Bloating
Bloating: physical abdominal distention, often uncomfortable or even painful. Can be upper, lower, or entire abdomen.
One symptom can have MANY different causes. Potential causes of chronic bloating:
️ Food Sensitivities- wheat and dairy being the most common. This doesn’t necessarily mean your bloating is limited to right after you eat these foods. It can be 2-3 days later.
TEST: IgG food sensitivities testing such as Alletess, Infinite Allergy Lab. OR a 21 day elimination. After 21 days reintroduce one serving of one category and assess how your body responds in the next 3 days.
TREAT: Remove the offending food from your diet.
️ Poor digestion - more likely if you feel like a brick is in your stomach after meals, bloating and gurgling after meals, or you run to the bathroom after high fat meals.
TEST: Functional stool testing such as GI Map or GI effects. Stool pancreatic elastase with Quest/Labcorp. OR a trial of taking digestive enzymes with each meal such as Digestazyme by Designa for Health
TREAT: replace the specific digestive agent you are lacking, betaine HCL for stomach acid, ox bile for lacking fat digestion(loose urgent stool after high fat me), pancreatic enzymes for replacement of deficiency. Some people can discontinue these after a while if the cause of deficiency is found and treated.
️ Gastritis - Inflammation of the stomach lining. More likely if you feel pain or burning in your upper abdomen when you are really hungry or after spicy or acidic or other specific food, you have heart burn or indigestion,
TEST - Upper endoscopy
TREAT - PPI medications (not ideal long term) or herbs such as mastic gum, aloe, Deglycyrrhizinated licorice, and MSM
️ Dysbiosis - an imbalance in your gut microbiome. This can cause any number of digestive or other symptoms such as bloating, gas, abdominal pain, constipation, diarrhea, skin conditions, fatigue,,
TEST - comprehensive stool test such as GI MAP or GI Effects not covered by insurance ~$300-400.
TREAT - herbs to decrease overgrowth, probiotics to increase deficiencies, diversity of insoluble and soluble fiber in diet to feed microbiome.
️ SIBO or SIFO - small intestinal bacterial/fungal overgrowth. More likely if your bloating is worse at the end of the day, high FODPMAP foods, fermented foods or sugar trigger bloat.
TEST- 3 hr breath test for SIBO. TrioSmart is sometimes covered by insurance. No test for SIFO developed.
TREAT - antibacterial/antifungal medications or herbs, along with long term treatment to improve motility and restore microbial balance. Fasting helps.
Pelvic Congestion Syndrome: dilated blood vessels within the pelvis. Often causes chronic back pain, hip issues, and discomfort down the legs
TEST: pelvic ultrasound or MRI
TREAT: pelvic PT, pelvic lifts/raises, gentle regular activity (yoga, walking, swimming), embolization procedure by a vascular surgeon
️ Women only:
Endometriosis: cells from the inner lining of the uterus implant on surrounding pelvic organs
TEST: exploratory laparoscopy
TREAT: hormone balance, PT, antiinflammatory diet, Excision surgery, followed by holistic treatments to prevent recurrence. Birth control can reduce symptoms.
Adenomyosis: endometrial cells grow into the muscular wall of the uterus.
TEST: pelvic ultrasound and/or MRI
TREAT: all of the above for endometriosis; hysterectomy
Large recurrent Ovarian cysts:
TEST: pelvic ultrasound
TREAT: hormone balance, insulin optimization, surgery.
Large Fibroids:
TEST: pelvic ultrasound
TREAT: surgery, uterine artery embolization, ablation, hormone balance to prevent recurrence
So as you can see there are MANY potential causes. But ALWAYS a cause
