Coming Soon - Gutbliss, The Book!
Stay tuned for Dr Chutkan's soon to be published book "Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins, and Dump Your Digestive Baggage—the Healthy Way".
Gutbliss is organized around chapters that explain in detail the main factors behind our bloating. Some of these causes you've probably heard of - like lactose intolerance and hormonal changes - but many of them are things you might be doing everyday without realizing that they're a major contributor to bloating.
What you can't see inside your intestinal tract may be much more important than what you can in terms of causing bloating. There are more than 1,000,000,000 bacteria per ml of fluid in the colon—a mixture so distinctive from person to person that an individual’s constellation of bacteria is a more specific identifier than their own DNA. Stool consists of about 70% bacteria and which particular species are present in your stool and your gut are an important determinant of whether you'll end up bloated or not.
Your transit time:
Stool is basically waste matter - toxins, bacteria and the leftover products of digestion that are meant to be in the sewer and not in your body. Stool that lingers longer than it should also means extra fermentation by bacteria and ultimately increased production of bloat-causing hydrogen, nitrogen and methane gases. A "backed up" system exacerbates this problem since the daily half liter of gas we would normally pass through the rectum is unable to be expelled, resulting in impressive bloating.
There are a number of foods that are classically associated with bloating, dairy products being at the top of the list. Fructose intolerance may be an even bigger contributor to bloating than lactose intolerance since so many people are unaware of the signs and symptoms and fructose is such a common additive to so many foods. Foods that change the pH of the digestive system like coffee and soda are major contributors to bloating, as are foods with an infinite shelf-life and lots of chemicals and preservatives ("edible food-like substances"). Celiac disease is an allergy to gluten, which is a protein found in wheat, rye and barley and almost 1% of the US population suffers from this condition, many of whom are undiagnosed. The number of people with gluten intolerance is even higher.
All drugs have potential side effects and many commonly used medications may actually be the cause of your bloating. 45 million Americans have heartburn and many of them are on drugs that block acid production in the stomach. An acidic environment is our body's first line of defense against harmful bacteria that enter the body through the mouth. Blocking the acid can result in overgrowth of many of these species and lead to small intestinal bacterial overgrowth (SIBO), which is a major cause of bloating. Antibiotics are strongly associated with bloating as they can wreak havoc with the delicate bacterial ecosystem in the bowel (the microbiome).
The digestive tract is a muscular structure, not that different from your biceps or hamstrings. Exercise is one of the most important stimulators of peristalsis - the wave-like contractions that move gas and food through the GI tract. Exercise also increases production of nitric oxide, a chemical that relaxes the smooth muscles of the digestive tract and speeds up peristalsis. Lymphatic flow, which is responsible for transporting digested fats and metabolic waste through the body, is also increased with exercise and poor lymphatic flow can lead to bloating. What time of the day you eat meals may be one of the most important determinants of bloating. The digestive tract actually has a bedtime - peristalsis is most active in the morning and becomes much less active after the sun sets. Unfortunately that's when most of us are dumping in the majority of calories, which sets us up for lots of late-night bloating.
Women are not just small men - they have completely different anatomy that predisposes them to bloating. The female colon is quite voluptuous compared to its male counterpart. Women have a longer and more redundant colon than men: 10 centimeters longer, on average. This “redundancy” means that there are many more twists and turns in the female colon, and all of these loops can cause the products of digestion to back up at multiple sites. Backed-up fecal matter traps gas behind it—and it contributes additional gas as it ferments.
Birth control pills (BCP) with high levels of estrogen are a very common cause of bloating. Estrogen stimulates the kidneys to retain fluids and salt, leading to bloating as a result of water retention. BCP can also cause gain weight, raising the possibility that the “bloat” is actually belly fat. Despite reassurances from the makers of certain pills, most studies show that women do gain about 5 pounds when they go on BCP for the first time. Sometimes high levels of estrogen also affect where the body distributes fat. Measuring your waist every couple of days throughout your menstrual cycle can help you to figure out what kind of problem you’re dealing with: bloat or belly fat. If it’s bloat, your waist measurement will vary; if it’s fat, it will stay the same.
Diseases you didn't know you had:
This is a really long list! Diseases can cause bloating via a number of different mechanisms: mechanical compression of the intestines by a tumor in the abdomen or pelvis is seen commonly with colon cancer, ovarian cancer and other malignancies. In fact, ovarian cancer is often called "the silent killer" because the signs and symptoms can be so vague and non-specific and bloating can be an important initial sign. Diverticulosis, endometriosis, ovarian cysts and fibroids are common non-malignant causes of bloating. Hypothyroidism, interstitial cystitis, fibromyalgia, chronic fatigue syndrome, polycystic ovarian syndrome (PCOS), parasitic infestation, kidney failure, various forms of liver disease and many kinds of infection such as urinary tract infections can all cause or exacerbate bloating.
When bloating turns toxic:
There are definitely some "alarm" symptoms that should prompt you to seek immediate medical attention if they occur in conjunction with your bloating. Unexplained weight loss is one, as are blood in the stool, anemia, fevers, or a change in your bowel habits or menstrual cycle. Although many people suffer from fatigue on a chronic basis due to dietary and lifestyle factors, the development of bloating and severe fatigue, particularly when accompanied by other symptoms is a cause for concern.
My 10 day bloating plan will get you started on the road to a bloat-free life. Banish your bloating for good!
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