Stomach bloating is an uncomfortable fact of life for many people. The common complaint is a stretchy, puffy sensation in the tummy, which is usually accompanied by painful abdominal cramps. Lifestyle factors such as eating gassy foods and drinking alcoholic drinks can trigger bloating. What may come as a surprise is the role psychological wellbeing can play in causing digestive upset.
As Dr Diana Gall explained: “When we’re stressed or anxious this puts a lot of pressure on the stomach and causes poor digestion. Stress disrupts the balance of hormones and bacteria in the gut which alters digestion, either slowing it down or speeding it up, and makes it difficult to break down food.”
This also has a knock-on effect on “intestinal permeability,” according to Dr Brewer, Medical Director of Healthspan.
“Stress can also affect intestinal permeability (so-called leaky gut which lets food particles and bacteria into the circulation) or alter the balance of digestive bacteria to increase gas production, distension and bloating,” she explained.
This is often why people feel sick when they are nervous, stressed or anxious, and may experience bloating, constipation, diarrhoea, or even vomiting, said Dr Gall.
Conversely, growing evidence shows that digestive microflora plays a role in the management of stress and anxiety as bowel bacteria secrete substances that can have indirect effects on the brain, said Dr Brewer.
As Dr Brewer explained: “Serotonin is best known as a brain transmitter that regulates mood, but it’s now estimated that 90 per cent of the body’s serotonin is actually made by cells lining the digestive tract.”
Maintaining the right balance of gut bacteria is therefore important for stimulating serotonin production, noted Dr Brewer.
A symptom of anxiety known as hyperventilation or breathing heavily and rapidly can also lead to stomach bloating, explained Dr Gall.
“Taking in too much oxygen during an anxiety attack leads to bloating and sometimes heartburn, you may find that you’re burping more before or after an attack to try and release some of the air,” she added.
What can be done to treat it?
Stress management techniques are key to maintaining gut health, said Dr Gall.
One simple coping strategy is to avoid arguing at meal times and keep relaxed while eating, she said.
“While your mental wellbeing has a direct effect on your gut, gut problems such as bloating can also cause feelings of anxiety,” noted Dr Gall.
If a person is hyperventilating, she also recommended trying to slow down breathing to prevent excess air getting in and bloating a person’s stomach.
“Practicing breathing exercises is great for calming you down and improving the condition of your gut too,” she added.
Dr Meg Arroll echoed this advice but went one step further: “Anything that you find relaxing and that effectively manages your stress levels will also temper the gut-brain axis.”
Dr Arroll also suggested undergoing gut-directed hypnotherapy, “which uses psychological processes to calm the workings of the gut, reducing bloating and related symptoms,” she said.
Another way to address the problem is to cut down on the culprits that tend to trigger bloating, advised Dr Brewer.
“Common culprits include wheat, gluten, lactose, yeast, onions, beans, excess sugar and artificial sweeteners, she said.
Dr Brewer added: “You may be advised to follow a low FODMAP diet (FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) which are a group of fermentable (gas-producing) sugars and fibres.”
Probiotics may also help to banish the bloat. “A probiotic supplement can help by reducing growth of gas-forming bacteria in the gut,” said Dr Brewer.
NICE guidelines also recommend that if a person opts for probiotics, these should be taken for at least four weeks while monitoring the effect, she cautioned.