We’ve all had the experience: One day, you go to fasten your pants, and they won’t. Your belly is a bit more of a belly than it was the day before. Although frustrating, this symptom is usually not dangerous, but learning more about its causes can help us cope.
According to Michelle Smith, nurse practitioner with Sutter Gould Medical Foundation in Modesto, bloating is often part of a women’s normal cycle. “It can be a pretty good little message that our period is coming soon,” says Smith. During certain phases of the menstrual cycle, there can actually be more water in the cells, especially as progesterone drops. Women can experience this extra fluid in fingers and feet, too.
What to do? Smith is not a big fan of either over-the-counter or prescription treatments but suggests two paths: natural approaches and plain ol’ acceptance.
“A woman might decide to pull out those more forgiving pants (we all have a pair) and spend the day in comfort. And she recommends using this cyclical signal as a chance to take better care of ourselves. “The appearance of bloating can remind you to take good care of your body right now. Walk more. Eat really nutritious foods. Rest.”
You can also trying eating natural diuretics like watermelon, celery and cucumbers. And perhaps counter-intuitively, Smith suggests you drink more water. “Drink more water; pee more frequently; get those kidneys to work.” (For more on how much water you need, read A Balanced Approach to Healthy Hydration.)
Smith does caution that a sudden appearance of a bloated belly in a woman who hasn’t had this symptom can be a warning sign. “If you’ve never had bloat as a symptom, and now you’re up a waist size, you might want to come in for a check-up.”
A physical exam, review of diet, and a blood pressure check can be a good beginning. Although rare, an enlarged abdomen can be a warning sign of ovarian cancer. So talking it through with your medical practitioner is a good idea, especially if you’re at a higher risk for ovarian cancer. Some of these ovarian cancer risk factors include never having been pregnant, never taking birth control pills; or having a family history of the disease.
If your symptoms of bloat are not timed with your menstrual cycle (or you’re a male or a post-menopausal woman), then gastrointestinal issues are the likely cause. And there can be many, from occasional gas to more chronic conditions like Irritable Bowel Syndrome, gluten sensitivity or lactose intolerance (see signs of lactose intolerance).
Richard Sundberg, M.D., a gastroenterologist on the staff of California Pacific Medical Center in San Francisco, notes that certain foods do, indeed, tend to produce more gas. That little ditty about beans is based on facts. “Most of our food is broken down in the small intestine, but sometimes food moves into the colon not fully digested, and is metabolized there, producing gas and causing discomfort.”
Lactose intolerance exists when the enzymes needed to digest milk and milk products is lacking. This family of enzymes, known as lactase, is most prominent when we’re babies -- when milk is intended to be our primary food. As we grow older, our lactase levels fade. Some ethnic groups also tend to produce less of the enzyme (see Lactose Intolerance in the Genes).
Dr. Sundberg says other types of food intolerance can prompt bloat as well, including sensitivity to the protein gluten, which is found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. Other interesting sources of gas can include legumes (beans, peas and peanuts) and Sorbitol, an artificial sweetener used in many things, including candy and gum.
Another surprising source of bloating discomfort can simply be swallowed air. “If you chew gum, drink through a straw, or smoke, you are bringing an extra amount of air into the digestive system.”
So, should I see a doctor if I have gas and bloating?
Dr. Sundberg says that symptoms after a meal, or late in the day, are probably related to your diet. A good home remedy for sorting out food intolerance is to remove a category of food (dairy products, or wheat) for a week, and then reintroduce it. “If that food was your problem, it should become very clear to you,” says Dr. Sundberg. For example, you can try this gluten free diet plan for one week and see if you notice an improvement in your symptoms.
If your discomfort is severe and persistent – or you notice it first thing in the morning, upon awakening – it would be wise to see your doctor.
Here are some tips for reducing common gas and bloat, provided by Dalia Perelman, a registered dietician with the Palo Alto Medical Foundation Mountain View Center.
Digestion in women: The impact of hormones and female anatomy
Sutter Health Gastroenterologists
Need to see a doctor? Find a Sutter Health gastroenterologist in your area.