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Bloated All the Time? Why It Happens and What Helps
By Alexis Brooks, Integrative Women’s Health Dietitian
For a couple of years, I planned my outfits around my belly. I’d eat lunch at work, and by afternoon I looked pregnant. If I wasn’t getting off until 7 or 8 at night, I’d put a jacket on to cover it, and on a stressful day I’d think about that before I even got dressed. It was embarrassing, but it also hurt. The distension was uncomfortable, and I didn’t want anyone asking if I was pregnant.
If you have endometriosis, you may know this as endo belly. It’s not a medical diagnosis, just the name the endo community uses, but the bloating behind it is real and has causes worth looking into. You don’t need endometriosis to deal with it, either. Bloating and constipation show up with PCOS, fibroids, interstitial cystitis, pelvic floor tension, IBS, and plenty of people with no diagnosis at all. It’s one of the top things people bring to me, and it’s easy to get brushed off about. So wherever you’re starting from, keep reading.
My own bloating started about a year before my endometriosis diagnosis and lingered for about a year after. Gluten was a big trigger, and for the year following my diagnosis, I couldn’t tolerate it at all. Pasta, bread, barley, the form didn’t matter. I’d bloat within about two hours. But food wasn’t the whole story. Stress at work was affecting my nervous system too, and that mattered. Things only turned around once I figured out what was actually going on and addressed it. Today I eat all the things with no digestive issues.
Why bloating and constipation happen
It’s usually not one thing. Inflammation, hormone shifts across your cycle, a pelvic floor that cannot fully relax, and a gut that’s working overtime all pile on top of each other. Constipation makes it worse, because when stool is backed up, gas has nowhere to go. For a lot of people, the balance of bacteria in the gut is off too. More on that below.
Read your pattern
When the bloating happens tells you a lot.
Cyclical: If bloating is worse before or during your period, hormones and inflammation are likely involved
After meals: If bloating worsens after eating, it’s often about how you’re eating (fast, stressed, distracted) or foods your gut is struggling with
Keep a simple log for two weeks: what you ate, how you ate it, where you are in your cycle, and your bowel movements. Patterns show up quickly.
Start by slowing down
I always start with the nervous system. Digestion works best when your parasympathetic nervous system, the “rest and digest” side, is running things. If you eat in a rush, or while you’re scrolling or stressed, your body stays in fight or flight mode and digestion slows down. Slow digestion means more gas and more bloating.
Here’s what I tell people to do. Before your first bite, take 60 seconds. Breathe slowly into your belly, or think of something you’re grateful for. Then chew thoroughly and put your fork down between bites. It feels too simple to matter, but it’s what gets your body ready to digest.
Then build the basics
Raise fiber slowly. Add one new fiber-rich food at a time, such as cooked vegetables, berries, oats, chia, or flax, and give it a few weeks. Increasing fiber too quickly can make the bloating worse
Drink enough fluid. Fiber needs water to move through, so sip across the day
Look for suspected triggers. Skip the big cuts. Notice which foods line up with your flares and pull back on one at a time
Move a little. A short walk after meals helps, and so does gentle pelvic floor relaxation
One thing I’ll defend: this isn’t all about removal. Many of the people who come to me are undernourished, and they need more nourishment, not less. I don’t believe in good foods and bad foods, either. If you can’t tolerate something right now, that doesn’t mean you never will. Where you are today doesn’t have to be where you stay.
When the basics aren’t enough
If you’ve done all of this and you’re still bloated, the next question is why. Your microbiome (the community of bacteria in your gut), may be out of balance. That’s called dysbiosis. Overgrowths like SIBO (small intestinal bacterial overgrowth) and SIFO (small intestinal fungal overgrowth) can contribute too, though testing and terminology vary, so a practitioner should help you sort through it.
Cutting out trigger foods can bring relief. But it doesn’t explain why those foods bother you to begin with. Low stomach acid, high stress, too little fiber, or a narrow diet can all set up an environment where dysbiosis thrives. If you only manage the symptom, the bloating tends to come back, which is why we need to figure out what created the problem in the first place.
What this looked like for one client
A client came to me about two months before her endometriosis surgery. She cooked nearly everything from scratch and avoided a long list of ingredients. She was on a low FODMAP diet, which kept things from getting worse but wasn’t giving her much relief. She was still bloated and constipated, and her list of safe foods kept shrinking.
We didn’t just cut more. We figured out her triggers, built her meals around everything she could eat, and added foods back wherever we could. We worked on her nervous system, her blood sugar, and anti-inflammatory foods, and we went after the dysbiosis with targeted gut support, supplements, and lifestyle changes.
Her constipation resolved. She started having a bowel movement every day, and her period pain eased too. The bloating improved a lot, and she could eat more foods again. What she missed most was going out to dinner with her husband. They used to have weekly dates, and once she had a strategy in place, she got them back. She went on to have her surgery and had support through her recovery too.
When to see your doctor first
See your healthcare provider promptly if your bloating is new, constant, or getting worse, or if it comes with any of the below. These need medical evaluation, whatever the cause turns out to be.
Pelvic pain that is persistent or severe
Feeling full very quickly when you eat
Unexplained weight loss
Blood in your stool
- A lasting change in your bowel habits
If none of those fit, but the basics haven’t helped after a few weeks, that’s your cue to dig deeper. A full workup and a plan built around your body is what finds the cause.
Where to go from here
If you’re looking for further support, join the free Ask Nomi community, where we talk about nutrition, pelvic floor health, movement, and lifestyle to support endometriosis. Inside, there are series that go deeper on topics like this one, and a place to ask questions and hear from people who get it. And when you’re ready for one-on-one help, I’d love to work with you.
Alexis Brooks, founder of Alexis Brooks Nutrition, is an Integrative Women’s Health Coach and Registered Dietitian with 13 years of experience. Inspired by her personal journey with endometriosis, she empowers women to understand their hormones, embrace self-care, and take control of their health.