Feeling uncomfortably full? Waistband tightens as the day progresses? One of the most common symptoms people come to me who are experiencing digestive discomfort is bloating. And I know that feeling as I still get it when I eat too much, too often of certain foods.
Certain carbohydrate foods are not well absorbed in the first part of the gut where most of our food is digested (the small intestine) and are quickly fermented further along (in the large intestines). This is a perfectly normal part of our digestive process. For example it’s common knowledge that certain ‘windy vegetables’ including beans and Brussels sprouts (which are high in galactans) can increase flatulence and change bowel habits, and this is because they are high in fermentable carbohydrates. For some people this fermentation causes symptoms including bloating, gas, pain and changes in bowel habit. Because it can take 4-6 hours to reach the large intestines it can become difficult to pinpoint a culprit food. The range and amount of these carbohydrates that can bother people varies by person.
FODMAP is an acronym that describes these carbohydrates and stands for Fermentable Oligo-, Di- and Mono-saccharides And Polyols. These comprise fructose, lactose, fructans, galactans and polyols. I won’t go into the food chemistry but two key groups are fructans (including wheat and rye) and lactose (in milk and milk products) because these are eaten most often in largest quantities. Loading matters so how often you eat these carbohydrates and the amount can determine whether symptoms are triggered or not. This may explain why a suspected food may cause problems after some meals, or on some days but not others.
Fructans include wheat which explains why many people attribute bread to their bloating and many people I see have already cut out bread. This can considerably cut down your total FODMAP load if you are having a lot of toast and sandwich lunches. But don’t forget wheat breakfast cereals (Weetabix, special K, bran flakes etc.), pasta, crumpets, teacakes, cous cous, pastry, pizza, cakes etc. It’s really easy to end up eating wheat at all 3 meals.
Stomach bug or even flu?
Lactose deserves special mention because it’s not just that you can be born with insufficient lactase (the enzyme that digests lactose) and are therefore lactose-intolerant, but your body’s natural production of lactase decreases as you get older. Certain populations are more likely to be lactose-intolerant like Asians and Hispanic communities.
If the cells of the lining of the intestines (where lactase is produced) are damaged by a bout of gastroenteritis including norovirus or even the flu this may reduce lactase production (called secondary lactase deficiency). Other reasons are chemotherapy, inflammatory bowel conditions (Crohns, ulcerative colitis) or sometimes surgery. Some people may find that after antibiotics they feel more digestive discomfort including bloating for a while as the antibiotics have removed the ‘good’ as well as ‘bad’ bacteria living in the large intestines that play a part in our digestive process.
My advice is to cut out both wheat and milk products for 2 weeks and see if you notice an improvement. Try a non-wheat cereal for breakfast (porridge, Oatibix, cornflakes), soup or a salad for lunch (without the roll or croutons) and avoid pasta or swap to gluten-free pasta at dinner. For milk there are alternatives like unsweetened Almond milk or Lacto-free milk.
Another tip is to take your time over your meals. Eating quickly may mean you swallow more air with your food and that can create gas. Also chewing releases digestive enzymes in your mouth which start the process of carbohydrate digestion. Sit down at a table and eat mindfully.
If you don’t feel better then it may be you are still eating too much of the other fermentable carbohydrates and a Nutritionist or Dietitian may be able to help you. Or it could be there is another reason you feel bloated so please see your GP for advice.