Bloated Stomach: Why Your Belly Looks Distended

Do you often feel bloated after meals?

Do you notice your stomach looks distended after eating or when you are stressed?

Do you have chronic constipation?

If you have been dealing with any of these symptoms and have been told it’s your diet but you have not seen changes, it is possible the cause may be something else.

In the world of pelvic health, we have to be core experts because the pelvic floor is part of the core. The abdomen and the respiratory diaphragm are part of the core as well. Issues dealing with digestion often affect the pelvic floor and are in our wheelhouse of care of pelvic floor physical therapists.

How is this related to bloating? It is now coming out in the research that bloating and distention can have biomechanical components to them. 

In order to understand this, you must first understand the true definitions of bloating and distention, as they are different.

Bloating is the sensation of discomfort with normal changes of gas and liquid at the lumen. Studies have shown that for folks with complaints of bloating, no increased volumes of gaseous content was found upon imaging. 

This discomfort usually results from the GI system becoming sensitized to changing sensations. This can come from inflammation, surgery, or trauma. The nervous system is deeply connected to gut dysfunction.

Distention, on the other hand, is the actual physical change in the abdominal wall. With distention, the abdominal wall becomes relaxed and gives the appearance of a bigger belly. 

This response can often come hand in hand with bloating. It makes sense because your brain often wants to move away from areas that are painful or uncomfortable. So, if you have discomfort from a bloating sensation, the brain will tell the abdomen to move away from the GI system to create space and decrease the sensation.

This change in the abdomen wall can lead to a biomechanical issue called abdomino phrenic dyssynergia.  When the abdominal wall relaxes, the respiratory diaphragm begins to contract to compensate for the abdominal wall that is no longer playing its role of helping to stabilize the trunk.

When the diaphragm starts to act like a postural control muscle more than a respiratory muscle, you loose the help and pressure of the respiratory function to actual pump gas through and help facilitate digestion. You also loose the ability to coordinate and relax the pelvic floor with the help of the diaphragm, which can contribute to pelvic floor dysfunction with bloating.

So, how do you treat this?

One of the most important things in abdomino phrenic dyssynergia is to retrain the respiratory diaphragm on how to relax and the abdominal wall on how to contract, when appropriate.

At Bodyful, we do a combination of hands on fascial work at the diaphragm and abdominal fascia to help facilitate changes via mechanoreceptors, and then follow up with individualized exercises that retrain the coordination of the abdomen and the diaphragm.

The key components to treat this are proper diaphragmatic breathing practices and coordinated transverse abdominus activation.

Interested in learning more? Reach out to us today to work with us!