I have new clients coming into my clinic multiple times a week who are seeking out strategies to get rid of their painful stomach, and digestive bloating. Throughout all of my years of practice, this has to be one of the most common symptoms, and almost everyone has different causes for this symptom. What I find the most alarming is that these symptoms have become more complex, severe, and prevalent over the years.

As you read through this article you will hopefully be able to appreciate how a very in-depth and complex strategy is required to overcome and get rid of a bloated stomach and digestive tract.

The symptom of stomach bloating may seem to be annoying, irritating, and even painful, but there can be many other much more serious, underlying disorders you could be suffering from.

I have listed below the most common health disorders which I see clinically associated with stomach and digestive bloating.

Malabsorption Syndrome

Stomach and abdominal bloating can be a very accurate indicator of malabsorption syndrome. This is simply the inability to absorb essential nutrients which in turn causes many other symptoms some of which are fatigue, hair, skin, and nail disorders as well as a multitude of other metabolic disorders.

Intestinal Permeability (Leaky Gut Syndrome)

Intestinal Permeability, also known as leaky-gut syndrome is where entire dietary proteins cross the gut-blood barrier. Once this barrier becomes breached, a whole host of other inflammatory and immune disorders can develop. There are many other causes of intestinal permeability, which I have discussed in my one-hour workshop “Understanding The Brain-Gut Connection and The Gateway to Autoimmunity”, and stomach bloating can be both a cause and in some cases a contributor to intestinal permeability. When this barrier becomes breached, intestinal contents leak from the digestive tract into the bloodstream. I have also briefly explained this concept in a short video “Leaky Gut and Leaky Brain, What are they”, but again, to understand this in greater detail, you can register for free access to my one-hour workshops titled “Understanding The Brain-Gut Connection and The Gateway to Autoimmunity”

Permanent Neurological Damage

When your stomach becomes chronically bloated (for an excessive duration), there becomes significant stress on your intestinal wall. Permanent neurological damage can result in the enteric nervous system if symptoms progress for extended durations. The enteric nervous system is the network of intricate nerves that form a network that wraps around the intestines.

Electron Microscope Image of The Enteric Nervous Plexus Surrounding The Intestinal Wall

As seen from the electron microscope image (above) there is a very close relationship between the enteric nerves (gut nerves) and the intestine. As the intestine becomes stretched or enlarged for extended durations, nerve trauma can result and further contribute to stomach pain, bloating gas, and abdominal distention.

Associated Symptoms Of Stomach Bloating

Some of the most common associated symptoms that I have seen clinically are:

• Nausea
• Reduced appetite
• Brain Fog
• Fatigue
• Passing undigested plant fibers
• Intolerance of probiotics
• Passing greasy and/or floating stools

The Two Major Causes Of Stomach Bloating

1. Bacterial Imbalances such as SIBO (Small Intestinal bacterial Overgrowth)
2. Inability to digest or tolerate fat

Throughout this article, I will provide you with a clinical framework so you can have a better understanding of which disorder you may be suffering from, and the associated strategies required to start reversing this uncomfortable, and painful disorder.

Please note that it can be a very complex, and complicated disorder. Should you read this article and become overwhelmed, you can reach out to us here and request an appointment.

The First Cause of Stomach Bloating- Bacterial Imbalances such as SIBO (Small Intestinal Bacterial Overgrowth)

SIBO: A Condition Where There Are Excessive Bacteria in The Small Intestine

This is the most common, and complicated of the three causes since digestive bacteria is extremely fragile and highly influenced by many chemical, physiological, and environmental inputs.

Simply put, SIBO is the result of bacteria that of which (the majority) should be in your lower, large intestine but manage to relocate to your upper small intestine. The symptoms of digestive bloating begin once enough of this bacteria colonize the small intestine.

Testing For SIBO:

1. The hydrogen/methane breath test– This is a non-invasive test and relatively cost-effective, however, it tends to be inaccurate and provide false positives.
2. The serum, blood test– I prefer using this test over the previous one since it is much more accurate, the downside is that it is more expensive, and results take longer to process.

The Causes of SIBO

There are multiple causes that create a digestive environment that facilitates SIBO, and some cases of SIBO can be very challenging (to say the least). Effective, and favorable outcomes always start with the proper diagnosis and the understanding of the disorder. Below are a few common causes; but it must be noted that SIBO is only a symptom of the underlying problem and the digestive environment must be corrected to truly and effectively eliminate SIBO permanently.

The most common causes of SIBO are:

1. Slow gastric motility (constipation)
2. Bacterial imbalances (good vs bad)
3. Reduced digestive enzyme production and reduced stomach acid

The First Cause of SIBO: Slow Gastric Motility (Constipation)

This may be the most common cause of SIBO and the associated symptoms of a bloated stomach. Any causes of constipation or reduced gastric motility must be corrected. So, how do you know if you have slow or reduced gastric motility?

Clinically, when I have a client who is trying to get rid of a bloated stomach, and they report that they do not have at least one bowel movement daily I suspect a problem. In addition, if they say they do, but also report they are not “emptying” would make me confident that at least part of their bloating symptoms is the result of slow gastric motility.

Some of the most common causes of slow gastric motility or constipation are:

• Hypothyroidism
• Food sensitivities and allergies
• Parkinson’s Disease
• Gallbladder Dysfunction
• Chronic Stress
• Chronic Fatigue
• Dehydration
• Sedentary lifestyle
• Hypochloridria (low stomach acid)

In addition to the above, there are some very effective nutrients that you can use to help with constipation. In the video below I discuss some of the strategies which I use in clinical practice.

Video: Effective Nutrients For Constipation (Dr. Glenn Harrison DC, BSc)

The Second Cause of SIBO: Bacterial Imbalances (Good vs Bad)

Bacterial Imbalances: Good vs Bad

When we have lower levels of beneficial bacteria many other dysfunctions can result. One of the most common is the inability to keep “bad” bacteria or pathogenic bacteria under control. Other common disorders associated with bacterial imbalances are:

• Skin disorders
• Nutrient Deficiencies
• Memory problems
• Increased food sensitivities
• Increased allergies
• Chronic pain
• Chronic fatigue
• Exacerbation of existing Autoimmune Disorders
• Mental health disorders

Diagnosing Bacterial Imbalances

Symptoms of bacterial imbalances are very diverse and a thorough evaluation is required to properly diagnose. A comprehensive digestive stool analysis can be very effective to rule in or out bacterial imbalances. One of the best stool analysis tests on the market is from Genova Diagnostics. You can contact us to order this test directly without requiring a doctor.

Causes of Bacterial Imbalances

Any foods or environmental and emotional stressors which facilitate pathogenic bacteria and inhibit beneficial bacteria are the most common causes of bacterial imbalances. In all honesty, we have much to learn in the complex world of the human biome and how specific bacterial strains influence every aspect of human physiology. However, we do know that there are some fundamental rules for correcting bacterial imbalances.

Below are some of the “high-level” strategies required to promote and maintain bacterial health.

• Avoid diets that are high in processed sugar since these feed pathogenic bacteria.
• Eat meals that have ample plant diversity.
• Avoid consuming highly acidic foods.
• Antibiotic use
• Smoking and other recreational drugs
• Alcohol
• Diets high in simple carbohydrates- feeds the pathogenic bacteria which helps out-compete the “good,” beneficial bacteria

Correcting Bacterial Imbalances

There are two approaches when trying to correct bacterial imbalances. 1. Reduce the pathogenic bacteria, and 2. Enhance the beneficial bacteria. In most cases, the strategy must incorporate both; however, knowing which strategy to incorporate first (if any) is when having a doctor with clinical experience is paramount.

See below, where I lay out the strategies for both eradicating pathogenic bacteria and enhancing beneficial bacteria.

Eradicating Pathogenic Bacteria

Pathogenic Bacteria

The most effective strategy which I have seen clinically for eradicating pathogenic bacteria is to simultaneously apply three approaches followed by a fourth strategy of enhancing healthy bacterial diversity.

The four steps to eradicating pathogenic bacteria:

1. Starve the bad bacteria
   • FODMAPS Restricted Diet
   • Elemental Diet
   • Enhancing Digestive Enzymes
2. Use neutraceuticals to kill pathogenic bacteria
3. Outcompete existing pathogenic bacteria
4. Increase healthy bacterial diversity

(1) Starve the bad bacteria

Dietary efforts may be one of the single, most effective lifestyle strategies to overcome SIBO and the associated symptoms of stomach bloating. It is also the one strategy that requires the highest level of discipline and commitment. The first dietary step that I recommend for my clients is to start the FODMAPS-restricted diet.

The FODMAPS Restricted Diet

This is what I recommend as the first step to starving the “bad” bacteria. FODMAPS stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. These are short chains of carbohydrates that the small intestine has a very difficult time digesting. When these foods are removed from our diet, SIBO bacteria have fewer short-chain carbohydrates to feed off of. This in turn starves bacteria in the small intestine and can reduce or eliminate stomach bloating and abdominal distention.

There are many different FODMAPS foods lists; however, the most comprehensive list is from Dr. Allison Siebecker which you can download here. Again, the SIBO or FODMAPS diet is not fun but can be very effective for the first step. I only recommend this for a maximum of four weeks, and if there are no significant changes in symptoms of stomach boating, I recommend taking the next (more aggressive step) which is the Elemental Diet.

The Elemental Diet

The elemental diet can be effective when the FODMAPS isn’t since the Elemental Diet has two additional benefits over FODMAPS. (1) The Elemental Diet is usually liquid, which increases gastric motility, and (2) The Elemental Diet is a cocktail of vitamins, minerals, and amino acids which are nutrients that are already in a digested form.

Simply put, the Elemental diet is more aggressive than the FODMAPS, and it is more restricted. It is important to note that neither of these diets should be used for more than 3 weeks.

After the FODMAPS or Elemental diet has been introduced an additional, and very important effort should include the use of digestive enzymes.

Enhancing Digestive Enzymes

Digestive enzymes can be a very effective strategy for starving bad bacteria, especially when used in conjunction with one of the diets explained above.

The purpose of digestive enzymes is simply to digest or break down any remaining food proteins or carbohydrates left in the digestive tract. If all of the proteins and carbohydrates are completely digested, pathogenic SIBO bacteria run out of their food source and the symptoms of stomach bloating can quickly disappear.

There are many digestive enzyme formulations on the market, and any product that has a high level of enzyme diversity will be the best. One of my clinic’s most prescribed, and effective enzyme formulations is EnzymixPro by Apex Energetics. You can contact us here to request access to this professionally prescribed product.

(2) Use Neutraceuticals to Kill Pathogenic Bacteria

After all fibers, carbohydrates, and proteins have been eliminated or digested in the gastrointestinal tract, the next step is to take advantage of using aggressive antimicrobials to kill off all problematic bacteria which are contributing to symptoms of digestive bloating.

The antimicrobials which I use most frequently in my clinic are:

• Barberry Extract
• Goldenseal Extract
• Oregano Extract
• Oregon Grape Extract
• Chinese Goldthread Extract
• Yerba Mansa Extract

One product that I commonly use to kill off pathogenic bacteria that has all of these ingredients is H-PLR from Apex Energetics. You can contact us here to request access to this professionally prescribed product.

It is important to note that there are many effective, and potent antimicrobial herbs that can be used to kill off bacteria in the body. It must be stressed that even though herbs are not pharmaceuticals, they can still be very aggressive and must be used with caution. I have seen all too often when clients start working with me and we learn that many of their symptoms were the result of the previous improper use of herbal formulations. I would also like to note that these herbal antimicrobials do not discriminate between good or bad bacteria and will destroy both.

The guidance of a qualified healthcare provider is highly recommended when using these potent antimicrobial herbs.

(3) Outcompete Existing Pathogenic Bacteria

Once pathogenic bacteria have been eradicated, efforts to innoculate the digestive tract with good bacteria (probiotics), and outcompete the pathogenic bacteria should be pursued. This is the only time that I will suggest introducing bacterial strains (probiotics), into the care strategy.

Probiotics should be used with caution when struggling with severe cases of SIBO. I have seen many clients struggle with SIBO symptoms for years prior to coming to my clinic. These individuals were told that probiotics are necessary for digestive health and ended up being a major contributor to their symptoms.

Most probiotics contribute to the problem of digestive bloating because they add more bacteria to an existing bacterial problem. There are only a few strains that will assist with outcompeting the pathogenic bacteria, and these are:

• Lactobacillus plantarum
• Lactobacillus casei
• Bifidobacterium breve

One of my favorite products is Sibiotica from Apex Energetics which is specially formulated for SIBO.

In addition, I have made a short video (below) explaining Sibiotica and how to use it.

Video: Learn How To Use Sibiotica For SIBO

Once there has been an effort to starve the pathogenic bacteria, and reinoculate the digestive tract with healthy bacteria (such as the strains found in Sibiotica), the next step is to work on expanding the bacterial diversity of the gut.

(4) Increase Healthy Bacterial Diversity

Increasing the bacterial diversity of the digestive tract is the ultimate goal for any digestive disorder. This should only be attempted once all of the previous strategies (mentioned above) have been implemented and all symptoms of stomach and digestive bloating have been eliminated.

In the video below, I share some of my favorite clinical strategies that I recommend to my clients for enhancing bacterial diversity. Please note that if your body is not ready for this high level of plant diversity a flare in digestive and stomach bloating can result. However, when you are able to increase biodiversity, every other aspect of physical health can, and will improve!

Video: How to Build A Healthy Gut And Improve Your Microbiome (Dr. Glenn Harrison DC, BSc)

Now that we have concluded the first two causes of SIBO; reduced gastric motility, and bacterial imbalances, the final cause is reduced digestive enzyme production and reduced stomach acid.

The Third Cause of SIBO: Reduced Digestive Enzyme Production and Stomach Acid

There are many causes that reduce both digestive enzyme production and simultaneously reduce stomach acid production; however, once this occurs multiple symptoms can be experienced.

Some of the most common symptoms of reduced digestive enzymes and stomach acid are:

• Bloating and abdominal distention after meals
• Protein-rich foods cause an excessive “fullness” where it feels like food is not moving
• Nutrient deficiencies
• Passing a stool with undigested foods
• Heartburn and/or indigestion
• Inability to tolerate spicy or acidic foods
• Reoccurring H Pylori infections
• Recurring stomach ulcers

The Causes of Reduced Stomach Acid

There are many causes of reduced stomach acid production which commonly lead to symptoms such as heartburn, and indigestion. I thoroughly explain all of the causes, symptoms, and associated solutions which you can read in my article titled “How to Get Rid of Heartburn and Indigestion”

The Causes of Reduced Digestive Enzyme Production

Many of the causes resulting in digestive enzyme deficiencies overlap with those that contribute to Hypochloridria (reduced stomach acid). In addition to these, the vast majority of what contributes to low digestive enzymes is dysfunctions in the nervous system.

It would be impossible to elaborate on all of the intricacies of how the nervous system produces enzymes; however, there are some simple concepts that must be understood to improve enzyme production. Specifically, this is an understanding of the two sides of the nervous system which influence the autonomic (automatic) nervous system. These are the sympathetic and parasympathetic nervous systems.

Understanding The Autonomic Nervous System

As mentioned above, the autonomic nervous system is made up of the sympathetic (Fight-or-Flight) nervous system and the parasympathetic (Rest-and-Digest) nervous system. Each of these “systems” is responsible for every process in the body.

Digestion is almost exclusively dependent on input from the parasympathetic nervous system; which can only occur when a person has minimal physical, chemical, or emotional stress. This means that if someone is struggling with either an emotional stressor, a bacterial infection, or sleep deprivation their digestive system will not receive enough stimulation from the nervous system and therefore become dysfunctional. A common, real-life example of the effects of stress on the digestive system is developing symptoms of constipation or other digestive irregularities prior to and during air travel.

The Second Cause of Stomach Bloating- Inability to Digest or Tolerate Fat

Abdominal Pain Associated With Gallbladder Dysfunction

As mentioned at the beginning of this article, there are two major causes of digestive, and stomach bloating: (1) Bacterial imbalances (such as SIBO), and (2) The inability to digest dietary fat.

Bacterial imbalances are much more complicated; however, a commonly missed cause of abdominal distention and stomach bloating is the inability to digest and process dietary fat.

The symptoms of this disorder are not always obvious; some of which are:

• Floating stool
• Greasy Stool
• Abdominal pain within 6-12 hrs of fat consumption
• Loose/ unformed stools
• Relief following bowel movements
• Digestive disorders become more severe with fatigue

Risk Factors of The Inability to Tolerate and Digest Fat

Risk factors are consistent with any system that is responsible for slowing down energy and metabolism, or anything which compromises gallbladder function.

Some common causes of gallbladder dysfunction are:

• Thyroid disorders (hypothyroidism)
• Adrenal insufficiency (Adrenal Fatigue)
• Sex hormone disorders
• Sedentary lifestyles
• Females, over 40 years of age
• Individuals who are overweight or Obese

The most common risk factor (by far) is when the gallbladder becomes dysfunctional or “sluggish.”

Gallbladder Function

The gallbladder is exclusively responsible for holding and releasing bile salts which are required to emulsify (digest) dietary fat. If anything compromises gallbladder function, the individual will experience severe stomach bloating that will continue until the dietary fat exits the body through the gastrointestinal tract.

I see many gallbladder disorders in my clinical practice which are rarely diagnosed. If the conventional medical system recognizes a symptom due to gallbladder dysfunction it will almost always result in surgical removal. Currently, it is the most common surgery in the United States, and once removed the patient will almost always have problems with digesting dietary fat.

Diagnosing Gallbladder Dysfunction

To properly diagnose, the individual should first have symptoms associated with the list above. Following this, the gold standard is to have an ultrasound performed. This will determine if there is a “sludge” build-up in the gallbladder and if stones have developed.

Gallbladder Improvement Strategies

If a gallbladder disorder has been diagnosed with an ultrasound image or has been determined through symptoms and history, there are many lifestyle strategies that can be introduced.

Please note, that even if you have had your gallbladder removed these strategies will be even more critical to follow:

• Average 30 minutes (3-4 times/week) of intense physical activity
• Reducing dietary fat intake for 1-3 months, then rechallenge slowly
• Supplement with bile salts and nutrients to facilitate fat digestion
  • Vitamin C
  • Dandelion extract
  • Milk Thistle extract
  • Phospholipids
  • Taurine
  • Ginger
  • Beet Root
  • Peptidase
  • Lipase

A product that has all of these ingredients is Bilemin, By Apex Energetics, which I regularly use for gallbladder disorders. You can contact us to request this professional product here.

• Address any common metabolic disorders
  • Correct any sleep disorders
  • Correct any thyroid dysfunction

In Conclusion

Learning how to get rid of a bloated and painful stomach can be very complicated, but the symptoms should never be dismissed. As I explained throughout this article, these symptoms are potentially due to many different underlying health disorders and the required depth of clinical investigation can vary significantly from one person to the next. It is extremely important to note that in some cases these disorders can cause permanent damage to the enteric nervous system and treatment should not be delayed.

In addition, we can help and have been able to work with many clients remotely. Click here to schedule a free 15-minute consultation and we can discuss your unique case.