Bloating and Nutrition

As a gastroenterologist, I frequently encounter patients troubled by bloating, burping, and flatus – symptoms often related to excess intestinal gas. While intestinal gas is a normal part of digestion, excessive gas can lead to discomfort and embarrassment.

Understanding the Causes of Excess Gas

Excess gas production can be attributed to two primary factors:

1. Aerophagia (Air Swallowing): This occurs when people swallow too much air, which can happen while eating or drinking too quickly, smoking, chewing gum, or drinking carbonated beverages.
2. Dietary Factors: Certain foods and drinks, particularly those high in FODMAPs (Fermentable Oligo-, Di-, Monosaccharides, And Polyols), are known to cause increased gas production. These short-chain carbohydrates are poorly absorbed in the small intestine and fermented by bacteria in the colon, producing gas. Common examples include certain vegetables (like cabbage and cruciferous veggies), fruits (such as apples and watermelon), dairy products, wheat, and sugar alcohols.

Managing Gas-Related Symptoms

• Low FODMAP Diet: This diet limits foods high in FODMAPs, reducing fermentation and gas production. It can significantly alleviate symptoms of bloating, burping, and flatus. However, given its restrictive nature, I generally recommend following this diet for 6-8 weeks, followed by gradual reintroduction of foods under the supervision of a registered dietitian. Monitoring the return of symptoms during this phase is crucial.
• Lifestyle Modifications: To reduce aerophagia, simple changes can be effective:
  • Eat slowly to reduce the amount of swallowed air.
  • Avoid using straws and water fountains, as they can increase the amount of air swallowed.
  • Cut down on chewing gum and hard candies.
  • Avoid carbonated drinks.
  • Quit smoking, as it can lead to swallowing excess air.

Dietary Recall and Counseling

During initial consultations, I focus on a 24-hour dietary recall. This helps identify potential dietary triggers, including specific seasonings, sauces, garlic,