Let's talk bloating, shall we? 

It's that pesky discomfort that can really throw you off your game – feeling tight, full, and gassy in the belly. And about half the folks experiencing bloating also deal with a visibly swollen tummy. It is a common annoyance that often comes hand-in-hand with constipation or alternating constipation/diarrhea. But there's more to it than meets the eye.

Did you know that up to 90% of folks with irritable bowel syndrome (IBS) deal with bloating? And it's not just them – even 10-25% of otherwise healthy individuals get hit with it occasionally, with about 10% facing it regularly. Hormonal changes can stir up the bloat pot too – about 75% of women deal with it before and during their period.

Functional medicine steps in as the detective in this scenario, aiming to uncover the root cause of bloating. It's like peeling back the layers of an onion to understand why it's making you cry. Your reason for bloating might be totally different from someone else's. 

Let's dive into some common causes:

SIBO, or Small Intestinal Bacterial Overgrowth, is when there's an abnormal increase in bacteria in the small intestine. It often happens as a result of other gut issues or abdominal surgery, slowing down food and waste transit and inviting all sorts of bacteria to the party.

Then there's dysbiosis, an imbalance in the gut microbiome. This means fewer good microbes and more bad ones, thanks to things like antibiotics or high stress. It can lead to inflammation, gut wall tears, and all the bloaty feels.

Ever heard of Exocrine Pancreatic Insufficiency (EPI)? It's when your pancreas doesn't produce enough digestive enzymes, leaving food undigested and primed for bacteria to feast on, leading to more bloat.

Food sensitivities are sneaky too. Unlike allergies, sensitivities trigger a delayed immune response, often days later. The result? Inflammation and – you guessed it – bloating.

And let's not forget our hormonal friends. PMS can bring on a whole host of emotional and physical symptoms, including bloating, thanks to those monthly hormone shifts.

Functional medicine doesn't just stop at diagnosis – it's all about treatment too. From customized dietary strategies for SIBO to gut-healing protocols for dysbiosis, there are tailored approaches to help you reclaim your non-bloated self.

Testing plays a big role too. Breath tests for SIBO, stool analyses for dysbiosis, and hormone tests for PMS – they're all tools in our detective kit to crack the case of your bloating.

So, if bloating's got you feeling like you're carrying around a balloon in your belly, know this – you're not alone, and there's light at the end of the tunnel. With a bit of detective work and some functional medicine magic, that flat, non-gassy belly could be yours once again.

Functional Labs to Run for Bloating

SIBO & Carbohydrate Malabsorption

The best way to test for SIBO is through the breath since the bacterial overgrowth will produce certain gases that can be detected in the breath. We use glucose and lactulose to formally test for SIBO. 

Other substrates (fructose, sorbitol, etc) may be used to test for specific carbohydrate intolerances or malabsorption.

Dysbiosis

Stool tests such as the GI-MAP, biomesight, Dr. Data GI360 provide comprehensive analysis that measuring gastrointestinal microbiota RNA/DNA. We can evaluate various pathogens, including bacteria, yeast, viruses, and parasites. Looking deeper into the makeup of your microbiome will enable you to understand the overall balance. If sufficient diversity and beneficial microbes are present, then dysbiosis is unlikely. But, almost everyone nowadays has some degree of dysbiosis.

EIP

To diagnose pancreatic exocrine insufficiency, testing for Fecal Elastase-1 in the stool is necessary. Values under 200 are considered diagnostic for this condition. 

Food Sensitivities

There are a vast amount of food sensitivity tests available. The Cell Sciences ALCAT is unique because it measures food sensitivities and inflammation by testing for your white blood cell response to foods. This means that the only foods that will show up positive are ones that actually activate an immune response in your body. Testing this way typically reduces false positives, which significantly helps the compliance factor of an elimination diet (because fewer foods will need to be removed from the diet).

This is different than the more mainstream IgG tests which simply look for an elevation of IgG in response to foods. IgG will ALWAYS raise in response to food. That’s normal. This is why IgG food sensitivity testing has a high rate of false positives.

PMS

Because PMS is strongly related to hormonal imbalances, a thorough hormone test, like the DUTCH Cycle Mapping test, or DUTCH Complete may be warranted. DUTCH cycle mapping assesses the hormonal pattern throughout an entire menstrual cycle. This test uses dried urine, which is more valuable than a blood test that only detects levels at the moment of the blood draw. DUTCH Complete assesses your hormones and the pathways through which they are metabolized.