MRI research, published in Gastroenterology · Why "less gas" was never the answer
If your evening ends with trousers that sit too tight by the end of the day, this article is about you. A free five minute check shows which pattern your symptoms follow.
"By four o'clock my trousers don't fit any more. Same trousers, same me, same day."
If that sentence could be yours, you have probably been doing your own research for years.
Was it bread. Was it onion. Was it stress.
In your head you keep track of what you eat and how your belly reacts afterwards. And that list never adds up.
I am Jesse van der Velde. Not a guru and not a doctor. I read published research and I share what it says.
On this subject it holds something almost nobody gets to hear: the gas everyone points to barely differed, once properly measured, from the gas in people without complaints.
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The story you were sold is about amount. Too much air in your gut, so your belly swells out.
So: skip the beans, chew more slowly, take something that breaks the gas down.
When researchers finally measured that amount with an MRI scanner, it turned out to differ barely in people with complaints from the amount in people without complaints.
So every remedy you bought to bring that amount down was aimed at the very thing that barely differed in that measurement.
The wrong enemy here is an assumption: that what you feel has to match what is physically in your belly.
That assumption is wrong. And below you can read why.
In 2017 Gastroenterology published a study by Giles Major and colleagues, carried out in the United Kingdom between January 2013 and February 2015.¹
What was studied: whether complaints after fermentable carbohydrates come about because more gas is formed, or because people feel the same amount differently.
How: 29 adults with persistent abdominal complaints and 29 without those complaints drank a 500 ml glass containing 40 grams of one single carbohydrate each time, on 3 separate days at least 7 days apart: glucose on one occasion, fructose on another, inulin on the third, in random order. The contents of their intestines went into the MRI scanner ahead of each glass and again once it was drunk, breath tests tracked the fermentation, and the complaints were recorded for 300 minutes each time.
The findings: within the same group of 29 people with symptoms, 13 came above the symptom threshold set in advance after the inulin, 11 after the fructose and 6 after the glucose. The MRI showed that in both groups the fructose increased the fluid in the small intestine, and in both groups the inulin increased the volume and the gas in the large intestine. After drinking, the people without symptoms scored lower on symptoms than the people with symptoms, at comparable MRI values and comparable breath tests.
Read that last sentence again.
Inside, almost the same thing happened in both groups. The difference was in what the people noticed of it.
What this study cannot say: 29 and 29 people, one British centre, one glass at a time. About how you eat day to day it says nothing, and the numbers 13, 11 and 6 stand in the publication without a p-value.
The researchers concluded themselves: the symptoms did not come from more gas forming, but from the large intestine of these people reacting more sensitively to stretching. Call that your "gut sensitivity".
That same year a review article by Malagelada, Accarino and Azpiroz appeared in the American Journal of Gastroenterology.
What was studied: how a bloated belly actually comes about, and why the common explanation falls short.
How: no new research. No participants. No measurements. Not a single number. Three researchers from Barcelona set out what the literature says. That is expert knowledge put in order, and so it is not proof.
The findings: the "bloated feeling" and the "visible distension" are two different things. The feeling is a symptom you experience, the distension is a sign that can be measured on the outside, and the two can stand apart from each other. What plays a part in each person can, according to these authors, be measured in stubborn cases at a specialist centre: the transit of your gut, the sensitivity of your gut wall and the activity of your abdominal muscles. Further clues come from a detailed dietary history and from how often and how firm your stools are.²
The review adds something to that: with a bloated belly, the first thing to check is whether a physical cause sits behind it. That is work for your doctor.
Your trousers at four o'clock and the identical complaint from your colleague can have a different cause.
That explains why years of trying things out on your own produced nothing.
You skipped the bread, and for a few weeks that seemed to make a difference. You skipped the onion, and the effect faded away. Nothing stayed reliable.
Because you kept track of only one thing: what is on your plate. What this research points to, your gut sensitivity, was nowhere in your list.
Does this sound familiar? Take the free check now.
Our scientifically validated questionnaire gives you answers
40.3 per cent. In 2021 Gastroenterology published the Rome Foundation Global Study.
What was studied: how often 22 ongoing stomach and bowel complaints occur, in 33 countries on 6 continents.
How: 73,076 adults, 49.5 per cent of them women, were given the Rome IV questionnaire, together with the older Rome III questions and 80 questions about additional factors. In 24 countries over the internet, in 7 countries in a face to face interview, in 2 countries in both ways.
The findings: of the people who filled in the internet version, 40.3 per cent met the criteria for at least one of those complaints.³
And now the number behind that number. The same questionnaire, the same study, but taken in person: 20.7 per cent.
The same question. A different way of asking. Roughly half the outcome.
Somewhere between one in five and four in ten adults walk around with this. It does not get more precise than that. And it stays a questionnaire: a doctor examined no one.
20.6 per cent. In 2018 the American Journal of Gastroenterology published a survey of 71,812 Americans.
What was studied: how many Americans had stomach and bowel complaints in the past week, and which ones.
How: through an app, MyGiHealth, with the questionnaires of the American National Institutes of Health. Look back period: 7 days.
The findings: 61 per cent had at least one symptom that week. A bloated belly came third at 20.6 per cent, after heartburn at 30.9 per cent and abdominal pain at 24.8 per cent.⁴
What that means for you: about one in five people in that survey reported the same.
And where it stops: people filled this in themselves on their phone, in the United States, over 7 days. About cause it says nothing.
13 versus 6. Out of the same 29 people with symptoms, 13 came above the symptom threshold after the inulin and 6 after the glucose, while the MRI images and the breath tests of those who did and did not react were comparable.¹
So in that study the difference was not in the gas production.
You know this moment.
You are sitting in a restaurant. The menu arrives. You are not reading dishes, you are making estimates. The pasta: probably safe. The soup: no idea what is in it. The salad with raw onion: not tonight.
And in the background that one thought that has been sitting there for years: "everyone at this table is just ordering food."
All that guessing costs you energy every time, and it gets you nothing.
Because all those years you have been busy with what is on your plate, while the research shows that it is about the sensitivity of your gut wall.
That is why your list never added up. You were keeping track of the wrong thing.
That is down to the method. Not to you.
The remedies for gas. Whether you use them is of course up to you.
But be clear about what they aim at: the amount of gas in your gut. They go no further. About the sensitivity of your gut wall they change nothing. And it is exactly that amount that was measured in the MRI study, and there it barely differed from the amount in people without symptoms.¹
So in that study the researchers found no excess of gas to take away.
Cutting out foods, one by one. Whether you leave something out is of course up to you.
But know what you are doing. If you do it alone, with lists from the internet, your list of forbidden foods gets longer and longer. In a few weeks it will also hold the food that still seemed safe today. You have noticed that yourself already.
Chewing more slowly, eating standing up, the whole etiquette. Harmless, and now and then sensible. But it tells you nothing about the question that matters: in your case, is it the contents of your gut, the transit, the sensitivity of your gut wall or the activity of your abdominal muscles that plays a part?²
Three remedies, one shared problem: not one of them makes clear which of those four is at play in you.
The problem is in the remedies you have tried, they fall short. Not you, it is not your fault. It can be different.
Four mechanisms come out of these two publications.¹ ²
With all four, the outside looks the same: those same trousers that no longer fit at four o'clock. With each of them, the sensible next step lies somewhere else.
So the first step is not another remedy. It is an ordered analysis of your own pattern: what happens, when, after what, and what it coincides with.
One condition. That analysis has to take in your whole pattern and not one separate symptom. In the MRI study the difference only came out when the measurements and the participants' symptoms were laid side by side.¹ With the scanner alone it could not be seen.
So your analysis has to take in two things: what happens on one day, and what changes over several weeks.
An analysis like that is something other than buying something. It costs you no willpower and it forbids you no food.
It only leaves you knowing more than you knew this morning.
BioProfile has built that analysis. A scientifically validated questionnaire, five minutes, free and without an account.
It maps which symptoms you have, when they come and what they coincide with, and shows which signals speak loudest in your profile. That gives your next step a direction.
Not a medical examination. An analysis of your own answers. You use the outcome yourself, or you put it on the table with your doctor or your coach.
The list in your head never reaches a conclusion. This analysis does.
You have been doing your own research into your own belly for years. Five minutes give you an outcome for the first time instead of a hunch.
Take the free check. No account, and there is nothing to buy.
At four o'clock this afternoon you will know more about your own pattern than after every anti-gas remedy you have ever bought.
One more evening of guessing costs you more than those five minutes.
Our scientifically validated questionnaire gives you answers
The scan is not a medical examination. It is an analysis of your own answers. If complaints persist, consult your doctor.
