Have you paid attention to the location of your bloating before?
If you are experiencing bloating, you likely have googled remedies to relieve the bloat and tried everything in the book, whether it is a change in diet, lifestyle, or maybe even a yoga pose. However, have you ever taken a moment to notice where in your abdomen your bloating is located? If not, this is where you should start as the location of your bloat can tell us a lot about what’s going on and why.
Upper vs Lower Abdominal Bloating
When you think of bloating, you may just think of your stomach; however, the source of bloating can be from your stomach, small intestine, large intestine, or colon, which will change the location of your bloat. For instance, if your bloating is most prominent in your upper abdomen, then it is likely from your stomach. In contrast, if your bloating is more prominent in your lower abdomen (this is where you may “feel or look pregnant”), then it is likely coming from your small intestine, large intestine, colon or could be hormonal.
The location of your bloating matters because it tells us where the bloating is happening. From there, you can start to begin to decipher why it is happening, given upper and lower abdominal bloat often have different underlying causes.
Common causes of upper bloat:
- Swallowing excess air (commonly from chewing gum, eating too quickly, using a straw, or carbonated beverages)
- Not chewing your food thoroughly
- Food allergies, intolerances, and sensitivities
- Infection (H. Pylori commonly resides in the stomach)
- Low stomach acid (contrary to popular belief, low stomach acid is a common culprit of bloating)
- Inflammation of the stomach ( aka gastritis)
- Inadequate digestive enzymes
- Gallstones
- Slow stomach emptying (gastroparesis)
Common causes of lower bloat:
- Constipation
- Small Intestinal Bacterial Overgrowth (SIBO)
- Dysbiosis (imbalance of bacteria in the gut)
- Parasites
- Food allergies, intolerances, and sensitivities
- Histamine intolerance
- Leaky gut
- Celiac Disease
- Gynecologic Conditions (think: hormonal imbalances, PMS, endometriosis, ovarian cysts)
Note that stress plays a large role in one’s digestion and therefore bloating. This is due to the gut-brain axis, which is a bi-directional network that communicates between the gut and brain through extensive interconnected pathways through neurotransmitters, hormones, nerves (hello vagus nerve!), and more. I find that stress is one of the most common culprits of bloating, which is why layering in lifestyle behaviors to decrease/manage stress is imperative in managing bloating.
How the location of your bloat affects treatment
Once the location of the bloat is identified, a health practitioner is able to narrow down the list of possibilities of why the bloating is occurring and identify the root cause. This may involve elimination diets, stool testing, hormonal testing, and stress management techniques. Each of these modalities provides valuable insight on food intolerances, the diversity of the gut microbiome and presence of potential pathogens, and hormonal imbalances – all of which are essential to understand when resolving bloat, given they are why bloating is occurring. Remember, the long-term goal is not to stick to a restrictive diet, have a strict supplement routine, or be reliant on certain hacks to relieve symptoms, but to address the root cause so that bloating does not happen in the first place. This way, one can live a healthy and nonrestrictive lifestyle. Based on the approach, I cannot recommend enough to work with a health professional who understands how to get to and treat the root cause, given the complexity of bloating.
The Bottom Line
Identifying your location of bloating is a great first step in resolving the bloat. Doing so provides insight into what’s going on so that you are one step closer to getting to and treating the root cause so you can live life with minimal bloating and feel good!
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Written by Alison Richman MS, RDN
