Author: Nicole Pawley-Reddington, BHSc Chinese Medicine

Bloating is such a common symptom we come across in a consultation. Often identified as a swollen belly, discomfort, heaviness, puffiness, large, distended or even tightness (particularly where undoing a button or zip towards the end of the day relieves it). Bloating is uncomfortable whether it is acute or chronic, visible or not.

The general state of a persons belly is considered a reflection of the health of the Kidneys and the reproductive system – particularly in women. It should ‘feel elastic, neither too tight or too soft’ . One 1 would expect there are exceptions to this rule – a postpartum mum would experience a very soft belly after bearing a number of children or in contrast, an avid exerciser would be more acquainted with a taunt or firmer abdomen. Either way, distension reflects the flow of Qi is contradicted.

There are a number of diagnostic clues that enable our Chinese Medicine practitioners to discern the exact patho-mechanism of a bloated belly.

What makes the bloating better?
Are the bowels affected?
Does the bloating improve or worsen with pressure?
What time of the day is the bloating felt worst?
Is it associated with burping, flatulence, bowel movement?
Is it better with burping, flatulence, bowel movement?
Do you notice it more with an emotional component?
Clinically we find the temperature of the skin significant. It’s amazing how many cold belly’s we feel on a daily basis. Clients are very unaware of the alternating temperature of their abdomens. If the skin is cold to the touch in the lower abdomen, it is a sure indicator there is cold pervading the reproductive area. This will affirm the mechanisms of period pain, infertility, urgent/frequent urination, loose bowels and of course, belly bloating.

Western medicine to date indicates bloating is not understood within allopathic health care. It is characterised with irritable bowel syndrome mostly and can include other functional gastric disorders, for example, chronic gastritis, peptic ulcers and colitis. Other biomedical causes include hepatic cirrhosis, pancreatitis, gall stones, PMT, oral contraceptive pill, hormone replacement therapy, carcinoma, anxiety or depression . In order to treat this condition, medicinals such as “prokinetics, 2 rifaximin, lubiprostone and linaclotide ” (drugs used to affect the Intestines) are utilised with a 3 recommendation in dietary changes.

Thankfully, Traditional Chinese Medicine is able to define the mechanisms that produce bloating as a response to either:

• how a person nourishes their body
• the circulation of Qi (particularly in the abdomen)
• constipation, and/or
• the retention of fluid.

More often we discover the flow of Qi becomes distorted and quite easily so when dealing with gastro-intestinal issues. Suffice to say, the dietary habits of those that suffer bloating are where we often first look to find the problem.

Our society has a concept bigger is better and upsizing is normal particularly with nutrient-poor food. Overeating floods the digestive system impacting on the levels of stomach acids leading to symptoms of indigestion, bloating, flatulence and burping amongst other niceties. Eating habits such as too many raw or cold natured foods (also attributable to medicines and herbs), excessive and refined sugars, generous quantities of grains and junk type foods can produce dampness and phlegm. All of these substances, weaken digestion as the Qi becomes obstructed and bloating occurs.
The lack of hydrochloride acid (HCl) in the stomach leads to malnourishment and poor digestive process as valuable nutrients are just not absorbed. Conversely, pharmaceutical companies are constantly advising the public that you have too much acid if you have symptoms such as bloating, burping or burning. What is really happening is that there is not enough HCl and the antacids are neutralising what little acid in the stomach there is. Acid and enzymes are needed to break down foods. It’s what nature intended, so why are we dissolving it away? The signs and symptoms expressed by these consumers are simply the result of lifestyles that involve “stress, junk food, antibiotics, smoking (second hand smoke included), ingestion of grains, vegetarianism, age and alkalising diets” 4 all deplete the levels of acid in the stomach. Not to mention that taking an antacid regularly damages bones by leaching calcium and promotes environmental hypersensitivity with superfluous aluminium. aluminium. In turn, the belly becomes weak as the metabolisation slows down, eventually creating bloating.

Constipation can also contribute to bloating and a baseline of the clients ‘normal’ bowel habits needs to be established first before treatment commences. It is important to analyse the reason behind the infrequent or lack of bowel movements as this determines the specific treatment. One size does not fit all in Chinese Medicine. For example, a laxative type remedy will do more harm than good for someone who perhaps is not energetically inclined and not strong enough to cope with the result intended.

What should dominate in treatment is recognising what specific function is faulty. An altered diet will be of upmost importance as the digestion of any food is affected by the flow of Qi whether Qi is the problem or food is the problem. Chinese medicine food therapy utilises energetics relating to temperature and sees whole nutrient dense food as essential for enabling the body to flow! Its a fascinating take on how to use food as medicine and should be an area for any person experiencing bloating to look into.

Of significance is the fact that we are dealing with the movement of Qi and the best way to do this is to simply move yourself – ‘exercise moves Qi and strengthens the digestion…’ . We would also 5 advocate abdominal breathing as we tend to hold our breath in certain situations and not make use of  our entire lung capacity essentially shallow breathing into the upper part of the lungs.

If bloating is a condition you have been putting up with, consider supplementing with some of these simple home remedies:

•A tablespoon of apple cider vinegar in a glass of water, 30 minutes before eating.
•Ginger contains an enzyme effective in improving gut function and a cup of ginger tea 1-2 times a day is a simple digestive aid.
•Include fermented foods to stimulate and improve gut function, giving it the ability to break down foods appropriately and input good bacteria.
•Chewing food until it is soft, then swallowing, allows salivary enzymes to build up and nutrients to be more functional.

If you have no significant relief or long lasting comfort from these corrective measures, follow it up with some acupuncture and herbal remedies.