beer checks a lot of bloat boxes, notes Adrienna Jirik, M.D., a gastroenterologist at the Cleveland Clinic. Besides carbonation, it contains grains and gluten, which bother some people. And alcohol can disrupt digestion and interfere with healthy gut bacteria, ultimately leading to more gas production. Then, bingo! You’re bloated.
6. Broccoli, brussels sprouts, other cruciferous vegetables
While they’re nutrient-rich, cruciferous vegetables are also chock-full of sulfurs and fiber that can pack a wicked punch of gas. Chang notes that there are new digestive enzyme supplements that claim to make it easier for your system to break down these foods, though their effectiveness remains to be proven.
7. Fruits you don’t eat often
Like many fruits, apples, pears, berries and grapes are high in fructose and can trigger digestive issues, especially when added to a diet abruptly. When you aren’t used to eating fruit and your digestion isn’t as efficient as it used to be, food stays in the GI tract for longer, Arévalo says, causing more fermentation, gas production and consequent bloating. She says she sees this when people newly diagnosed with prediabetes, high cholesterol or high blood pressure are told to eat more fruits and vegetables. “If they don’t already consume fruit regularly, their bodies react badly at first,” she explains. Introduce new fruits slowly and add no sugar low-fat yogurt to your diet to help your gut tolerate them.
When to seek treatment
If you suspect your belly bloat is related to diet, you can track what you eat using a food and symptom diary to pinpoint which foods are problematic for you. See a doctor if bloating is bothersome or getting worse. Besides lifestyle changes, such as adding exercise and drinking more fluids, there are many treatments available, notes Chang, who is also a fellow of the American College of Gastroenterology. “There’s prescription medicines, over-the-counter remedies, GI behavioral therapies, like gut-directed hypnotherapy or cognitive behavioral therapies, that reduce abdominal symptoms,” she offers.