"Why do I sometimes wake up looking bloated?"


"Dear BBW,

I've always felt my digestion ran a bit on the slow side, but over the past year, I've noticed things getting worse.  I used to feel bloated and a bit short of breath often at night, but lately I'm even waking up feeling full, a bit nauseous and looking three months pregnant. The belly just grows as the day progresses, and my appetite shrinks along with it. What could be going on??"

-LT, New Jersey

Dear LT,

Sounds like you might indeed be pregnant... with what I call a "food baby."  You mentioned feeling full, nauseous and having lost your appetite, which makes me wonder if perhaps your stomach emptying might have slowed down.  Sometimes a sudden change in stomach emptying can happen following an acute infection-- a bad stomach bug or flu, a case of food poisoning or a parasitic infection. It may be worth taking to your doctor about investigating your gastric emptying. 

In the meantime, try this out for the next few weeks: steer clear of rough, tough textured foods like raw veggies, nuts and popcorn and eat soft, lower fat meals and snacks like eggs, sushi, well-cooked veggies, smoothies, soups, turkey sandwiches, veggieburgers, baked fish, ripe/skinless fruits and yogurts.  Try to eat 4 small meals or large snacks per day that are spaced out by 4 hours, and limit your drinking to between meals.  Make dinner your lightest meal of the day, not your largest. 


"I'm constipated and bloated, but eating fiber for my constipation makes me more bloated!"


"Dear BBW,

I'm pretty constipated.  I only go to the bathroom (#2) once every 2 or 3 days, and even then it feels like there's more I need to get out but doesn't come out.  My doctor told me to eat more fiber and to take Metamucil, but I feel like salads and fiber supplements constipate me even more!  I know I need to eat more fiber to go to the bathroom so I won't be so bloated all the time, but more fiber makes me feel even MORE bloated all the time. Help!"

-CF, New York

Dear CF,

There are many ways to tackle constipation, and fiber is only one of them.  What's more, there are many different types of fiber, and some may be more bloating than others--particularly when you're 'FOS' (that's short for 'full-of-stool.') You didn't mention whether you take anything in the laxative department. When my patients present with similar problems, we usually take a three-pronged approach:

  1. Coffee every morning right after waking to help stimulate the urge to go
  2. Gradually increasing fiber from "soluble" sources that aren't going to cause too much gas: oatmeal, chia/ground flaxseeds, quinoa, sweet potatoes, avocadoes, oranges/clementines, papaya, cantaloupe, zucchini, winter squash, peeled eggplant and carrots. I'd lay off the fiber supplements and lots of roughage, like kale and salads and popcorn for now. And steer clear of any 'high fiber' bars or fiber-fortified foods.
  3. If your kidneys are healthy, you can also try taking some magnesium supplements in the evening. Doses of 400mg to 800mg usually do the trick, and they're not dependency forming.

Of course, there are PLENTY more tricks up my sleeve if this trifecta doesn't get the job done. But you'll have to buy my book next February to learn the rest of them! ;)




"Why do I feel MORE bloated after starting a probiotic supplement?"


"Dear BBW,

I have IBS, and I decided to try taking a probiotic supplement after reading lots of things online and my having my doctor recommend it. Am I the only person who actually feels more bloated and extra gassy since starting a probiotic??  Why could this be?"

-MK, San Diego, CA

Dear MK,

You're definitely not the only person to have this experience.  Without knowing the nature of your bloating and which brand of probiotic you've been taking, I can't offer a very informed opinion about why this particular pill gave you these particular symptoms, but I can comment in general.

Probiotics are bacteria pills. Different bacteria feed on different dietary compounds in the gut, and they produce gas as a byproduct. If your probiotic pill happened to introduce a species/strain of bacteria that particularly loves to dine on a staple of your usual diet-- a certain type of fiber, starch or sugar-- it may be rewarding you with all sorts of gas.

Another common reason for probiotics increasing gassiness and bloating is related to the product's inactive ingredient fillers. Some brands of probiotics contain pure lactose, and other brands contain ingredients called "prebiotics," like inulin or fructo-oligosaccharides (FOS), designed to feed the gut's "probiotic" bacteria.  Objectively, these prebiotics are probably health-promoting. But subjectively, they can cause lots of gas and bloating for susceptible people-- especially people with IBS!

Sometimes, people acclimate to the probiotic after a week or two.  Sometimes people switch brands and find one that doesn't cause side effects. Some people just stop taking probiotics entirely.  Personally, I've not found probiotics to be any sort of "silver bullet" for bloating among my patients with IBS, though some people get lucky and find a particular brand that happens to make a difference for them. There's a fair amount of expensive trial and error involved with that.