Are You Bloated or Fat? How to Tell the Difference

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Are You Bloated or Fat? How to Tell the Difference - Thomas DeLauer
Top 2 Bloating Mechanisms

Intestinal Gas Accumulation

In the fasting state, the healthy GI tract contains only about 100 mL of gas distributed almost equally among 6 compartments - stomach, small intestine, ascending colon, transverse colon, descending colon and distal (pelvic) colon

Postprandial volume of gas increases by about 65%, primarily in the pelvic colon

The excessive volume of intestinal gas has been proposed as the likely cause of bloating and distension, and many researchers have attempted to determine this view

A few studies using plain abdominal radiography demonstrated that intestinal gas volume was greater in patients with IBS than in controls (54% vs. 118%), however, the correlation between intra-abdominal gas contents and bloating was poor

Some studies using CT scans combined with modern imaging analysis software have also shown that excess gas was not associated with abdominal bloating in some patients

Suggests that increased volume of gas may not be the main mechanism of bloating, but rather impaired gas transit or distribution are more often the sources of problem

Food Intolerance and Carbohydrate Malabsorption

It is well recognized that dietary habits may be responsible for abdominal symptoms, and there have been efforts to prove the relationship between diet and IBS symptoms

Fiber overload has long been regarded as worsening factor of IBS symptoms through decreased small bowel motility or intraluminal bulking

In addition, lactose intolerance may contribute to symptom development in IBS patients - in the small intestine, disaccharides are split by intestinal enzymes into monosaccharides which are then absorbed

If this process is not carried out, the disaccharide reaches the colon, in turn is split by bacterial enzymes into short chain carbonic acids and gases - hence, malabsorption of lactose may produce the symptom of bloating in patients with IBS or FB

Additionally, a new hypothesis is proposed, by which excessive delivery of highly fermentable but poorly absorbed short chain carbohydrates and polyols (FODMAPs; fermentable oligo-, di- and monosaccharides and polyols) to the small intestine and colon may contribute to the development of GI symptoms

FODMAPs are small molecules that are osmotically active and very rapidly fermentable compared with long-chain carbohydrates

These molecules induce relatively selective bacterial proliferation, especially of bifidobacterium, and it has been demonstrated indirectly that these can lead to expansion of bacterial populations in distal small intestine

How to Identify Bloat vs Fat

if you're bloated, you'll get a tense "drum feeling" when you touch your stomach - if fat is the culprit, on the other hand, your stomach will feel "much more dense"

Stomach fat will feel spongy and malleable when pressure is applied, whereas bloating usually makes your abdomen appear tight and noticeably firm

Best Solutions for Bloat

Reduce FODMAP Intake (Slowly Reintroduce)

FODMAP is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols

Since your body is unable to completely digest these sugar molecules, they travel through your GI tract and reach your colon undigested, where the bacteria that live in your colon begin to ferment them - the fermentation can produce gas and bloating

Specifically, the small intestine does not produce enzymes capable of hydrolysing these FOS or GOS bonds and as such neither fructans nor GOS can be absorbed across the small intestine

Cruciferous Veggies

Cruciferous veggies (cauliflower, broccoli, cabbage, etc.) cause bloating and gas when eaten in their raw form. This is because they’re extremely high in insoluble fiber, which can be difficult for your body to break down.

Cruciferous veggies also contain raffinose, a sugar molecule - Raffinose cannot be broken down in the small intestine as humans lack the alpha-galactosidase enzyme required to break it down. It passes through your GI tract completely undigested.

Note on Dairy:

Products containing lactose can be hard to digest, even for those that aren’t lactose intolerant, as lactose increases acid production in your stomach that can irritate ulcers, which are open sores on the stomach lining

References

1) Abdominal Bloating: Pathophysiology and Treatment. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816178/

2) Functional Abdominal Bloating with Distention. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388350/

3) How Fat Cells Work. (2000, October 27). Retrieved from https://science.howstuffworks.com/life/cellular-microscopic/fat-cell1.htm

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