Bloating & Gas: How to Limit It

What can I do to reduce or prevent bloating?

1. Stick to a low FODMAP diet ^[1-4]
Even in healthy individuals with no enzyme deficiencies, certain sugars can cause bloating. These sugars have been given the acronym FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols).

The main dietary sources of FODMAPs that should be avoided are:

• Fermentable Oligosaccharides includes cruciferous vegetables (i.e., broccoli and cabbage), wheat products (i.e., bread and pasta), alliums (i.e., onions and shallots), and soy products.
• Disaccharides includes dairy products, such as milk, yogurt, and soft cheeses, as lactose is the main carbohydrate of this group.
• Monosaccharides includes many fruits (i.e., apples, grapes, watermelons, and mangoes) and products containing fructose, such as honey and agave nectar sweeteners.
• Polyols includes centain fruits and vegetables (i.e., nectarines and apricots) and low-calorie sweeteners, such as candies and chewing gums listed as “suger free”. Sorbitol and mannitol are two known polyols.

2. Chew food slowly, and do not gulp food down
Spend about 25-30 minutes to finish a meal ^[5]. 

3. Avoid chewing gum, smoking, and drinking beverages through straws
…especially carbonated drinks ^[6]!

4. Include (some) fiber in your diet
High fiber foods can help prevent constipation, but they are also known to worsen bloating. Monitoring fiber intake, ideally with the advice of a dietitian, will be most beneficial ^[7].

5. Stay hydrated
Increasing the water content of feces will help prevent constipation ^[8].

6. Exercise
Mild to moderate exercise has been shown to improve the passage of intestinal gas ^[9].

7. Minimize the use of medications
Antibiotics, antacids, and pain medications should only be used as prescribed by your physician ^[10].

8. Visit a doctor
Always speak to a medical professional to determine if your symptoms of bloating are due to chronic conditions such as IBS or functional dyspepsia ^[11].

References:

1. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Gastroenterology and Hepatology. 2010. Cited 19 July 2021. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2009.06149.x
2. Dietary fructose intolerance, fructan intolerance and FODMAPs. Current Gastroenterology Reports. 2014. Cited 26 July 2021. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934501/
3. A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome. Advances in Nutrition. 2017. Cited 19 July 2021. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508768/
4. Dietary Triggers for IBS Symptoms: The Low FODMAP Diet Approach. International Foundation for Gastrointestinal Disorders. 2011. Cited 27 July 2021. Available from: https://mk0iffgd43a85spvyq6.kinstacdn.com/wp-content/uploads/251-FODMAP-9.14-3.pdf
5. Gas, Bloating, and Belching: Approach to Evaluation and Management. American Family Physician. 2019. Cited 27 July 2021. Available from: https://www.aafp.org/afp/2019/0301/p301.html
6. Abdominal Bloating. The Journal of the American Medical. 2013. Cited 27 July 2021. Available from: https://jamanetwork.com/journals/jama/article-abstract/1752757
7. Effects of High-Fiber Diets and Macronutrient Substitution on Bloating: Findings from the OmniHeart Trial. Clinical and Translational Gastroenterology. 2020. Cited 27 July 2021. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056053/
8. Treatment of Constipation in Older Adults. American Family Physician. 2005. Cited 27 July 2021. Available from: https://www.aafp.org/afp/2005/1201/p2277.html
9. The impact of physical exercise on the gastrointestinal tract. Current Opinion in Clinical Nutrition and Metabolic Care. 2009. Cited 19 July 2021. Available from: http://arquivos.info.ufrn.br/arquivos/2011220160ad35779460efc693ad9b9f/OLIVEIRA_EP__BURINI_RC.pdf
10. Which Medications and Food Supplements Are Associated with Bloating in Patients with Functional Bowel Disorders? The American Journal of Gastroenterology. 2005. Cited 27 July 2021. Available from: https://journals.lww.com/ajg/Fulltext/2005/09001/Which_Medications_and_Food_Supplements_Are.925.aspx
11. Management of Chronic Abdominal Distension and Bloating. Clinical Gastroenterology and Hepatology. 2021. Cited 19 July 2021. Available from: https://theromefoundation.org/wp-content/uploads/Lacy-article.pdf