Beating the Bloat

Bloating is a common symptom in people with coeliac disease.  For most, the bloating goes away once you start on a gluten free diet.  But what if it doesn’t?  We take a look at common causes of bloating and what you can do to manage it.

On a gluten free diet and still getting bloated?

Bloating can be caused by quite a few things including:

• Constipation
• Other food sensitivities (e.g. lactose intolerance)
• Irritable Bowel Syndrome

It can also be a sign of more serious problems like ovarian cancer.  This is why you do need to see your GP if you do have bloating – it’s important to make sure that there’s nothing more serious going on.

Where to start with beating the bloat…

Is it still gluten?

Well, if you do have coeliac disease, double check that you’re not accidentally eating gluten.  It’s amazing how something can sneak in.  Are you using a separate toaster? Are you avoiding foods that say “may contain gluten/wheat/rye/barley”? Sometimes bad habits can creep in, especially if you don’t get a big reaction when you eat gluten.

One of most common causes of bloating in people on a gluten free diet for a few years is actually a little bit of gluten that has just gone unnoticed.  Go through your kitchen and check that a familiar brand hasn’t added a gluten ingredient.  Check that no one else is using your butter, jam, etc.  Make sure your toaster is a gluten-free space or get some toaster bags.  Eating out can be tricky so do double check there. You can always check in with your dietitian for a review if you’re not sure.

Are you constipated?

Very often bloating is due to constipation, even if you go everyday…

Sometimes people go to the loo everyday but still feel that not everything came out.  This is often described as having an “incomplete bowel movement”.  What gets left behind can cause bloating.

The ordinary type of constipation (where you don’t go to the loo everyday) can also cause bloating.  Either way, it is worth looking at how much fibre you are eating and topping up on your water as well.  Some probiotics can help with bloating and constipation, again check with your dietitian for recommendations.

Most people don’t eat anywhere near enough fibre so remember:

• You need fibre-rich foods at every meal, not just breakfast
• Add fruit and/or vegetables to every meal
• Top up fibre by adding seeds to cereals, yoghurts and salads
• Choose wholegrain or high fibre carbs like jacket potatoes and brown rice.
• Fibre supplements can be helpful but again, see your dietitian for advice.

Lactose Intolerance

Around 10% of people in Ireland are lactose intolerant.  This may be more common in people with coeliac disease and it is a common cause of bloating.  Other signs of lactose intolerance are excess wind (or farting, to be blunt) and you might also get some diarrhoea.  Lactose is the natural sugar found in milk and yoghurt.  There is a very small amount in butter, cream and cheese.  People who are lactose intolerant can use lactose free milk and limit how much yoghurt is eaten.  Butter, cream and cheese are low in lactose so most people can eat them without any problems. 

Irritable Bowel Syndrome

Irritable bowel syndrome, or IBS, can cause a wide range of bowel issues and bloating is one of them.  There can be lots of causes including food sensitivities, stress, sluggish bowel muscles, or it can be unexplained.  People with coeliac disease can also have irritable bowel syndrome but it is not common to have both. 

If you do have IBS as well as coeliac disease do ask your dietitian for help looking at possible food sensitivities.  Your GP may also be able to advise on other therapies.  Do save yourself time and money and skip IgG blood tests that claim to diagnose food intolerance.  The Health Products Regulatory Board in Ireland have reviewed them and found that they cannot either diagnose or rule out any food sensitivities.

What else can cause bloating?

• Endometriosis can cause bloating for lots of women. Endometriosis is where the lining of the womb grows outside of the womb.  It can build up around parts of the bowel and affect bowel movements. 
• Usually bloating comes and goes, but if your bloating is there all the time and never goes away, this may be a sign of ovarian cancer. This is why you need to see your GP when you have bloating. 

Got any questions?

Contact us at info@coeliac.ie