Introduction If you''re bloated and looking for solutions, you''ve come to the right place. In my gastroenterology practice, the Digestive Center for Women, I''ve helped deflate thousands of women and get them comfortably back into their skinny jeans--and chances are I can do the same for you. From air swallowing to yeast infections and everything in between, there''s always a reason for why you''re bloated. Some require just a simple fix, such as switching to a cough medicine that doesn''t contain codeine, giving an underactive thyroid a little bloat-busting boost, or identifying a soy allergy that''s filling you up with gas. Others are more complex, such as figuring out how to repair a damaged intestinal lining that might be leaking, rebalancing out-of-whack gut bacteria, or speeding up transit time through a sluggish colon. Understanding all the different factors that conspire to bloat you--and having a toolbox of integrative solutions to deal with them--is the key to banishing your bloat for good. Most of the things that bloat you are benign and fixable, but knowing the signs and symptoms of more worrisome causes that require immediate medical attention is also important. You''ll find essential information about those serious sources of bloating here, too.

The good news is you''re just a few pages away from identifying the root cause of your bloating. By the time you get to the end of this book, you should be as flat as a pancake. Let''s get started! Aerophagia It''s normal to swallow a little air when you eat or drink, especially if you''re drinking carbonated beverages such as seltzer, beer, soda, or champagne. But as the day progresses, if you feel like the Michelin Woman and fantasize about deflating your stomach with a pin (not a good idea!), you may be swallowing large amounts of air on a regular basis--a condition called aerophagia, which can lead to a massive buildup of gas in your gastrointestinal (GI) tract and major bloating. Aerophagia is incredibly common but very underdiagnosed, and it''s frequently confused with conditions such as ulcers, gallstones, and bacterial overgrowth that can also cause abdominal discomfort and bloating. Most people with aerophagia complain of three main symptoms: bloating, burping, and a tense, distended stomach that feels like an overinflated tire. If you have chronic sinus problems, a deviated septum, or a history of allergies or asthma, you may be a mouth breather rather than nose breather, which predisposes you to aerophagia. Chewing gum, sucking on hard candy, smoking, eating too quickly, talking when you''re eating, drinking lots of liquids with your meals, or holding your breath when you''re anxious can all cause aerophagia.

Eventually most of the air you''ve swallowed will get burped up or make its way through your GI tract and exit via the other end, but not without causing a lot of bloat in between. Solution If you''re bloated and think you may have aerophagia, try these tips: * Spit out the gum and hard candy. * Eat slowly and mindfully. * Don''t talk on the phone while eating. * Save drinking liquids for the beginning or end of the meal. * Drink flat, not bubbly, water and beverages. * Try some meditation if you feel anxious. * Practice taking deep breaths that expand your lungs, not your stomach.

* If you''re still feeling bloated, a speech pathologist may help you identify whether the problem is related to your speech, swallowing, or breathing patterns. Birth Control Pills Birth control pills (BCPs) contain various forms of estrogen that can be very bloating. If you''re on a high-estrogen BCP, deflating your midsection may be extremely challenging due to fluid and salt retention as well as weight gain. These pills are associated with insulin resistance, a condition that can interfere with your ability to lose weight, especially if you eat a lot of carbohydrates. If you already have a tendency toward insulin resistance or are prediabetic, you may be more likely to become bloated and gain weight from BCPs. Solution Weight gain of more than 5 percent of your total body weight after starting BCPs may be a sign of insulin resistance and should prompt a discussion with your doctor about a glucose tolerance test to diagnose it. Using an alternative nonhormonal form of birth control or choosing a BCP with the lowest amount of estrogen possible makes sense if bloating, weight gain, or insulin resistance is an issue. Ironically, going off BCPs can lead to temporary bloating and constipation due to ovulation starting again, especially if you''ve been on the pill for a long time.

Cruciferous Vegetables All gas and bloating is not created equal. Beans and cruci ferrous vegetables such as cabbage, cauliflower, kale, and broccoli contain potent cancer-fighting compounds and lots of healthy fiber, but they also contain a starch called raffinose that your body can''t fully break down and digest. Bacteria in your colon ferment raffinose and produce methane, which you may experience as bloating accompanied by smelly gas. This is what I consider good gas, though, because it''s accompanied by the health benefits that eating those foods confer. Solution I never recommend completely eliminating the "good gas" foods, because they contain lots of nutrients, but here are some things you can do to cut down on your gas when eating them: * If you haven''t been eating foods such as broccoli, kale, and cauliflower, start with a small amount and gradually increase your serving size to let your body get acclimated to them. * Add lemon juice to your good-gas veggies to stimulate digestive enzymes. * Soak dried beans overnight before cooking. * Avoid canned beans, which tend to cause more gas and may also contain a chemical called bisphenol A in the can lining, which has been linked to cancer and other conditions.

* Cook beans with a sea vegetable such as kombu (found at Asian markets and health food stores), which makes them more digestible because it contains the enzyme needed to break down raffinose. * Take Beano or Bean-zyme at the start of a meal; both contain a plant-derived enzyme that breaks down raffinose. * Eat a pinch (about â…› teaspoon) of fennel seeds or chew on a stalk of raw fennel at the end of a meal to benefit from its gas-reducing oils. You can also make fennel tea by steeping a teaspoon of crushed seeds or fresh fennel bulbs in a cup of boiling water for ten minutes, or you can add it to salads or cooked dishes.