Stomach bloating happens when the GI tract is full of air or gas. Most people describe bloating as feeling full, tight, or swollen in the abdomen. Your abdomen may also swell (distended), be firm, and have pain. Bloating is often accompanied by pain, flatulence, constant burping, and abdominal rumbling.
In this video, however, Dr. J and Evan talk about the other causes of bloating that may be due to medical conditions. These include irritable bowel syndrome and disease, bacterial overgrowth, altered gut motility, aging and stress, and many more.
Dr. Justin Marchegiani
In this episode, we cover:
0:41: Bugs and gut infections
2:58: Low Enzymes, acids, and bile salts
3:45: Aging and stress
5:29: Adrenal stress and food allergens
8:43: Mold toxins
10:29: Low thyroid hormones
12:55: Gut autoimmune disease
Dr. Justin Marchegiani: And we are live! It’s Dr. J here in the house with Evan Brand. Evan, how are you doing today, my man?
Evan Brand: I’m doing well. We’re ready to talk about like, the mainstream topic. Like, sometimes, you and I, and we go into some of these nuances, that unless you’re into functional medicine or natural medicine, you may just be like, what the heck are you talking about? But every single human being, man, woman, baby, they can already relate to bloating. So, let’s dive in. You came up with the magic number of seven. So we’re going to riff on who knows, could be 7 or 17 different causes that we see clinically from bloating. Let me start off with number one. Gut infections which if open that can of worms, we can do five to twenty infections, and then get to that magic seven number right away. But I’m just gonna go ahead and say…
Dr. Justin Marchegiani: 100 percent.
Evan Brand: Bacteria and Candida-those are probably like, two of my biggest smoking guns. I, I know parasites cause a lot of gut damage but I’ll say personally, when I had parasite infections, I don’t think I had much bloating. I think it was more of my dysbiosis, my candida problem driving the bloating than the parasites.
Dr. Justin Marchegiani: You know, when people have parasites, there’s a lot of issues happening so it’s really hard to know like, is the parasites alone the root cause why you’re having these issues. And it’s hard to know that. I mean, parasites can definitely do it because they can affect you body’s ability to generate stomach acid, and enzymes, the bile support. Obviously, they can eat a lot of these foods and they can be fermenting, and creating gases being released from them, you know, they’re pooping in their, you know, um, farting inside your intestines and creating gases and things, and obviously, they’re creating information which then can affect digestion so parasites, we can just kind of lump bugs all the same bucket if you will. So we could say bugs, parasites, H.Pylori, fungal overgrowth-we can say small intestinal, bacterial overgrowth, or SIBO, or candida overgrowth, or fungal overgrowth. All those things kind of go in the bucket worms kind of goes in that parasite bucket as well. Anything else you want to highlight there before we go number two?
Evan Brand: Yeah, how about, uh, you can call it SIFO too. We haven’t hit that term but, just, just in case people aren’t clear on it so when we talk about fungal overgrowth. You can literally have what’s called SIFO. So this means you can have SIBO but, you can also have SIFO, and as you mentioned, it’s rare to see these things in isolation. So we’re often going to be using broad spectrum herbs, or antimicrobials, anti-fungals, antiparasitics all at once to try to knock all these down.
Dr. Justin Marchegiani: 100 percent. So regarding, um, bugs, SIBO, SIFO, and fungal overgrowth, or candida that are kind of all in the same bucket there. Uh, I would also say, diff kind of isn’t that bucket too, right?
Evan Brand: Yeah.
Dr. Justin Marchegiani: Um, you know. You can almost put some of the mold, um, the colonized mold, uh, fungal critters in there as well. Some of the aspergillus and things like that potentially, they may have different root cause of why they’re there but, that’s something that should be looked at. Next thing, is um, low enzymes, low acid, low bile salts. And again, some of these things are caught like they’re connected. So like yeah, HCL, enzymes, low bile salts if we are, aren’t able to break down those foods adequately, they can ferment, they can acidify, they can create gases; and of course, those bugs on step on can also create low stomach acid, low enzyme and bile salts. So everything is kind of connected in this web here. So I would say, the digestive secretions I think would be there. I’d also throw in, maybe some lifestyle things like not chewing your food enough, and maybe drinking too much water which shifts the pH in the stomach from a two-ish to closer to a seven which water is, and those would be the things I want to highlight. What do you think?
Evan Brand: Yeah, good call. And I’ll also point out just age and stress, not chewing some of this lifestyle measures you mentioned. That could be enough to create the bloating. As we know, the infections are going to drive some of this too. So kind of like, chicken or the egg, and it is possible that just age alone by the time you’re 40, 50, 60 beyond, you’re going to be making less stomach acid and Dr. Wright’s book. He had an amazing graph in their age and stomach acid levels. So if you’re one of the lucky few that are 40, 50, 60 with no gut infections, you simply just have an aged-induced low stomach acid. Well, that’s cool but, the low stomach acid will eventually drive some sort of infection, right? Now you’ve got this fermentation and purification of the food. So even if you’re like, somehow magically clear on stool or urine, and you just have low stomach acid, it won’t be that way forever. Eventually, stuff will pop up.
Dr. Justin Marchegiani: 110 percent. Now, everything’s connected right? So of course, if we have fungal overgrowth and bacterial overgrowth, well that can affect stomach acid but, now that also can affect motility, and so if we have slower motility, right? On the faster motility side, like diarrhea and such. You know, that can really cause a little bit of bloating but tends to be more on the slower stool side because, the stool is just sitting in your intestines longer, and maybe getting compacted. Maybe it’s taking you two to three days to kind of move that stool out. That may give you a sense that you’re feeling more bloated more as well. So I would say now that the slower motility, potentially caused by the bugs, caused by the HCL, could now start to increase that feeling of bloat.
Evan Brand: Yeah. So you’re saying like, you’re literally just full of poop as opposed to the infections or releasing gases which make you feel full but that’s a different type of bloat. So that’s a good, that’s kind of a good distinction there.
Dr. Justin Marchegiani: Yeah. It could just be a combination of everything, you got a little food baby inside of you, you know.
Evan Brand: Yeah.
Dr. Justin Marchegiani: That’s possible. Next, I would say adrenal stress. And so adrenal stress, the adrenals are part of the stress handling system that helps your body manage stress. Whether it’s through making adrenaline to help your body like, get the spider senses going so you can deal with that stress, uh, it could be just chronic low-grade stress where you’re making a lot of cortisol, and or you’re chronically inflamed from foods and emotional, and maybe even physical stressors, where the adrenals are just really over romped up and that’s activating the sympathetic nervous system, and so you have that see-saw, right? And sympathetic is the fight-or-flight, that’s the go-go-go, that’s the gas pedal. The break is the parasympathetic, they’re on a see-saw. So it’s hard to like, double clutch you know, and have a hit the gas and the break at the same time, so usually the sympathetics are up, the para are down. If the parasympathetic’s up, the sympathetics down, and the parasympathetic is to rest and digest. That’s the vagus nerve, right? People are like, “Oh! Gargles, sing”, right? Well, those maybe palliative things but, how about just fix the stress in your food, in your emotional life, in your physical life, work on that first. Uh, that’s going to make a huge difference and of course, gluten and processed sugar, and inflammatory foods, and foods that are nutritionally deficient can drive that kind of stress as well.
Evan Brand: Oh, yeah. Let me piggyback off that then. So you got the food-adrenal connection but how about just food connection in general? I mean, if you’ve got dairy in the system, you’ve got gluten in the system, you’re going to effect the tight junctions in the gut, so you’re going to maybe contribute to leaky gut but, also you may have some bloating from that. Now, there are enzymes, I know you and I, we manufacture some custom enzymes that things that can contain, what’s called dpp4, which is an enzyme that can help break down gluten. There’s also some allergy enzyme type formulas that we use where we can break down the occasional instance of all these types of proteins, dairy protein, and soy protein if people are getting exposed to it but, food allergies are big one, so I know you and I talk a lot about good quality meats, good quality fats, organic vegies and such but, if you haven’t got your diet boring before, I think I would go boring. I mean, look at me, I’ll do like a grass fed steak and a handful of blueberries for breakfast and I feel great. So, for me I would just recommend really, simplifying, trying to get your foods in isolation where you know, what you’re reacting to. For example, let me use my wife as a story. So, we were doing swapples which are awesome! It’s like a healthy waffle-it’s yuca, yuca-based, and she thought those were affecting her stomach but, she was also doing organic coffee, and she was doing eggs, and she was doing pastured sausage or bacon. I’m like okay, well, you got too many foods in here. We don’t know what it is. So we got down to elimination and then boom! We figured out it was the coffee affecting the gut. It wasn’t the food after all. Even the eggs which are common trigger were no problems. So I think you got to dial the food allergies, the food sensitivities, and just try to eat you food in isolation. Maybe do a food journal. Even on your phone, you could do an app, like I use Day Book a lot to take notes and you can just make a note like, :Hey! Eggs hurt my tummy today, or eggs got me bloated”, and then you can figure out what it is.
Dr. Justin Marchegiani: Absolutely! So the food component, just the inflammatory nature of that food. I think is also going to be a big one. Um, like you mentioned, I would say next, mold toxins. I know mold, uh, can do different things, whether it’s, you know, we kind of talked about it as kind of being a bug thing, which I guess it could be connected but, the problem is you may live in a moldy home. You may have things in your environment, whether maybe it’s too humid, right? And there may be a different solution for that than fixing out your bugs, clearing out the bugs in your tummy, so we may have to go about that a different way. So I guess, the mold kind of connects with the bugs but, there’s also a different solution to it. So we’ll put mold as a separate entity on that list, and that could be just too humid of a home. It could a leak in the home that was never fully remediated properly, um, it could be lack of good quality air filtration. All of those things could play out and of course, mold also is a sympathetic nervous system stressors as well.
Evan Brand: Definitely and they’re two different categories because, you can have two different situations you can be colonized for mold, meaning you’re growing in your gut and sinuses. Or you could just be a mycotoxin reservoir and some people are lucky enough to where maybe, their immune system was able to not allow the colonization or maybe the exposure of the mold was not too long-term, therefore, they’re just reservoir of mycotoxins but they’re not growing it. That’s a better situation. It makes out job easier if that is a situation, and yeah for sure, I mean, mycotoxins for me definitely affected my gut, my brain, my stool, consistency, so binders really help. So if you are having bloating but you’re having more IBS type symptoms, you know, of course bringing in the binders; we’ve done podcast on that is going to be the next step. Let’s go back to hormones per minute because yeah, I would consider you one of the best experts in hormones, and you’ve taught me over the years about hormones, and I know that PMS for a lot of women. PMS is a big deal, not only is it mood changes but, it’s bloating. So can you full us in there? What’s the hormone connection outside of cortisol to bloating.
Dr. Justin Marchegiani: Yeah. So I would say out of the gates, um, low thyroid has a string connection with affecting motility. So one of the side effects of low-thyroid hormone. Obviously, can be the conventional hair loss, cold hands, cold feet, eyebrow thinning of the outer third, maybe mood issues, maybe irritability, and obviously some of that overlaps with adrenal and female hormones and male hormones. But low-thyroid also affects motility, and so low thyroid hormone could easily affect motility. And if we slow down motility, that could easily allow more time for those foods, the ferment kind of create that food baby if you will. Just put more bulk in your tummy just make you feel a little bit more bloated and distended so it’s very possible could be playing a role in the whole situation.
Evan Brand: Okay. Well, we talked about thyroid and 90% of hypothyroid cases are hashimoto’s, so I mean, we could just say hanshimoto’s could be a cause. It’s a roundabout way. It’s a long, it’s along route to get from hanshimoto’s to bloating but, it does make sense.
Dr. Justin Marchegiani: Yep! Exactly. Um, so yeah, at this stage of the game, female hormones can plug in. Like if you have estrogen dominance, right? Lower progesterone, higher estrogen. Um, relatively speaking and just lower hormones. That can create potential things that could affect motility via stress, via sleep, and then if those things are compounded, that can create more adrenal stress. So you can kind of like, you know, it’s kind of like, it’s six degrees of bloating, right? It may not be a direct, direct indication but, it can easily, kind of dovetail two or three you know, weighs in and hit a couple of these different factors, that makes sense. So I would say some of the female hormones, um, obviously, some of the cortisol, and adrenaline, and of course the big one that we’re hitting now is the thyroid, the low-thyroid hormone. Evan Brand: Yep! Yeah.
Dr. Justin Marchegiani: Is that number five or six?
Evan Brand: Two… I don’t know. I don’t know. I think we got, we got more of those. So how about just bowel obstruction? I mean, this is not going to be a common situation but, you know, if somebody hasn't poop in a week, and they’re listening to this podcast, I mean, you have to consider the possibility of bowel obstruction. Unfortunately, this is pretty rare but it does happen.
Dr. Justin Marchegiani: Yep! Yep. 100 percent. Um, so that can definitely happen. An again, all these things that we’re taking about would be contributing factors of that,right? So that makes a big difference on that front. Um, so we hit the enzymes, we hit the food allergens, we hit the bugs, we hit mold,
Evan Brand: That’s five.
Dr. Justin Marchegiani: We hit adrenal stress,
Evan Brand: That’s six.
Dr. Justin Marchegiani: We hit thyroid stress. That’s seven! I think we hit them all.
Evan Brand: All right.
Dr. Justin Marchegiani: Is there anything else you want to add as a bonus or value add for the listeners?
Evan Brand: Uh, yeah. So any kind of autoimmune gut stuff. So celiac, crohn’s, ulcerative colitis. Even diverticulitis in some cases could cause any and all of these issues we talked about in terms of bloating, and stomach pain, and all of that. So if you are seeing more than just bloating, you’re seeing blood in the stool, or you’re seeing floating stool, maybe there’s fat malabsorption issue. We could go into gallbladder potential issues there as well; where we need to use some extra bile salts. So I would just say any kind autoimmune gut stuff is going to be a big one.
Dr. Justin Marchegiani: Yeah, a hundred percent. Autoimmune is gonna just create more inflammation. It’s gonna inflame the tissue to make it more raw, the more inflammation in the tissue, and the more sensitive the intestines are, the more your adrenals, and you cortisol, and your fight or flight system will totally get activated. I think it’s a really good step out of the gates here. I think we really hit a lot of good things here. So, we have food, we have low enzyme, we have low acid, we have bugs, we have mold, we have adrenal stress, right? We talked about thyroid and then the last thing we talked about is just the bowel obstruction and or the autoimmune um, gut stuff. So I think we hit seven to eight there. So a little, a little extra. So guys, if you’re listening.. go ahead.
Evan Brand: Let me, let me do the outro for you today. So today’s shorter and we want your feedback because we’ve done, I, I, lost track, I know my podcast is over 400 episodes. I know you and I have done hundreds together. So we want feedback on this. Is, is this is coming up on 15 minutes. How do you enjoy a 15 minute podcast? Is this all you need? Do you enjoy the 30-45? What do you like, because I mean, we could always go deeper but, eventually It becomes um, maybe rants or tangents. Today is just like, boom boom boom. So please, uh, go on Justin. Look up maybe his Instagram page, just in health or Justine Marchegiani. Look him up there and look up me Evan Brand and send us a message, and let us know. ‘Cause sometimes, we forget to check the reviews but yeah, send us a message maybe on Instagram. That probably the best place. We don’t use the Facebook too much because of some of the censorship going on but anyway, check us out, send us a message. Let us know what you think! Is it shorter, and sweet, and boom boom boom episode, is that good enough for you or do you want deeper dive? Let us know, and if you need help clinically, you can reach out. Justin works around the world with tons of people, thousands of people over the years, and he can run all sorts of labs to investigate these issues. So to reach out to Dr. J, justinhealth.com and for me Evan Brand, evanbrand.com. We would love to help you, we offer intro calls too. So you can book a quick call to discuss your symptoms, your goals, see if you’re a good fit, and we can help you anywhere. So the beauty of these type of symptoms, there are root causes, it’s not a deficiency of some sort of gas x or other thing you’re going to get ate walgreens, you know, there are root causes here that you can investigate and you can reverse these symptoms.
Dr. Justin Marchegiani: 100 percent. And then in regards to the solutions here, the solutions are addressing those root cause. We can go, we can do another podcast in the top six palliative kind of solutions, but out of the gates you know, fixing the bugs, fixing the stomach acid, look at what those adrenal stressors are, getting the food right. I think those would be the big kind of the root cause foundational things today. We’re not going to go too granular into extra protocols but, just kind of more big picture stuff and we’ll do another podcast in the future where we get more into the nitty-gritty in this.
Evan Brand: Sounds good.
Dr. Justin Marchegiani: Awesome! And guys, if you want to leave us a review, evanbrand.com/itunes or justinhealth.com/itunes. We’ll put the review link below. We really appreciate that review, really appreciate your comments below. You guys have an awesome day. We’ll talk soon.
Evan Brand: Take care now.
Dr. Justin Marchegiani: Bye!