Bloating can be painful as well as unsightly. Who wants to look 7 months pregnant. When your clothes are too tight that causes abdominal pain. Bloating is a common problem for women with endometriosis, irritable bowel syndrome (IBS) and other bowel diseases.
Healthy women complain of bloating. I hear bloating complaints more frequently from women in their forties. It is tied to estrogen as many women experience less bloating after menopause, but not those on HRT. The American College of Obstetricians and Gynecologist warns not to promise an end to bloating with hysterectomy when the ovaries are left.
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. They are short-chain carbohydrates that are difficult for the small intestine to digest and are thought to attract water osmotically into the small bowel triggering or exacerbating bloating and distension, this leads to a faster bowel transit time, which impairs absorption. When FODMAPs enter the colon undigested, they are fermented by bowel bacteria causing gas production, flatulence, and bloating.
Studies from Australia and the Netherlands have demonstrated less bloating and improved quality of life (QOL) when patients with IBS and endometriosis adhered to a low FODMAP diet.
Selectively eliminating foods can improve bloating in endometriosis patients who do not have IBS. The results from one small study showed that approach to be equivalent to a low FODMAP diet.
Eliminating gluten has not been shown scientifically to improve bloating in endometriosis patients who do not have a proven gluten sensitivity. Those studies concluding a gluten free diet improves endometriosis pain are criticized as low-quality research.
Concerns about low FODMAP and gluten free diets is the lack of fiber. Some experts express concern about the absence of fiber in these diets. Nongluten/low FODMAP fiber sources are available.
My observations about bloating in patients I have seen for years are that it wasn’t a complaint 15 pounds ago. Weight management and exercise are part of a healthy lifestyle and play a role. When patients eat less and lose weight, they experience less bloating.
For patients who are weight stable and troubled by bloating eliminating FODMAPs may help them become less bloated. Likewise, selectively eliminating certain foods could also help.
The low FODMAP diet does not mean a bland diet. The Good Life website features information and a cookbook that present many enjoyable meals you can prepare to enjoy food without as much bloating
