We've all been there. You go GF. Then you keep bloating. You feel like a whale. Spanx hold in pants don't help. You can't even get into them. You ask your coeliac nurse and she just smiles and says 'some people get this. It'll settle'. But who wants a wardrobe of clothes two sizes too big. Women don't want to look pregnant. Men don't want to either.
Here's my top 10 hit list on the common culprits and things to explore with your GP to identify and rid yourself of it...
1. Avoid gas producing foods
Yes baked beans and their ilk. Avoid fizzy drinks. Be wary of salads in the early days. Healthy but often hard for your damaged villi to process. Always made me bloat without fail. Try cooking food before eating - often gentler than raw veg etc. You get the drift
2. Have a follow up endoscopy
1 to 2 yrs after diagnosis. Check your villi are healing. If not the bloat will continue as your villi have trouble helping digest food. It can take 3 yrs GF for villi to heal. Be patient
3. Go lactose free!
Well for at least a year after diagnosis. As the damaged villi can't process the lactose protein in dairy products. So consider this and monitor how it works. Use your phone to track when you bloat and what you've eaten. Spot any patterns. Hey presto! I felt nauseous every time I had any dairy initially after diagnosis and now I can tolerate dairy as long as I don't go wild have lots in one go
4. Watch the alcohol
Yes. Not a popular one but alcohol is inflammatory and it strains the liver and can be harsh on the intestines. So bear in mind your bloat maybe from that. Even GF deglutenised beers can set off bloating. The fizz and low levels of barley can affect some coeliacs even though they're well within the less than 20ppm to be called and labelled GF!
5. Get moving!
Another common sense one. But even if you're bloated like a whale and think you'll get laughed out of the gym, simple gentle exercise can get the bowel moving and help reduce bloating. So start with walking or get a pedometer and slowly build up to more steps a day. Then try pilates or gym or swimming. I always find that I bloat more when I'm sat at a desk and against a busy deadline. Just as long car journeys can slow and crush your intestines a bit sitting at desk is no good. Get moving. Ideally every 20 mins. Set a reminder on your calendar and see if that helps improve the bloat.
6. Try the FODMAP Diet
A harder one to master but useful if you've tried many other pointers and had no luck. Ask your coeliac clinic or GP for a referral to a dietitian that is an expert in this. In a nutshell it involves cutting out long chain sugars, carbs, dairy, fructose that can irritate people with irritable bowel or inflamed bowels. It began in Oz and has been adopted by researchers at Kings College and many other hospitals. You'll need support trying it so don't do it on your own as it's complex and needs monitoring for example you may not be able to tolerate a whole apple but half an apple may be fine and a dietician can guide you through the diet and food diary and reintroducing food. Search the forum here with 'FODMAP' for more tips. Or visit: kcl.ac.uk/lsm/research/divi...
7. See your GP
Get a once over for other conditions. And for the ladies see if you can get endometriosis, adenomyosis and ovarian cancer excluded. Many gynae conditions can cause bloating and it could be something simple that can be identified that's causing it. Remember that IBS isn't a diagnosis itself and is a diagnosis of exclusion. Google the NICE guidelines so you can ensure you're not fobbed off with this catch all umbrella diagnosis!
8. Cut the crap
Literally. Cut out all processed foods. Hard when you've switched from processed foods to GF processed foods. But believe me it can really work. I found as did other coeliacs that after a while my body became very sensitive to even GF versions of foods e.g. those GF breaded chicken pieces from M&S - bloated after. Those oven chips. Nope bloated after. Read the labels not just for gluten (!) but also for artificial additives, preservatives and any funny long words that aren't natural. My sister and I have both ditched GF bread and found we don't bloat any more in the mornings. It seemed the cellulose added to most GF bread was bloating us up. Try and switch your diet and see if eating less processed stuff works for you too. A lot of coeliacs often switch to a Paleo diet and find that works well for them. For inspiration see this Paleo blog round up paleomagonline.com/top-10-p... Also consider pre and probiotics. Pop into your local health shop and ask about good gut bacteria. Most of those shop bought drinks that aim to help your stomach bacteria are packed full or sugars. But eating bananas and good bacteria foods can help. And avoid oily, fatty food. Again hard to process and often causes a bloat. Anything too heavy or rich to digest seems to put my digestion to the test. Which is positive as it means cooking and eating good food is essential.
9. Cut the sugar
Another toughie for some I know. But honestly, it's amazing what is put into Free From aisle products. Sadly far too much salt, fat and sugar. I bloated loads after taking calci-chew supplements prescibed as my Vit D levels were severely low at diagnosis (15 when they should be 75 and over!). Luckily after moaning on my coeliac nurse sent me to the dietitian who quickly spotted that my calci-chew contained a lovely cocktail of fake sugars e.g. Mannitol, sorbitol and beyond. As soon as I cut these out my bloat disappeared. So read all the fine print on labels - after all we're already hunting for gluten in all it's forms (wheat, rye, barley, oats, spelt etc) what's a few more names to check eh! And if you need some cold turkey avoiding sugar inspiration I can highly recommend Sarah Wilson's book and blog. All focused on her 'IQS aka I quit sugar programme'. Read her blog here: sarahwilson.com/ Remember most natural sugars from fruits etc are find. But try and eat them as fruit not as smoothies as doing so increases your sugar intake and messes with how your body absorbs them.
10. Ditch the spices and embrace H2O
I found that I couldn't tolerate chilli or anything spicy after going GF. And that remains now 7 yrs on. So learn to use other great herbs and spices instead of chilli. Another common sense bit of advice is drink lots of water. We rarely do as we lead busy lives. But around 2 litres a day is good for digestion and skin and hydration generally. If you hate water try adding sliced cucumber or lemon and lime. And grab a re-suable bottle and just use good old tap water to be more environmental.
So there's my top ten. It's not full proof. As I type this I'm bloated like a whale. It could be a slight bit of cross contamination or it could be the oven chips I had last night that I really shouldn't have had as I find them hard to process. Either way you're not alone. I find tonic water can help reduce the bloat as can some herbal teas when it strikes. But mostly it comes and goes at will. So learn how to master a varied fashion wardrobe and remember, coeliac or not - everyone bloats. We're all human.
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