Bloating is one of the most common digestive complaints, affecting an estimated 16-31 per cent of the general population. For many people, it is an occasional inconvenience after a large meal. For others, it is a daily struggle that affects confidence, comfort and quality of life. While bloating is often dismissed as 'just something you have to live with,' it is almost always a signal that something in the digestive system needs attention.
What Causes Bloating?
Bloating occurs when the abdomen feels full, tight or distended, often accompanied by visible swelling. The underlying mechanisms can vary significantly from person to person.
Excessive Gas Production
The most common cause of bloating is excessive gas in the digestive tract. This can result from:
- Fermentation of poorly absorbed carbohydrates (FODMAPs) by gut bacteria
- Swallowing air (aerophagia) while eating quickly, chewing gum or drinking carbonated beverages
- Bacterial overgrowth in the small intestine (SIBO), where bacteria ferment food before it can be properly absorbed
Impaired Gut Motility
When the muscles of the digestive tract do not contract efficiently, food and gas move through the system too slowly. This can be caused by low thyroid function, certain medications, dehydration, insufficient fibre intake or autonomic nervous system dysfunction.
Food Intolerances and Sensitivities
Common culprits include:
Lactose intolerance — Inability to digest the sugar in dairy products, affecting an estimated 68 per cent of the global population to some degree.
Fructose malabsorption — Difficulty absorbing the sugar found in fruits, honey and high-fructose corn syrup.
[Gluten](/resources/articles/gluten-gut-health/) sensitivity — Non-coeliac gluten sensitivity can cause bloating, even when coeliac disease has been ruled out.
Histamine intolerance — Difficulty breaking down histamine in foods such as aged cheese, wine, fermented foods and cured meats.
Small Intestinal Bacterial Overgrowth (SIBO)
SIBO is one of the most underdiagnosed causes of chronic bloating. When bacteria that normally reside in the large intestine colonise the small intestine, they ferment food prematurely, producing hydrogen, methane or hydrogen sulphide gas. Bloating that occurs within 30-60 minutes of eating is a classic sign of SIBO.
Gut Dysbiosis
An imbalanced microbiome — with reduced diversity or overgrowth of gas-producing organisms — can cause chronic bloating even in the absence of SIBO. Factors such as antibiotic use, poor diet, chronic stress and infections all contribute to dysbiosis.
Digestive Enzyme Insufficiency
Inadequate production of digestive enzymes (from the pancreas) or stomach acid (hypochlorhydria) means food is not broken down efficiently, leading to fermentation and gas production further along the digestive tract.
Stress and the Gut-Brain Axis
Stress activates the sympathetic nervous system ('fight or flight'), which diverts blood away from the digestive organs, slows motility and reduces enzyme secretion. Many people notice that their bloating worsens during periods of high stress or anxiety.
When to Seek Professional Help
While occasional bloating is normal, certain patterns warrant further investigation:
- Bloating that occurs daily or after most meals
- Progressive worsening of bloating over weeks or months
- Bloating accompanied by unexplained weight loss
- Blood in the stool or persistent changes in bowel habits
- Severe pain associated with bloating
- Bloating that does not improve with dietary changes
A Functional Medicine Approach to Bloating
Step 1: Identify the Root Cause
Rather than simply treating the symptom, functional medicine seeks to understand why bloating is occurring. This may involve:
- Comprehensive stool analysis to assess microbiome composition, inflammation and digestive function
- SIBO breath testing to check for bacterial overgrowth
- Food sensitivity testing or a structured elimination diet
- Blood work to evaluate thyroid function, coeliac markers and nutrient levels
Step 2: Dietary Interventions
The low-FODMAP approach — A temporary reduction in fermentable carbohydrates can provide significant relief while the underlying cause is being addressed. This is not intended as a long-term diet but as a diagnostic and therapeutic tool.
Mindful eating practices — Chewing food thoroughly (aim for 20-30 chews per bite), eating slowly and avoiding distractions during meals can dramatically reduce bloating for many people.
Food combining — Some people find that separating proteins and starches at meals, or eating fruit separately, reduces fermentation and gas production.
Step 3: Support Digestion
Digestive enzymes — A broad-spectrum enzyme supplement taken with meals can improve the breakdown of proteins, fats and carbohydrates.
Bitter herbs — Traditional digestive bitters (gentian, artichoke, dandelion) stimulate the production of stomach acid, bile and pancreatic enzymes.
Apple cider vinegar — A tablespoon in water before meals may support stomach acid production for those with hypochlorhydria.
Step 4: Restore the Microbiome
Targeted [probiotics](/resources/articles/probiotics-complete-guide/) — Specific strains can reduce gas production and improve bloating. Bifidobacterium infantis 35624 and Lactobacillus plantarum 299v have the strongest evidence base.
[Prebiotic foods](/resources/articles/prebiotics-feed-gut-bacteria/) — Introduced gradually, prebiotics feed beneficial bacteria and support a diverse microbiome. Start with small amounts and increase slowly.
Antimicrobial protocols — If SIBO or pathogenic overgrowth is identified, herbal antimicrobials or targeted antibiotics may be necessary before probiotics can be effective.
Step 5: Address Lifestyle Factors
Stress management — Daily practices such as deep breathing, meditation or yoga can activate the parasympathetic nervous system ('rest and digest') and improve digestive function.
Regular movement — Walking after meals, gentle yoga poses (particularly twists) and regular exercise all support gut motility and reduce bloating.
Adequate hydration — Water supports the movement of food through the digestive tract and helps prevent constipation-related bloating.
Quick Relief Strategies
While addressing root causes takes time, these strategies can provide more immediate relief:
- Peppermint tea or peppermint oil capsules (enteric-coated) to relax intestinal smooth muscle
- Ginger tea or fresh ginger to stimulate digestive motility
- A gentle walk after meals to support gastric emptying
- Fennel seeds or fennel tea, a traditional carminative that reduces gas
- Abdominal massage in a clockwise direction to encourage gas movement
The Bottom Line
Bloating is not something you simply have to accept. It is a symptom with identifiable causes and effective solutions. Whether the root cause is SIBO, food intolerances, dysbiosis, enzyme insufficiency or stress — any of which can also contribute to increased intestinal permeability — a systematic functional medicine approach can help you identify the specific factors driving your bloating and implement targeted strategies to resolve it. If bloating is affecting your daily life, it is worth investigating further rather than simply managing the discomfort.