Next up, Mark Pimentel, MD from Cedars-Sinai, MAST program, weighs in on bloating too.
Kate: How does SIBO contribute to the symptom of bloating?
Dr. Pimentel: The main source of gas in the intestinal tract is the gut microbiome. As such an expanded microbiome as is seen in SIBO would have a greater fermentation potential. More importantly, excessive bacteria in the small bowel mean that these bacteria receive fresh food that is easier and quicker to ferment than the left overs that would be found in the colon. More gas=more bloating.
Kate: Is hydrogen or methane + SIBO more likely to contribute to bloating—or do you see bloating in both?
Dr. Pimentel: This is complicated. We think methane is worse for bloating. Methane slows the gut down so any gas produced tends not to be expelled as easily. Therefore, patients with methane have more gas retention and therefore more bloating.
Kate: In your clinical practice, what are the main causes of bloating?
Dr. Pimentel: Absolutely the main cause of bloating is SIBO.
I like this overview article here that outlines a few additional tips to manage bloating: such as gentle exercise (walking), certain yoga poses (hello, child’s pose!), warm tub, abdominal massage, to name a few.
A big thanks to Tamara Duker Freuman and Mark Pimentel, MD for sharing their expertise and insights on bloating.
For a chance to win, Tamara’s book, leave a comment about what other gut health topics you would like me to cover in an upcoming blog post.
Winner will be selected May 8, 2019.