Bloating and gas are common symptoms with up to 30% of the population suffering enough to complain to their doctors. 

Educational content reviewed by licensed APRN medical staff. Not personal medical advice.

Dr Vikki Petersen explains what the 5 most common causes are and what you can do to determine which may be bothering you and some steps you can take to alleviate the discomfort.

1. Low stomach acid - the common symptoms are fatigue, heartburn, feeling full, bad brath, undigested food in stool, diarrhea/constipation. 
Home test: 1/4 tsp baking soda in 4-6 oz cold water first thing in the morning before any food or drink. Time when you burp. Normal is within 2-3 minutes. If no burp at 5 minutes it may indicate low stomach acid.
You can trial some betaine hydrochloric acid but check with your doctor first.

2. Poor gallbladder health - bile breaks down fats and absorbs fat soluble vitamins. Bile also works with the pancreatic enzymes which we are about to discuss.
Symptoms include - bloat after a fatty meal, nausea, upper right quadrant (just below your ribs on the right) discomfort that can radiate around to your shoulder blade, nausea and feeling full after a fatty meal.
You can try adding bitters such as ginger, arugula, milk thistle to see if it improves symptoms.
check with you doctor first however.

3. SIBO - small intestinal bacterial overgrowth. Symptoms include cramping, gas, pain, diarrhea and or constipation.
Causes are PPI meds, antibiotics, low stomach acid, slowed motility
Test - your doctor can order a Breath Test.
You can trial oregano, garlic, fasting and a carnivore diet for 2 weeks - consult with your doctor first.

4. Poor pancreatic function - the pancreas makes enzymes to digest every type of food: fat, carbohydrate and protein.
Symptoms include bloat, greasy, smelly stool, nausea, vomiting, bloat and diabetes symptoms.
You can trial pancreatic enzymes with your doctor's approval.

5. Food sensitivities - common foods can cause a variety of symptoms including bloating.
Trial a modified elimination diet and a planned reintroduction after 3 weeks. This is the gold standard for food sensitivity testing. 

References:
Vavallo M et al. Autoimmune gastritis and hypochlorhydria: Known concepts from a new perspective. International Journal of Molecular Sciences. 2024.

Filardo S et al. The potential role of hypochlorhydria in the development of duodenal dysbiosis. Microorganisms. 2022.

Whitcomb DC et al. AGA Clinical Practice Update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency (EPI). Gastroenterology. 2023.

Jung SW et al. Epigastric symptoms of gallbladder dyskinesia mistaken for functional dyspepsia. Korean Journal of Gastroenterology. 2017.

Feng X et al. Prevalence and predictors of small intestinal bacterial overgrowth in inflammatory bowel disease: a meta-analysis. Frontiers in Medicine. 2025.

Saadati S et al. Effects of a gluten challenge in patients with irritable bowel syndrome: A randomized clinical trial. Scientific Reports. 2022.

Pasta A, et al. Food Intolerances, Food Allergies and IBS: Lights and Shadows, Nutrients 2024.

#bloating #guthealth #rootcausemedicine 

Disclaimer: The information provided in this is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this.
The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary.