1. The Mind & Gut are Connected
Riyadh Hammod, MD
Bloating isn’t always caused by extra gas or slowed digestion. Sometimes it’s about how your body senses what’s happening inside.
One example is irritable bowel syndrome (IBS), one of the most common conditions treated by Riyadh Hammod, MD, a gastroenterologist with Inspira Health. People with IBS often have normal test results, such as bloodwork, endoscopies or imaging scans, but their gut nerves are more reactive. As a result, normal digestive activity can feel uncomfortable or even painful.
For patients with this kind of heightened sensitivity, Dr. Hammod often prescribes a very low dose of a tricyclic antidepressant. “It’s not for depression,” he says. “It’s to calm the gut–brain communication so normal sensations aren’t interpreted as painful.”
2. FODMAP Foods May Matter
The cause of bloating may come down to the way certain foods are broken down in the gut. Some foods ferment more easily, feeding gut bacteria and creating extra gas as they digest, enough to make some people feel noticeably bloated.
“Fructose is a big one we see,” says Dr. Hammod. “It’s a natural sugar in many fruits and vegetables, and for some people, it causes significant bloating.”
High-FODMAP foods – fermentable carbohydrates – are a common culprit that many people know little about. “Onions, beans, Brussels sprouts, carrots, bagels – these can all be triggers,” he says. “They feed gut bacteria in a way that produces more gas.”
Hammod suggests experimenting. “Track what you eat and how you feel afterward. When a pattern appears, you can make small changes and see if your symptoms improve.”
3. Why Women Notice It More as They Age
Beth Gardner, MD
For many women over 40, bloating becomes more noticeable. That’s when shifting hormones start to change how the digestive system works.
“Constipation plays a really big role in bloating,” says Beth Gardner, MD, a gastroenterologist with Jefferson Health in Sewell. “A lot of women become more constipated as estrogen levels change and drop.”
She adds that aging can also change how well the body breaks down certain foods. “Suddenly,” she says, “foods they’ve eaten for years cause bloating.”
“Women over 50 should be getting about 21 grams of fiber a day,” Dr. Gardner says. “Adding a fiber supplement can help. And you have to stay hydrated and keep moving. Even a simple walk makes a difference.”
4. When to Look Deeper
For many people, bloating improves with simple steps – ingesting more fiber, drinking more water. However, there are times when it signals something more.
“If you wake up in the morning with a bloated abdomen and it never goes down, that’s different,” says Dr. Gardner. “That could mean fluid in the abdomen, which is never benign. It can be caused by heart or liver disease, and in rare cases, ovarian cancer.”
Dr. Hammod adds: “Pain that wakes you at night, unexplained weight loss, blood in the stool, persistent nausea or vomiting – those are reasons to see a doctor quickly.”
They can screen for celiac disease – an immune reaction to gluten that damages the small intestine. There’s also SIBO, when bacteria build up in the small intestine. Both can be identified with tests, and addressing them often brings significant improvement.
