Find bloating cause with elimination diet
DEAR DOCTOR: My husband and I ate more junk food than usual during the coronavirus lockdown, and we both gained a few pounds. We’re trying for a healthier diet, with more fresh fruit and vegetables, but now I’m getting bloated after meals. What causes that? How can I make it stop?
DEAR READER: Whether it’s due to stress, boredom or simply experimenting in the kitchen to help pass the time, many people during the lockdown began taking in more fuel than their bodies were burning. At the same time, physical activities that had been hardwired into our daily routines were suddenly absent. Visits to the gym, the two-block walk from the parking space to the office, the staircase you choose rather than taking the elevator, those quick, darting runs as you chase a toddler through the park — they all add up. For many, the increase in food and the loss of activity have resulted in what has been dubbed the “quarantine 15.” And as you have experienced, dietary changes to address the weight gain can lead to abdominal bloating.
Although bloating can be a symptom of gastrointestinal disorders, including irritable bowel syndrome, Crohn’s disease and ulcerative colitis, more often, the condition is associated with a buildup of excess gas in the digestive tract. Symptoms can include a feeling of fullness that causes discomfort or pain, and which can cause the stomach to become distended. This is often accompanied by an increase in belching or passing gas and rumbling sounds in the stomach or bowels. If bloating leads to nausea, diarrhea, fever or blood in the stool, seek medical care.
One of the most common reasons for a sudden onset of bloating is a change to the diet. For people who are lactose intolerant, even a small amount of a dairy product can set off an episode. Unfortunately, many of the foods we turn to when cleaning up our diets are notorious for causing gas. Cauliflower, kale, broccoli, Brussels sprouts and other cruciferous vegetables contain a sugar known as raffinose. It gets digested by the bacteria in your gut, which produce gas as a byproduct of their meal. Beans, legumes and certain grains also contain indigestible fiber and sugars that feed our gut bacteria and earn us a bout of bloating.
With a bit of detective work in the form of an elimination diet, it’s possible to pinpoint the foods causing your episodes of bloating. Remove all suspect foods from your diet for a few days. Then, day by day, reintroduce one of the suspected culprits. You can then either skip the difficult food altogether, or reintroduce it very gradually and see if your body adjusts. Some people who can’t tolerate raw broccoli or kale find that breaking it down through cooking helps mitigate the aftereffects.
Carbonated beverages, eating too much or too quickly, and meals high in salt and fat can also contribute to bloating, so be aware of your behaviors as well. And if the bloating continues or gets worse, please check in with your doctor to eliminate other potential causes.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.