Beating The Bloat—Stomach Bloating and Good Gastrointestinal Health

Posted by Medical Board on February 24, 2019 in Uncategorized Last updated on May 22, 2019
Beating The Bloat—Stomach Bloating and Good Gastrointestinal Health

Derived from the Greek word “pausis” meaning cessation, and the root word “men” meaning month, menopause literally translates to, the end of monthly cycles.  This is a natural time in a women’s life when she ceases to menstruate monthly.  This usually occurs anytime between age 45 and 55.  Over the course of time, a woman’s ovaries decrease the levels of estrogen and progesterone the body receives.[8]  

These hormonal changes cause uncomfortable symptoms; including bloating and water weight gain for many.

Most women are familiar with the hot flashes, night sweats, insomnia and mood swings that accompany menopause, but many don’t readily associate bloat and fluid retention with the change in midlife.  Much like abdominal swelling and gas experienced with PMS, menopausal bloating occurs frequently at this time in life.[5]

Abdominal bloating occurs when the belly feels uncomfortable, full, or tight.

The belly may also become distended and stick out, causing discomfort. 

Causes of Bloating in Middle Age

 Bloating may occur for a number of reasons including:

  • Constipation
  • Irritable bowel syndrome
  • Lactose intolerance
  • Medication
  • Bacterial overgrowth in the digestive tract
  • Lack of necessary enzymes for digestion
  • Overconsumption of sodium.[10]

How severe is bloating?

Regardless of the primary causes for abdominal bloating, more than 75% of individuals who suffer, report experiencing moderate to severe discomfort.  Another 50% said they had changed their schedule or decreased the amount of activity they normally engage in because of uncomfortable bloating.[12]

Understanding Belly Bloat

Gas and bloat are symptomatic of gastrointestinal difficulties or fluid retention.  Micro flora are bacteria present in the gut, which aid the body in healthy digestion, help metabolize certain medications, and play an important role in overall gut immune function.  Their byproducts are a factor in gut health as well, with more than 500 species of bacteria in the colon alone.   Changes in the micro flora balance may occur in some individuals, leading to gas and bloating.

What is edema or water retention?

The term “edema” refers to excess water that collects in the tissues of the body when tiny capillaries leak.  Sometimes the cause is an injury to the body, an imbalance in electrolytes or a diet rich in sodium.  Edema can occur in the limbs of the body as a response to poor circulation as well.  Menopause, PMS, pregnancy, medication, or sitting/standing in one place too long can all cause bloating and water weight gain.[3]

Why Women Retain Fluid

Water retention may occur in menopause because estrogen levels become erratic at this time.  This is a similar symptom to PMS (premenstrual syndrome).  Estrogen is also involved in the production of bile, which helps lubricate intestines involved with digestion.  As estrogen decreases, bile levels off. This can lead to more constipation and gastrointestinal problems.

Sometimes bloating may be referred to as “functional bloating”.  This typifies bloating that affects 10-30% of the population and is tied to irritable bowel syndrome, hormone changes, or some other condition of unknown origin.[13] 

How common is abdominal bloating overall?

While abdominal bloating affects up to one-third of individuals of both genders in every life stage, it appears to be a frequent complaint of women in the menopause transition.  Constipation and fluid retention associated with menopausal hormone changes can also occur at this time.[1]

The Menopause Transition

Menopause can actually be broken down into several stages including:

Premenopause—The time before the menopause transition where menstrual flow and cycles are normal and predictable.

Perimenopause—The period leading up to menopause where periods are irregular and many physical and psychological changes take place.

Late transition—During this time, a woman has not menstruated for a period of 2-11 months.

Menopause—The time when a woman has not menstruated for a period of 12 consecutive months.

Post Menopause—The period after menopause has been reached through the end of life.

While menopause occurs for most women in their mid to late 40’s, some  experience symptoms well into their 50’s. 

Common symptoms most women experience in menopause are:

  • Hot flashes
  • Night sweats
  • Sleeping disturbances
  • Vaginal dryness
  • Mood disturbances
  • Difficulty concentrating[10]

Many women report gastrointestinal symptoms during menopause that include:

  • Bloating
  • Gas
  • Water retention
  • Constipation
  • Heartburn

Abdominal gas and bloating may result from excess gas trapped in the small intestines and colon.  This is generally made up of both air that has been swallowed throughout the process of chewing and bacteria from the digestion of food trapped in the colon.  The discomfort of bloating and fullness stems, in part, from these biological processes.[2]

Treatment for Menopausal Symptoms 

Menopausal bloating can often be misdiagnosed as irritable bowel syndrome (IBS).  Gastrointestinal discomfort during menopause can be linked to changing estrogen levels, just like PMS.  A reduction in bile production because of fluctuating hormone levels may also impact the way women digest food at this time in life.  All of this contributes to gas, bloating, and water weight gain in menopause.

While there is hormonal replacement treatment available to help slow or eliminate many of the uncomfortable symptoms related to the menopause transition, there are also natural treatment options available for individual symptoms.  The (FDA) Food and Drug Administration has approved a non-hormonal product for treating severe hot flashes.  There is also a medication available to help treat severe discomfort with sexual activity (dyspareunia).[5]

Many women benefit from treating uncomfortable menopause symptoms.  

These may include:

  • Estrogen supplementation
  • Hormone replacement therapy
  • Bioidentical hormone replacement therapy
  • Diet and nutrition counseling
  • Exercise program
  • Relaxation and meditation[7]

What’s being done for menopausal symptoms overall?

Many government studies conducted through university research help to identify changes in women throughout the menopause transition.  Multi-site long term studies such as SWAN (Study of Women’s Health Across the Nation) are ongoing and examine midlife issues in women that are physical, biological, psychological in nature.[9]

Many research studies support specific lifestyle changes for female health and wellness in mid life.

Physical activity of any kind is especially recommended to help keep bones, muscles and tissues healthy.  It also improves overall mental, sexual and physical health at this time.[6]

Life past 50 can be as exciting and healthy as life before 50.

What should I do to decrease bloating in menopause?

  • Exercise
  • Reduce stress
  • Eat a low carb diet
  • Drink more water
  • Supplement with licorice
  • Reduce salt intake

Treating Menopausal Bloat

Bloating can be extreme in some individuals causing uncomfortable distention and abdominal pain.  It can also be mild with only minor discomfort.  Either way, some intestinal gas is always contained within digestive tracts.[4]  

To reduce bloat:

  • Identify and eliminate food allergies and sensitivities
  • Enhance gut health with probiotics or digestive enzymes
  • Incorporate herbs such as mint, ginger, and fennel into cooking
  • Take apple cider vinegar before meals

The Do’s and Don’ts for Menopausal Bloating

Do reduce foods that cause intestinal build up of gas.  Certain foods such as milk, pasta, potatoes, and the artificial sweetener, Sorbitol can contribute to bloat and gas in the body as well. 

Do eat licorice to help combat heartburn.  This can help reduce gas and bloating present during the menopausal transition.

Do drink a lot of water.  Water helps overall kidney function and works to flush the body of toxins.  Water also facilitates digestion and elimination, associated with bloating during menopause.

Do not eat salty foods.  Sodium causes tissues in the body to retain fluid, which may lead to uncomfortable bloat.

Do not wear restrictive clothing.  If you tend to bloat during menopause, stay away from tight fitting waistbands, shape wear, and compression clothing, designed to help you look slimmer.  These garments can actually exacerbate bloat by pressing on the stomach and forcing acid up towards the esophagus. 

Do not become sedentary at this time.  We all slow down as we age, but menopause is not the time to stop moving.  Now, more than ever it is important to keep fit for optimal physical and mental health.  Simple walking several times a week can help minimize some of the symptoms throughout the menopause transition, including bloating.

Elimination Diet for Belly Bloat

After a bloating episode, try eliminating certain foods, one by one that may have contributed to feelings of fullness, gas, or abdominal discomfort.  Dairy, fried foods, carbonated drinks and some vegetables contribute to bloating in women in midlife.  Identifying the cause of bloat takes time, patience, and effort.

Foods That Help Bloating

Some foods may help reduce bloating.

Fruit—Fruit provides fiber, which aids in digestion.

Soymilk—Milk can cause bloating and digestive problems. Switching to soymilk can reduce bloating.

Herbs—Herbs can be useful for seasoning and take the place of bloat- causing salt. 

Medication and Bloating

Hormone replacement therapy is known to cause belly bloat during menopause in women.  Other medications however, including antibiotics, probiotics, and antispasmodics may be helpful in reducing symptoms of irritable bowel syndrome, which can lead to bloat in women.

Other Serious Causes of Belly Bloat

There may be other reasons for midlife bloating besides menopause and hormonal changes.

These include:

  • Esophageal reflux 
  • Constipation 
  • Ovarian cancer 
  • Pancreatic insufficiency 
  • Tumors 
  • Celiac disease

Each of these conditions is serious and should be diagnosed and treated by an experienced healthcare provider.

Menopause—How to Reduce Water Retention

There are a number of ways to fight against menopausal bloat and fluid retention.  

Individuals should:

  • Reduce sodium
  • Exercise
  • Try Tincture of dandelion which helps relieve bloat or
  • Dong Quai that has a diuretic effect 

Consume foods that may help reduce fluid in tissues including:

  • Corn
  • Cucumber
  • Grapes
  • Watermelon

Oils may reduce water retention as well:

  • Cypress
  • Geranium
  • Juniper
  • Lavender
  • Rosemary

Though a number of symptoms present in mid life as important female hormones decrease, many treatment options are available for women, both pharmaceutical and natural.  Getting the right help to suit your specific needs is crucial.[5]

References

1Med.Unc.Edu, 2017, https://www.med.unc.edu/ibs/files/2017/10/Abdominal-Bloating.pdf.

“Bloating And Gas | Symptoms And Conditions | MUSC DDC”. 

2Ddc.Musc.Edu, 2019, https://ddc.musc.edu/public/symptoms/bloating-gas.html.

3″Bloating Or Water Retention? | Go Ask Alice!”. Goaskalice.Columbia.Edu, 2019, https://goaskalice.columbia.edu/answered-questions/bloating-or-water-retention-0.

4″Healthy Buffs: How To Beat The Bloat”. CU Boulder Today, 2019, https://www.colorado.edu/today/2018/03/14/healthy-buffs-how-beat-bloat.

5″Menopause”. Fda.Gov, 2019, https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117978.htm.

6″Menopause”. Menopause.Northwestern.Edu, 2019, http://menopause.northwestern.edu.

7″Menopause – Jefferson University Hospitals”. Hospitals.Jefferson.Edu, 2019, https://hospitals.jefferson.edu/diseases-and-conditions/menopause.html.

8″Menopause – Gynecology – UR Medicine Obstetrics & Gynecology – University Of Rochester Medical Center”. Urmc.Rochester.Edu, 2019, https://www.urmc.rochester.edu/ob-gyn/gynecology/menopause.aspx.

9″Menopause | Medical Conditions | Rush University Medical Center”. Rush University Medical Center, 2019, https://www.rush.edu/services/conditions/menopause.

10″Menopause | Menopause Symptoms | Medlineplus”. Medlineplus.Gov, 2019, https://medlineplus.gov/menopause.html.

11bloating, Abdominal. “Abdominal Bloating: Medlineplus Medical Encyclopedia”. Medlineplus.Gov, 2019, https://medlineplus.gov/ency/article/003123.htm.

12Brian E. Lacy, Michael D. Crowell. “Pathophysiology, Evaluation, And Treatment Of Bloating: Hope, Hype, Or Hot Air?”. Pubmed Central (PMC), 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264926/.

13Sullivan, Stephen. “ISRN Obstetrics And Gynecology”. US Library Of Medicine NIH, 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388350/. Accessed 23 Feb 2019.

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