Five Types of Bloating
Feeling bloated?
Over 90% of patients with irritable bowel syndrome have symptoms of bloating or abdominal distention.
Factors to consider in bloating include:
Microflora
Gas production
Intestinal transit time
Intestinal propulsion of gas (up or down)
Sensory function in the gastrointestinal tract
Gas is a normal product of large intestinal microbial fermentation of food. Both probiotics and antibiotics are prescribed with success in treating microbial based bloating. Basically, get the bad guys out and the good guys in. But there is more to it than that.
“In bloating patients who did not have IBS, over 75% of patients characterized their symptoms as moderate-to-severe, and over half stated that they had reduced their daily activities to some degree due to their bloating symptoms.” |
There are five basic kinds of bloating:
Visceral hypersensitivity
Carbohydrate malabsorption and food intolerance
Dysbiosis and SIBO
Dysmotility
Abdominophrenic dyssynergia
Visceral hypersensitivity is one of the most common reasons for bloating. It involves the gut-brain communication, where by the nervous system overreacts to a normal volume of gas produced and the changes in chemical, mechanical and thermal conditions of the gut. Factors that contribute include genetics, psychological stress and trauma, and the gut microbiome. Help: Address body’s stored reaction to trauma, soothe and retrain the nervous system, nourish the microbiome.
Carbohydrate malabsorption and food intolerance happens with about 60% of those with a gut-brain communication issue and about 51% of those intolerant to lactose. In many patients this is due to fructan sensitivity. Help: That’s where the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet can be helpful. Sometimes a non celiac gluten sensitive person can have a reaction to the fructans in food, not the gluten, because wheat contains both. Help: Food sensitivity testing, guided elimination and re-introduction diets.
Dysbiosis and SIBO (Small Intestinal Bacterial Overgrowth) is caused by the migration of bacteria that normally reside and ferment things in the large intestine up to the small intestine. Breath tests are not always reliable. Clinical symptoms are the real key: gas, pain, bloating, and changes in bowel habits. Help: Remove the bad bugs, add some good bugs, address the health of the gastrointestinal valves, heal the gut lining.
Dysmotility means the peristalsis, or the wave like motion of the muscles that moves the food through the gut are not acting properly. This can be from medications, hypothyroidism and other factors. Help: Address the root cause, and look for plant medicines with factors that can help promote intestinal motility.
Abdominophrenic dyssynergia, the diaphragm actually goes down, forcing the tummy to push out. This is a behavoural reflux disorder, not a food or microbiome problem. The normal reaction to gas loading will trigger contraction in the abdominal wall, allowing the diaphragm to rise, giving room for the food and the normal production of gas from large intestinal microbial fermentation. Help: This is where prokinetics, things that help the bowel move, are helpful.
Bloating can be more complex that one might imagine. A trained practitioner will help narrow down your own root cause and create a plan that addresses the one or more factors that contribute to your gastrointestinal distress.
References:
Brown, Laura. (2021) How Gut Health Connects to Your Mind, Body and Soul. Lioncrest Publishing. https://geni.us/BeyondDigestion
Lacy, B. E., Gabbard, S. L., & Crowell, M. D. (2011). Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?. Gastroenterology & hepatology, 7(11), 729–739.
Sandler RS, Stewart WF, Liberman JN, Ricci JA, Zorich NL. Abdominal pain, bloating, and diarrhea in the United States: prevalence and impact. Dig Dis Sci. 2000;45:1166–1171. doi: 10.1023/a:1005554103531. [DOI] [PubMed] [Google Scholar]
Tang, W., Wang, J., Wang, W., Xue, J., Wang, Y., Jiang, F., Kechiyerunda, D. C., Gao, S., Yuan, T., & Guo, F. (2026). Reviewing the Peripheral and Central Mechanisms of Visceral Hypersensitivity in Intestinal Disorders. International journal of medical sciences, 23(3), 1121–1143. https://doi.org/10.7150/ijms.126361
