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Practical Tips to Reduce Bloating
By Sonya Worthy Okolo, PT, PRFS
Abdominal bloating and distension are amongst the most common gastrointestinal (GI) complaints experienced by many people with Irritable Bowel Syndrome (IBS), Constipation, Endometriosis, Adenomyosis, and other gut-brain interaction disorders.
These symptoms can result from several overlapping mechanisms including:
- Diet
- Constipation
- Hypersensitivity of nerves in abdominal wall
- Muscle coordination issues like abdomino-phrenic dyssynergia (a mismatch between the diaphragm and core muscles containing abdominal pressure)
- Muscle coordination issues like pelvic floor dysfunction (pelvic floor muscles that fail to relax during bowel movements can impair gas and stool evacuation)
Abdominal bloating is rarely about just gas. It’s a neuromuscular and biomechanical problem in many people, especially those with pelvic floor dysfunction or IBS-like disorders.
How Can Pelvic Floor Therapy Help with Bloating?
1. Improves Pelvic Floor Muscle Coordination: When the pelvic floor doesn’t relax properly during defecation or gas passage, stool and gas can become “trapped,” worsening bloating.
Practical tip: Practice relaxation by visualizing pelvic floor muscles widening and lengthening…think “let the pelvic floor soften as I breathe in.”
2. Address Breathing Patterns: When breathing patterns are altered due to stress, pain, posture, or muscle imbalance, the diaphragm may move inefficiently. This can disrupt abdominal pressure control and contribute to distension.
Research has shown that people with pain or muscle imbalance often have abnormal diaphragm positioning and movement.
Practical tip: Practice diaphragmatic breathing daily: Lie on your back with a book on your belly. Breathe slowly in through the nose, aiming for belly rise under the book (not chest).
3. Restore Thoracic Spine & Ribcage Mobility: If the thoracic spine is stiff, breathing mechanics change — often increasing strain on the abdominal wall. Restricted rib mobility can contribute to pressure mismanagement and visible bloating.
Practical tip: Lie over a foam roller or ball for 2-3 minutes daily. Perform ribcage breathing with hands behind the head working to expand fully.
4. Core Muscle Retraining: The Transverse Abdominis “TA” is often called the body’s “natural corset” which regulates abdominal pressure and stabilizes the trunk. When the TA is poorly coordinated, whether from weakness, habitual bracing, or breath-holding, pressure becomes dysregulated. The abdomen may bulge outward instead of being gently supported.
Practical tip: Exhale slowly. Gently draw the lower abdomen inward about 20–30%. Keep breathing. Core training should be gentle, avoiding excess tension, and emphasizing coordination with breathing and functional integration (such as bend, lift).
While pelvic floor dysfunction and breathing mechanics are often overlooked, diet remains a core contributor. Research shows that a low-FODMAP diet—one that eliminates fermentable carbohydrates—can significantly reduce bloating and abdominal distension in people with IBS and related conditions. It’s best to work with a dietitian to guide the elimination phase, which typically lasts 4–8 weeks. During this time, track any symptom triggers, then gradually and systematically reintroduce foods to identify what your body tolerates.
By combining these physical strategies with dietary adjustments, you address both the root muscular and dietary contributors giving you a practical roadmap to feel lighter and more comfortable.
Sonya Worthy Okolo, PT, PRFS is a licensed Physical Therapist with more than 30 years of experience. Located in the suburbs of Washington, DC., she is the founder of Oasis PT & Pelvic Health offering holistic pelvic floor therapy for all genders and life stages. The Oasis Team offers a personalized, comprehensive care plan specializing in pelvic pain, pregnancy and postpartum care, core recovery, bladder and bowel concerns, sexual health, and optimization of fertility. To determine if we are the right fit for you, contact our office to set up a free 15 min consultation.
