Ask the Doctor: My stomach is always bloated. Is sparkling water the cause?

Question: I am a woman in my 30s who exercises regularly and have a healthy BMI. However, I always have a bloated stomach. Admittedly, I always go for sparkling water as I find it tastier. My friend says this is the cause but I can hardly believe it. If that’s true, does staying hydrated with bottled water do me any more harm, even if I drink the recommended two liters of water daily?

dr Grant replies: Even in patients with a healthy BMI, bloating is a common complaint, especially in women, although hormonal factors undoubtedly play a role as well. It’s a buildup of gas or air in the intestines that causes uncomfortable pressure in the abdomen. The exact underlying cause is usually multifactorial.

Sparkling water may contribute to bloating in some people and not in others. In your case, I would suggest looking at the other potential factors and possibly reducing the amount of sparkling water but maintaining your current two liters of water per day (well done) by replacing it with a little plain water.

Unfortunately, the relationship between the amount of intestinal gas and abdominal symptoms is ambiguous. But as always, common sense applies!

The list of medical conditions that can cause bloating can be exhaustive. Some of the more common conditions include irritable bowel syndrome (IBS), small bowel bacterial overgrowth (SIBO), and aerophagia (excessive air swallowing). The latter can be attributed to chewing gum, smoking cigarettes, or not having enough time to sit and relax during a meal.

Irritable bowel syndrome (IBS) is a functional bowel disorder in which patients have recurrent abdominal pain or discomfort and changes in bowel habits. An empirical study of dietary restriction may be sufficient to diagnose IBS. Your GP or dietitian can give you advice on following a “low FODMAP” diet, as it can reduce IBS symptoms. But you can also try it yourself.

A low-FODMAP diet essentially limits gas-producing foods like dairy (but take a calcium and vitamin D supplement for bone health), cabbage, onions, garlic, broccoli, cauliflower, plums, apricots, apples, pears, peaches and wheat one.

Whole grains can also contribute, so avoid them for a while to see if you notice less bloating. Another obvious one is beans and peas — yes, they make you fart. Also avoid fried fatty foods, chewing gum and smoking. Finally, look at the list of ingredients in processed foods so you can avoid sweeteners — apart from stevia or steviol, which are made from a plant and are known as diabetic (safe) sugars.

Keep a food journal (record everything you eat) along with a symptom severity journal to clarify what might be triggering your symptoms. Other less common causes of bloating include the later stages of diabetes, lactose or fructose intolerance, medication side effects, celiac disease, abdominal obstruction, or previous abdominal surgery.

You should also document your bowel habits (how often you tend to have a bowel movement) and whether you feel your stools contain blood, mucus, or are too watery/loose. Worse symptoms include unexplained episodes of constipation/diarrhea, abdominal pain, unintended weight loss, nausea, vomiting, heartburn, or loss of appetite.

It probably goes without saying, but daily cardiovascular exercise in the form of brisk walking, running, swimming, or biking improves gastrointestinal transit and helps reduce bloating. Interval training is even better for cardiovascular health. Last but not least, take a daily probiotic to boost the healthy gut microbiome – these guys need all the help they can get!

dr Jennifer Grant is a GP at Beacon HealthCheck Ask the Doctor: My stomach is always bloated. Is sparkling water the cause?

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