Bloating, Low Stomach Acid and IBS

Bloating that hangs on through a clean diet usually means your body can't break food down and clear it out as fast as it comes in. Gas is fermentation, and bloating is pressure from trapped gas, fluid or inflammation. The causes Meghan sees most:

• ■Microbial imbalance: candida, H. pylori, parasites, SIBO or gut disruption after antibiotics.
• ■Constipation, even if you go every day.
• ■Poor bile flow. Signs are bloating after fatty meals, nausea and floating, sticky stools.
• ■Low stomach acid, often from chronic stress, long-term antacid use, long gaps between meals or low zinc.
• ■A stagnant lymphatic system, chronic stress and a high toxic load.

Food sensitivities usually come downstream of these causes, which is why cutting out one more food rarely solves it. Stress plays a bigger role than most people think, because eating in fight-or-flight lowers stomach acid, slows bile and pulls blood away from the gut. In her words, "Chronic stress is a digestive condition." Her daily steps: eat at least 1 meal a day with no phone or laptop, take 30 to 60 seconds of slow breaths away from screens before you eat, and chew until your food is nearly liquid, about 32 chews per bite. Add bitter foods like arugula, radicchio, dandelion greens or lemon water before meals. Sip only a little liquid with meals and drink between them, and walk after you eat. Many people feel worse when they add probiotics or extra fiber before digestion is working, so get your bowels moving first. If bloating continues once drainage is in place, she looks to testing such as a SIBO breath test or a stool test for parasites and pathogens. Her line: "Inputs matter, but outputs matter way more." Her free Gut Health Diagnostic is a good place to start.

Bloating, burping, reflux or a heavy, overly full feeling after normal meals often point to too little stomach acid, even though many people are told they have too much. Stomach acid breaks protein into amino acids, triggers bile and pancreatic enzymes, frees iron, B12, zinc and magnesium from food, and guards against microbes. When it runs low, food sits and ferments, and the gas and reflux come from digestion that never finished. Over time Meghan sees:

• ■Nutrient gaps despite a healthy diet
• ■Brittle nails, thinning hair and skin that won't clear
• ■Fatigue and slow recovery
• ■More gut imbalances, including SIBO and parasites

The usual drivers are chronic stress, mineral depletion, long-term antacid use, long gaps between meals, low zinc and years of rushed eating. Her steps:

• ■Step away from screens to eat, and take 30 to 60 seconds of slow breaths before the first bite
• ■Chew each bite about 32 times
• ■Eat bitter greens like arugula, radicchio or dandelion, or drink lemon water, before meals
• ■Only sip liquid with meals
• ■Replenish minerals, especially sodium, chloride and zinc
• ■Talk to your doctor before changing any acid medication

Her free Gut Health Diagnostic is a good place to start.

IBS usually has one or more specific causes underneath it, and Meghan sees the label as a name for what the gut is doing that doesn't explain why. It is a diagnosis of exclusion, given once celiac, IBD and structural problems have been ruled out. The 10 drivers she finds most often:

1. 1.SIBO, IMO or SIFO. Bacterial, methane-producing or fungal overgrowth in the small intestine. This is the most common driver.
2. 2.Low stomach acid, which is why many people with IBS feel worse on acid blockers.
3. 3.Bile problems. Sluggish bile flow slows digestion, and bile acid malabsorption can cause watery diarrhea.
4. 4.Parasites that linger, especially when symptoms started after travel, food poisoning or a gut infection.
5. 5.Disruption after antibiotics, especially if symptoms began within a year of a significant course.
6. 6.Chronic stress affecting the gut through the vagus nerve.
7. 7.Food intolerances beyond FODMAPs, such as histamine, salicylates, oxalates, fructose or lectins.
8. 8.Gut permeability, sometimes called leaky gut.
9. 9.Low pancreatic enzymes, a partly blocked bile duct or a removed gallbladder.
10. 10.Mold exposure, especially if symptoms are worse in certain buildings or seasons.

Her order:

1. 1.Drainage first. Get bile flowing, bowels moving 1 to 3 times a day, the gut lining supported and minerals replenished.
2. 2.Proper testing. Ask for a trio breath test (hydrogen, methane and hydrogen sulfide) for SIBO and IMO, a stool test for parasites, pathogens and fungal overgrowth, and a comprehensive digestive panel with bile acid markers, elastase and inflammation markers. Consider mold testing if your history points to it.
3. 3.Targeted work matched to the driver that testing finds.
4. 4.Nervous system support alongside everything else.

What she says to skip: settling for "just IBS," eating low-FODMAP for life without finding the driver, and stacking more probiotics and enzymes on an untested, backed-up gut. Her free Gut Health Diagnostic gives you a read on where your gut stands.