If you’ve ever muttered the words, “I look six months pregnant,” you’ll know that extreme bloating can make your stomach look completely different — sometimes in a matter of minutes.
Many people deal with bloating, and a big factor is your diet. FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) foods are the most common culprits to creating gas and bloat, says Dr. Marvin Singh, founder and CEO of Precision Clinic. FODMAPs are the typical foods that aren’t easily digested. “Gluten and dairy are at the top of the discussion, but even super-healthy foods like cauliflower and cabbage are also FODMAPs that are highly fermentable [which causes gas],” he says. You also have to think about what you drink, whether that’s carbonated beverages — even unflavored sparkling water — that cause a buildup of air, or beer (which often contains aforementioned gluten) and alcohol that can disrupt the gut microbiome, he says.
There are also lifestyle and behavioral reasons why you might be experiencing intense bloat, like eating your food too quickly (your stomach has to work harder to process the food, which creates gas) or frequently drinking through straws that force you to swallow more air.
Though you may already be aware of these common causes, there are a few other sneaky reasons why your body may be experiencing extreme bloating. Below, Singh helps break down a few of the culprits.
P.S. As always, discuss with your doctor before making any changes to your routine.
What it is: “Simply put, it’s a separation of your abdominal wall muscles. You’ll be able to physically feel that there’s a separation or a weakness of your muscles in the abdominal wall, which will cause bulging” that may give you a “pregnant” look, says Singh. In addition to the bulge, you may have lower back pain, incontinence, or bad posture.
Why it happens: It’s common after pregnancy, when the tissues and muscles of your abdomen are stretched out from the growing uterus. However, anyone can get it (since everyone has an abdomen) from doing exercises incorrectly, intense weight fluctuations, or other causes.
How to treat it: If you’re postpartum, wait six to eight weeks after giving birth for your body to recover. You can work with a physical therapist to treat your core and pelvic floor muscles. For more serious cases, a surgeon can perform a procedure that allows for the separated muscles to repair themselves.
What it is: Stress is a natural human response of emotional or physical strain to a challenging or new situation. Stress can be a positive thing in the short-term to keep you alert — for example if you need to stay on top of your game for an important meeting. But long-term, chronic stress can cause the body to break down. In addition to bloating and stomach problems, you can have headaches, high blood pressure, chest pain, muscle tension, and more.
Why it happens: “Stress, anxiety, and depression are very intertwined with the symptoms of bloating and distension. The reason is that stress can impact the motility of our GI tract. When you’re chronically stressed or anxious, our gastrointestinal tract — our guts — is basically feeling like we’re in a ‘fight or flight’ situation all the time. When that happens, the GI tract slows down so digestion is not happening properly. When your bowels get backed up, you feel constipated and bloated,” says Singh.
How to treat it: “A large part of the discussion on treatment has to really involve stress management” and that’ll look different from person to person, says Singh.
What it is: Your body’s immune system is triggered when you’re allergic to a food or an ingredient. You’ll often experience serious and immediate skin reactions (like swelling, itching, hives or a rash) or trouble breathing, but it’s not unheard of to also have digestive symptoms, says Singh. The most popular ingredients people are allergic to are peanuts, eggs, shellfish, wheat, and soy.
Why it happens: When your body thinks a certain protein in your food is an invader, your immune system fights to protect it.
How to treat it: Avoidance of the foods is key. “If you have these kinds of allergies, you may want to carry around an EpiPen in case you get exposed to it inadvertently. Oftentimes, you’ll have seen an allergist that specializes in managing people with allergies and they’ll do testing to verify that you have this kind of allergy,” says Singh.
What it is: Not to be confused with a food allergy, food intolerances or sensitivities are not immune-mediated and the reaction is in your digestive system. Symptoms include diarrhea, constipation, and nausea, in addition to bloating or gassiness.
Why it happens: Food intolerances happen when your digestive system can’t properly break down certain enzymes in food. Some common food intolerances could be “a lactose intolerance or gluten intolerance,” says Singh.
How to treat it: “Your doctor can do tests on your stool to take a look at your gut microbiome and see if there’s fat malabsorption. You can check your stool to see whether your pancreas is operating properly to give you digestive enzymes from your own body. They can then create a personalized diet plan from there,” says Singh.
What it is: Celiac disease can present itself as a food allergy since it’s an autoimmune disorder. It’s triggered by gluten — which are proteins found in foods like bread, baked goods, grains, pasta, and beer — and can attack the small intestine. Digestive symptoms can range from bloating and gas to nausea, vomiting, pale-colored stool, or stomach pain. Other physical and mental symptoms can include fatigue, weight loss, and anxiety.
Why it happens: The precise cause isn’t known, but your genetics can play a factor.
How to treat it: You’ll need a blood test to check for antibodies to confirm that you have celiac disease. There’s no treatment plan other than to avoid foods with gluten and explore a gluten-free diet.
Irritable Bowel Syndrome
What it is: Irritable Bowel Syndrome (IBS) is basically an umbrella term for any flare-up in your digestive system, whether that’s bloating, cramps, diarrhea, constipation, or another abdominal issue. It affects the large intestine, which is responsible for getting rid of undigested food.
Why it happens: The cause of IBS is largely a mystery, but some factors could be weak intestinal contractions, recovering from a stomach infection like gastroenteritis, an overgrowth of bacteria in the intestines, stress, and an abnormal gut microbiome.
How to treat it: Though there’s no cure, studies show it helps to stay hydrated, exercise regularly, minimizing stress, taking prebiotics and probiotics, and finding out your food triggers through a FODMAP diet.
What it is: Endo belly is a colloquial term to describe the severe bloating that can be a symptom of endometriosis, which is “a condition where endometrial tissue migrates from the uterus and implants itself in various different parts of the body,” says Singh.
Why it happens: Endometriosis can be related to a number of gastrointestinal issues like bloating or inflammation because of the build of extra tissue that’s unable to exit the body (unlike uterine tissue that sheds during one’s period). “If you’ve had surgery for your endometriosis, it’s possible that surgery could cause adhesions that are like scar tissue. Those adhesions might cause disruptions with your bowels that’ll make them feel distended and cause bloating,” says Singh.
How to treat it: The treatment plan will depend on the severity of the pain and if you plan on/are trying to conceive. It’ll range from anti-inflammatory drugs, hormonal medications like birth control pills to try to slow the growth of excess tissue, or laparoscopic surgery to remove the adhesions.