Preventing and relieving bloating through diet

To fully understand this phenomenon, we must first put the terms used in order. The following terms are synonyms, but they vary according to certain criteria:

• Aerophagia : disorder characterized by the entry of air into the esophagus and stomach. We regularly notice belching (“burps”), which are swallowing of air. If the expansions are excessive; aerophagia causes abnormal dilation of the esophagus and stomach, as well as their swelling.

• Bloating : symptoms of trapped gas, abdominal pressure and full stomach.

• Flatulence : result from the production of intestinal gas. They cause bloating and induce the voluntary or involuntary expulsion of gas through the mouth (eructation) or through the anus (“fart”).

• Bloated stomach : scientifically called abdominal distension, it is a measurable increase in abdominal circumference.

Functional abdominal bloating and distension are defined by the Rome IV criteria, which are medical criteria characterizing a pathology based on specific symptoms and causes. Functional abdominal bloating and distension are often associated with other functional gastrointestinal disorders, such as functional dyspepsia, irritable bowel syndrome, and functional constipation. They can develop for multiple reasons: food intolerances, a delay in intestinal transit, a previous infection which disrupted the intestinal microbiota, a disorder of visceral sensation, or even abnormal viscerosomatic reflux (sensory information coming from an organ).

Generally speaking, bloating is caused by lack of digestion. Certain carbohydrates (glycoproteins, fibers including cellulose) and other ingested materials are not assimilated in the small intestine. These arrive whole in the colon and the bacteria present digest them and produce hydrogen, methane (from hydrogen) and carbon dioxide. This carbon dioxide is a fermentation product released when hydrochloric acid reacts with bicarbonate in the intestine. These three gases, along with swallowed nitrogen, make up about 99% of the gases in the colon. The remaining percent is reserved for traces of gas which are characterized by the strong odors emitted during flatulence.

Hygiene and dietetic measures play a major role in the management of bloating. Although no diet has been systematically effective, it is first necessary to study the causes bloating. Therefore, it is recommended to eliminate foods one by one to see which are likely to be the cause.

• THE excess fiber and starch are poorly tolerated by the intestines. Fiber is not assimilated by the body during digestion because digestive enzymes are not equipped to digest this type of carbohydrate. In addition, the body struggles to secrete amylase (starch digestive enzyme).

• THE raffinose contained in certain foods causes aerophagia because the latter is digested in the colon and not by the intestines.

• To avoid accumulation of intestinal gas, it will also be best to avoid soft drinks and beer.

• Also, “light” products rich in polyols escape absorption in the intestines and enter the colon where they are fermented by bacteria, resulting in the production of gases like hydrogen and methane during this digestion.

• Finally, the lipids are insoluble and are composed of hydrogen, oxygen and carbon. These take time to be broken down and digested by lipases (specific enzymes) and bile salts, which make them so small that they can pass through the watery layer at the border of the enterocytes (digestive cells). Excess lipids are therefore poorly tolerated since they tend to slow down gastric emptying.

These foods limit the production of flatulence and act on the colonic fermentation, avoiding the formation of gas. They also help eliminate air accumulated in the intestines and stomach. Indeed, to eliminate excess gas from your body, you will have to expel them, whether through flatulence or aerophagia.

Vegetables, fruits, legumes, or even whole grain products, are families of foods rich in fiber, and in particular legumes (white beans, chickpeas, lentils). These are rich in fiber and excess poorly digested carbohydrates.

We recommend you :

• to limit the excesses foods rich in fiber: 5 servings of fruits and vegetables per day (80 g per serving).

• to limit the gas-producing plants following: onions, salsify, artichokes, cabbage, turnip, soya, leeks, asparagus, peas, mushrooms. These foods have raffinose that is digested in the colon instead of the intestines, which is likely to produce excess intestinal gas.

• of cook well gas-producing foods in order to eliminate as many fibers as possible thanks to the heat of cooking. For gas-producing foods cooked in water, it is recommended not to consume the cooking water which contains fiber.

• to divide your meals into 4 to 6 times with the aim of limiting excessive fiber digestion.

• to reintegrate the fibers gradually (5 g per week).

Excessive foods rich in sugars, and particularly sugary products, are likely to cause bloating. In fact, sugar promotes increase in active fermentation populations and particularly fungi in the intestine or colon. This causes certain symptoms related to increased intestinal gas. Additionally, starchy foods are high in carbohydrates and starch and are less well tolerated when consumed in excess. In fact, the body struggles to produce amylases, enzymes allowing the digestion of starch.

We recommend you :

• not to consume starchy foods in excess, be aware that starchy foods triple in volume during cooking. Thus, 100 g of raw rice yields between 250 and 300 g of cooked rice. For example, the ideal portion for rice consumption is between 60 and 80 g raw (around 200 g cooked).

• to limit white bread to 1/2 baguette per day, because it contains amylase inhibitor proteins, and to alternate its consumption with breads made from buckwheat or chestnuts.

• to limit confectionery to occasional consumption, spacing them between meals so as not to create digestive overload, leading to bloating.

Foods high in fat and meals that are too large lengthen digestion time. This causes the bolus to stagnate in the intestines for longer and ferment, leading to additional gas production.

We recommend you :

• to avoid excess food rich in lipids and in saturated fats : fried foods, meats in sauces, cold meats, red meats, oils, sauces, industrial products (also rich in poorly tolerated additives).

• to divide your diet into 4 to 6 meals to limit excessively rich intakes in a single meal.

• to limit the fatty cooking methods such as fried foods, preferring gentle and healthy cooking methods such as steaming and cooking in foil.

Industrial products labeled "light" or "reduced" are rich in food additives and in particular polyols: sorbitol, mannitol, xylitol, maltitol, isomalt, lactitol. These sweeteners are synthetic sugars which are lower in calories than table sugar (sucrose). However, manufacturers do not count these calories in their drinks. In addition, these polyols are known to health authorities for their fermentation and the bloating they cause (sorbitol, xylitol, maltitol). These sugars are found in confectionery, “zero sugar” drinks, and in chewing gum (xylitol).

We recommend you :

• to reduce the light industrial products : sugar-free drinks, sugar-free confectionery, sugar-free chewing gum, etc.

• avoid chewing gum because, typically, when you chew it, you swallow air and promote gas accumulation.

Carbonated drinks, hence their name, cause air accumulation in the intestines. The gas, once swallowed and released, becomes blocked in the digestive tract, which causes the walls of the intestine and stomach to distend, leading to a bloated stomach. Concerning beer, it contains brewer's yeast which is the origin of its fermentation. This component transforms the sugar in the must into alcohol and carbon dioxide. This is why heavy consumption of beer causes the stomach to bloat. In addition, beer causes further fermentation and, therefore, a release of gas during its digestion.

We recommend you :

• to eliminate beer consumption, or to limit it to one beer per day, and not every day.

• limit your consumption of carbonated drinks as much as possible and switch to plain water.

Only you can know which foods you digest poorly. Be aware that there are many cases of intolerance such as lactose, gluten and fructose. These foods are not intolerable by everyone and a lot of abuse of language is present around these foods. However, your body may struggle to digest these components and you may be one of those people who digest them poorly.

We recommend you :

• d'eliminate one by one foods that you feel may cause these problems. It is recommended to eliminate one food per day to feel the effects and understand whether or not it is the cause of your symptoms.

• to try eliminating food rich in lactose : dairy products, and in particular whole milks, and foods containing milk (milk chocolate, coffee with milk, milk chocolate spread, etc.). Indeed, it is possible that the body is deficient in the production of lactases, enzymes that digest milk.

• eliminate certain foods containing gluten : all products derived from wheat, barley, oats, rye, spelt and einkorn, and especially their flour. Be careful, because gluten is also present in many products from the food industry since it is used as a texture or stability agent.

• to eliminate certain products rich in fructose : honey, dried fruits (grapes, dates, figs), industrial products, “low” products sweetened with fructose. In some people, fructose cannot be assimilated in the intestine as it should and is broken down in the colon by bacteria, leading to the formation of additional gas.

• to consult your doctor or dietician to detect an intolerance to one or more foods.

Mild aromatics have carminative properties. In fact, they help to evacuate gas and limit the symptoms of bloating. It is recommended to turn to the following spices and aromatic herbs, each of which has proven itself on the reduction of symptoms bloating according to certain studies: fennel seeds, peppermint infusion, sweet woodruff infusion, turmeric, cumin seeds, cinnamon infusion.

We recommend you :

• to make infusions based on aromatics and spices: cumin, fennel seeds, peppermint, woodruff, cinnamon.

• d'spice up your dishes with the following spices: turmeric, cumin, cinnamon.

According to PubMed, there is high-quality evidence for the effectiveness of probiotics in functional gastrointestinal disorders like bloating. Indeed, probiotics are renowned in reduction of flatulence, which restores the balance of the intestinal flora. In fact, the Lactobacillus acidophilus acidify the intestines and maintain the natural balance of digestive fermentation processes. In addition, a study of 60 patients with abdominal bloating without constipation showed that this bacteria as well as Bifidobacterium lactis are effective in improving symptoms after 4 weeks. However, the lack of clear guidelines on when to use probiotics, and which probiotic is most effective for different gastrointestinal conditions, can be confusing for family physicians and their patients. We believe these microorganisms may help relieve your bloating.

We recommend you :

• to direct you towards foods rich in probiotics like natural yogurts, kefir and kombucha. Be careful not to eat fermented vegetables (cabbage, onions, pickles, tomatoes, celery) because they are gas-producing plants.

• to consume once a day a food rich in probiotics.

• to discuss with your doctor about a probiotic supplement.

Combining the consumption of vegetables with starchy foods allows to avoid excesses fiber and carbohydrates causing fermentation and intestinal gas.

We recommend you :

• increase your fiber content gradually (5 g per week). Fibers are very important in regulating transit and for their effects on reducing cholesterol and blood sugar levels (cholesterol levels and blood sugar levels).

• of cook your vegetables well if your consumption of vegetables, and particularly raw vegetables, remains high. In fact, cooking will denature the fibers which will no longer irritate the intestinal walls.

• to have a plate composed of 1/3 vegetables, 1/3 starchy foods and 1/3 of a protein source (meat, fish, eggs).

Lean meats and lean fish are the best sources of protein for bloating. Indeed, it is recommended to limit intakes rich in poor quality fats and lipids, in order to avoid difficult digestion for fragile intestines. Indeed, excess fats will make digestion heavier and prolong it, which will cause the food bolus to stay longer in the colon and ferment. To avoid this inconvenience, we therefore favor foods that are sources of lean proteins, and therefore less rich in fat.

We recommend you :

• to bring a portion food rich in protein at each meal (100 g per serving), avoiding daily excesses, because excessive intakes of proteins and lipids are difficult to digest.

• to favor the lean meats (chicken, turkey, guinea fowl) and lean fish compared to red meats, cold meats and eggs rich in fat and likely to be consumed in excess.

• also direct you towards oily fish since, even if they are rich in fat, they have a good omega-3/omega-6 ratio. However, it is best to avoid adding fat to cooking.

• To limit bloating and gas accumulation, it is recommended to eat without speaking (brings extra air into the mouth), not to drink while eating while taking your time to eat, and not to drink too much at once.

• In case of bloating, it is recommended to split your meals with the aim of not eating too much at once and thus limiting overly intense digestion.

• Practice physical activity : this helps strengthen the abdominal muscles and in particular peristalsis. This phenomenon is characterized by the contraction of the muscles of the intestines in order to move the food bolus towards the colon. Be careful if your bloating is due to diarrhea, because physical activity accelerates transit and promotes diarrhea.

• Bloating may be related to constipation or some diarrhea. Therefore, you can refer to the management of these pathologies which we explain in the following articles: constipation and diet ; diarrhea and diet.