Prevent Bloating, Gas, and Stomach Pain—This Is What Most Doctors Miss

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When you feel like you’ve been pumped full of air and just want to sit on the couch and groan, who cares how you got that way? Relief is the first order of business. We suggested several tactics that work in the previous article.

Now, we’ll look at how to prevent bloat, gas, and associated stomach pains. There are a lot of tactics that may help you. So let’s run through them and end up with the one doctors are most likely to miss. It’s the one most likely to solve the problem if none of the more conventional answers work.

What you’re doing wrong to cause bloating and pain can be pretty obvious when you’ve gone to a chili cook-off and sampled everything on offer. In other cases, the reason you get bloated can be surprising. And even when you think you know what it is, the culprit may be hidden.

A case in point is the food additive inulin. It’s perfectly safe and is naturally contained in onions, wheat, bananas, artichokes, asparagus, and many other fruits and vegetables. It’s often added to prepared foods to increase fiber content. In that case, it was probably derived from chicory root. But here’s the thing…. Say, you think wheat bothers you, so you buy gluten-free bread. That’s smart. However, some of them also contain inulin, which could be another thing that bothers your digestion. In fact, if wheat is a problem, inulin may very well be an issue, too.

There are a host of small things that can cause bloat. Stop doing them; problem solved for many people. For instance, chewing gum.  Or drinking through a straw. Also soft drinks and carbonated beverages. These all cause you to swallow air.

Do you talk a lot when you eat? Eat on the run and bolt your food down? That will do it for many people because those habits also cause you to swallow air. Air in the gut is gas, and the effect is bloat. Slow down. Put your sandwich down, or your fork on the plate, swallow first, then talk.

Another tactic you may try is dividing your intake into smaller meals. This isn’t for some mythical “natural way to eat” or “key to weight loss” reason. Here’s why that can really help a lot of people who suffer frequent rounds of bloat and gas: As with irritable bowel syndrome, there is some evidence that the misery of bloating is actually a sensitivity to your own digestive processes. It is believed that some of us simply feel what is going on in our stomach and colons more acutely than most people do.  

Sugar can be a culprit in bloating and gas as well. But don’t think honey is an automatic pass, or that sugar-free candies are the perfect solution because they all contain different kinds of sugar (fructose in honey; mannitol, xylitol, etc. in candies) that cause problems of their own for many people.

After these simple causes have been eliminated, your next step is to see whether there is an allergy or food sensitivity involved. Now you are in for some work, and unfortunately, you may have to take the lead here and do a lot of problem-solving yourself. But there is a place to get help

If you have persistent bloating and gas, have tried everything above, and have already had a clean colonoscopy, your doctor is very likely to check out on you. Even good doctors. He/she will say something like, “try cutting out dairy, a lot of people have trouble with that.” Or “wheat could be the problem.” But there’s something else that really could be at issue besides wheat and dairy.

It took me two years and several doctors before anyone said, “FODMAP.” The acronym stands for fermentable oligo-saccharides, di-saccharides, monosaccharides and polyols. These are all forms of sugar alcohol, and they are present in almost all foods.

If you are desperate and willing to do a bit of work, a FODMAP investigation is absolutely worth trying. In the time it takes to investigate what is bothering you, a low FODMAP diet won’t do you any harm. Even if it takes many weeks.

Basically, you go on a very strict low-FODMAP diet to clear the system. Only after you are reliably free of any gas, bloating, constipation, diarrhea, borborygmi ( that’s fancy for “stomach rumbling”) do you proceed. At that point, you begin to test a few foods to find out what you react to.

It’s important that in each test, or “challenge” you only look at one kind of FODMAP at a time. For instance, to see if the problem is sorbitol, which is one of the polyols, you will introduce high-sorbitol foods like blackberries and avocados. Nothing else in the FODMAP universe. This is not the time to slide in a bite of pizza.

Food sensitivities can be so puzzling; it’s critical to test only one thing at a time.

Ideally, you can work with a dietician, but even many dieticians aren’t very well trained in this procedure, so check credentials.

Medical schools are notorious for not doing a very good job in nutrition training. On top of that the first paper published on FODMAPs was in 2005, so most textbooks say nothing about it.

Let me give you a bit of encouragement if all the normal treatments like eating slower or avoiding dairy fail to help.  The process of a thorough FODMAP evaluation will take weeks, but when you are tired of hurting, you’ll try anything. And it is completely worth the effort. In fact, if you find one thing that you can say for certain causes a problem, keep going. Most people with FODMAP issues react to more than one category of sugar alcohols and you may be very surprised by what you find.

I was shocked. Truly.

 For me, dairy products –the most common intolerance—are no trouble at all. Despite four different doctors suggesting that.  Wheat is, which I already knew,  but my FODMAP tests showed me that wheat wasn’t the main problem.  

The big surprise was that fruit was making me feel lousy. Yes, fruit.

I used to eat fruit every day, striving for three servings or more, but always getting at least two.  It turns out that polyols and fructose are my weak spots. It was the daily apple and the frequent peaches and cherries that were getting me down. I never realized they were an issue because they were always in my diet. I also discovered that honey is a trigger for trouble. In fact, once I cleared myself of symptoms and tested honey, I discovered it causes a reaction almost instantly for me.

If you want to do this, I highly recommend buying the book “The IBS Elimination Diet and Cookbook: The Proven Low-FODMAP Plan for Eating Well and Feeling Great,” by Patsy Catsos. It will explain everything and walk you through the whole program. See if you can find a dietician also.  And good luck.

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