Bloating Reduction

Bloating reflects some combination of excess gas production from carbohydrate fermentation, impaired transit, visceral hypersensitivity and abdominal wall dyssynergia. It is the most common complaint in irritable bowel syndrome but also appears in coeliac disease, SIBO, pancreatic insufficiency, and ovarian pathology. New persistent bloating in a woman over 50, or bloating with weight loss, bleeding or anaemia, requires investigation rather than dietary experimentation.

Run a supervised low-FODMAP elimination for 2-6 weeks, then reintroduce methodically — the reintroduction phase matters as much as the elimination and long-term restriction harms the microbiome. Eat slowly, avoid carbonated drinks, chewing gum and sugar alcohols. Supplement layer: enteric-coated peppermint oil 180-225 mg two to three times daily before meals, a multi-strain probiotic trialled for at least four weeks, ginger 1 g/day for delayed gastric emptying, and lactase or alpha-galactosidase where a specific intolerance is confirmed. Address constipation, since retained stool amplifies distension.