On Instagram @AndreaHardyRD, I discuss the difference between bloating and distention and what cause !both!
Bloating is the FEELING of abdominal pressure, while distension is the visible expansion of your abdominal girth.
Both are normal, but if you’re frequently experiencing bloating and distension with abdominal pain and a lot of gas, it may be time to do something about it.
Interestingly, a series of studies over the past few years have been working on figuring out the CAUSE of distension, and it may not be what you think!⠀ Bloating from fermentation happens (or should happen) in the colon, where the majority of your bacteria live. Those bacteria break down what we can’t – fermentable carbohydrates! This creates gas, bloating and distension, and if the expansion is enough or you have IBS, can also trigger pain. This type of bloating typically takes place ~2-8 hours after you’ve eaten, depending on what you’ve eaten.
However, I frequently see in my practice, patients that complain of ‘instant’ bloating – within 15 minutes of eating, and usually not from consuming fermentable carbohydrates. Many times I see patients jump RIGHT to #SIBO as the culprit. BUT! Research suggests that is less likely to be the case. In fact, in a new 2019 study, they were able to show that those that experience frequent bloating and distension have bloating not from food, but uncoordinated abdominal wall muscles.
This was shown on CT after the participants ate lettuce, a poorly fermentable, bulky food. The study participants that experienced bloating and distension had an abnormal somatic response, triggering discoordination of the diaphragm and abdominal walls – meaning the diaphragm didn’t move up adequately to accomodate increased volumes.
Interestingly, With biofeedback therapy, the participants learned to control their abdominal muscles to reduce bloating and distension. This particular type of biofeedback is not available in my city, however we often have patients see pelvic floor physios to assess proper function of the pelvis and diaphragm.
BOTTOM LINE: It’s not always food that causes bloating and distension. Working with your dietitian and gastroenterologist to REALLY understand your bloat can help tease out the cause!
Looking for help with your nutrition? Book an appointment with our private practice gastroenterology dietitians at Ignite Nutrition.