Getting older is often accompanied by positives like a greater sense of self, improved confidence, and an expanding family. Unfortunately, journeying through middle age can also be accompanied by increased incidences of belly bloat.
Data from a 2023 study published by Clinical Gastroenterology and Hepatology found that bloating becomes more common as individuals progress through middle age, with those aged 50 to 59 at the highest risk.
Ahead, we’ll break down the most common reasons why bloating becomes more of a mainstay as people reach middle age.
- ABOUT OUR EXPERTS: Leslie Greenberg, M.D., M.S.C.P, is a physician with Pandia Health, which specializes in women’s hormonal care. Michael O. McKinney, M.D., is a women’s health and weight loss expert with Healthy Outlook Weight Loss Clinic in Jacksonville, FL. Lisa Richards C.N.C., is a nutritionist from Alberta, Canada, and founder of The Candida Diet, a platform dedicated to helping people with gut issues.
Bloating Explained
At its most distilled, bloating is trapped gas, says Leslie Greenberg, M.D., M.S.C.P, a physician with Pandia Health, which specializes in women’s hormonal care. “It’s excess air in the intestinal tract that creates a sensation of abdominal fullness or pressure,” she explains. Often, bloating is accompanied by additional symptoms, such as abdominal pain, bad breath, early satiety, and nausea.
Crucially, while bloating and belly fat can both create a distended abdomen and fuller appearance, the difference is that “bloating will decrease after a bowel movement or passing gas whereas belly fat remains regardless of bowel movement or passing gas,” Greenberg notes. Further, while belly bloating can come on suddenly—after a single meal, for example—weight gain is put on gradually over the course of weeks, months, and years, adds women’s health and weight loss expert Michael O. McKinney, M.D., a provider with Healthy Outlook Weight Loss Clinic in Jacksonville, FL.
Diet Is The Most Common Cause Of Bloating
If you’re in the business of finger-pointing, you can probably aim your index at your kitchen. Specifically, at the high-fiber foods in your fridge and pantry, according to McKinney.
Across all age groups, he says the most common bloat-inducing, high-fiber foods include:
- beans
- lentils
- broccoli
- Brussels sprouts
- cabbage
- cauliflower
- onions
These and other high-fiber foods are harder to digest than lower-fiber foods, McKinney explains. As a result, the bacteria in the colon have to work overtime to break the foods down. They produce hydrogen, carbon dioxide, and methane gasses in the process. Further, since high-fiber foods are harder to digest, they spend more time in the GI tract, which results in more gas production than usual.
To be clear: The solution isn’t to forgo high-fiber foods. You absolutely want fiber in your diet, as it adds bulk to your stool, absorbs water, and generally makes excretion easier. Consuming adequate amounts of fiber daily—38 grams for men and 25 for women—also benefits GI health, decreases cholesterol, boosts metabolism, and supports heart health, all of which are of special concern for older adults. Unfortunately, one 2024 study published in Appetite found that many older adults already under-consume the vital nutrient.
Read More: How To Make Supplementing With Fiber More Enjoyable
So, rather than forgoing fibrous foods, the key is to consume adequate water throughout the day and eat slowly. Drinking eight to 10 glasses of water daily is thought to help keep fibrous foods soft, decreasing the risk that stool will be too hard and essentially get “stuck” in the GI tract. Meanwhile, chewing more thoroughly and eating slowly can reduce your likelihood of ingesting air as you eat.
Drinking Habits Can Lead To Bloating, Too
It isn’t just what’s on your plate that can lead to bloating—what’s in your cup can, too. Bubbly drinks like soda and seltzer often use something called hydrostatic pressure to create bubbles, which can lead to excess air in the digestive system once consumed, explains McKinney.
Meanwhile, alcoholic beverages can irritate the gastrointestinal tract and lead to unwanted symptoms like bloating, according to research published in Alcohol Research. This is mainly because alcohol is an inflammatory agent and can keep the protective mucus lining the GI tract from working quite as effectively, while also throwing off the balance between “good” and “bad” bacteria that help keep bloating at bay.
Fruit drinks like orange juice, grape juice, and fruit punch may also cause bloating. The reason? Usually, they contain two types of sugar known as sorbitol (sugar alcohol) and fructose, neither of which are properly absorbed by the GI system, according to research published in Gastroenterology & Hepatology. Increased gas production is a common side effect when your system attempts to digest these sugars, the researchers say.
For individuals who are sensitive to carbonated beverages, alcohol, and/or fruit drinks, the easiest solution is to limit intake. If you do continue to occasionally consume these beverages, drinking plenty of other non-irritating fluids (like water) ahead of time can aid in their digestion.
Age-Related Culprits
What goes in your belly may be the most common—and obvious—cause of bloating in people of all ages. But for older adults, there are a few other common culprits.
1. Menopause
Hot flashes and night sweats may be the hallmark symptoms of menopause, but bloating is a common occurrence during this transition, too.
The estrogen-level fluctuations that occur during this life stage cause changes in every part of the body, including the gastrointestinal tract, says Greenberg. You see, the gut contains estrogen receptors that support digestion. So “the drop in estrogen that occurs around menopause can slow down gastrointestinal function and contribute to individuals feeling bloated,” she explains.
Read More: Your Guide To Menopause—Signs, Symptoms, And Solutions
Estrogen is also involved in regulating water and minerals throughout the body, adds McKinney. When levels of the hormone ebb and flow, it impacts body fluids and can lead to swelling of the limbs and abdomen, he says.
Notably, “bloating during menopause can also be exacerbated by other factors typical of midlife, such as changes in diet,” says Greenberg. Plus, “abdominal fat gain, which is more common during menopause, can also make bloating more noticeable or uncomfortable.”
There isn’t a one-size-fits-all approach for managing menopause bloat, says Lisa Richards C.N.C., a nutritionist from Alberta, Canada, and founder of The Candida Diet, a platform dedicated to helping people with gut issues. However, “addressing menopause-related bloating usually involves a combination of dietary changes, physical activity, and lifestyle modifications,” she suggests. Eating a balanced diet, drinking enough water, limiting sugar and refined carbohydrates, continuing to engage in regular physical activity, and prioritizing stress management and quality sleep can all reduce bloating and improve overall health during this stage of life. (Here’s some info on how to keep menopause from wrecking your sleep.)
If you’re experiencing additional menopause symptoms—or the frequency or severity of your bloating is interfering with your quality of life—talk to a menopause-informed provider. They may decide that you are a good candidate for hormone replacement therapy (HRT), which some women report alleviates symptoms of bloating.
2. New food intolerances
If you’ve long assumed that all intolerance to foods or food groups start when you’re a kiddo, you’ve been misled. It’s actually quite common for older individuals to become intolerant to foods they used to digest with no problem, according to McKinney. For instance, it’s common for individuals to become lactose intolerant around middle age—and the average age for celiac disease diagnosis is 40 to 60 years old.
“The sensitivity of the digestive system tends to increase as an individual ages,” McKinney explains. Meanwhile, the body reduces its production of certain digestive enzymes, which can make it more difficult to digest certain foods.
Given this, if you’re experiencing bloating after foods that never used to bother your stomach, you’d be wise to chat with an allergist, immunologist, or gastroenterologist. Ditto if you are experiencing other symptoms of food intolerance, such as stomach pain, headaches, rashes, a runny nose, or swelling. They can help you figure out what’s going and recommend dietary tweaks to keep discomfort at bay (which may or may not include enlisting the help of certain digestive enzymes, like lactase, probiotics, or other gut support supplements).
3. Low level of physical activity
Less than 17 percent of Americans age 50 and older hit the recommended 150 minutes of moderate-intensity aerobic exercise and two strength training sessions per week, according to research published in the journal Preventing Chronic Diseases.
The problem here is that, in addition to contributing to the risk of many chronic diseases that occur in older adults (including heart disease, stroke, diabetes, lung disease, Alzheimer’s, hypertension, obesity, and cancer), lack of physical activity can also cause bloating.
How and why lack of exercise can contribute to bloating is multifactorial. For one, strength exercises build metabolically-active muscle, according to Richards. As such, individuals increase their rate of digestion as they put on muscle mass, ultimately limiting the amount of time the food spends in the GI tract. Research published in Adipocyte found a direct relationship between muscle hypertrophy (a.k.a. growth) and faster metabolic processes.
Read More: How To Adjust Your Strength Training Game As You Age
Meanwhile, aerobic exercise—especially high-impact aerobic exercises like running, dancing, or hiking uphill—literally jostles the gastrointestinal system, which can help keep food and waste products moving and grooving. In fact, research published in The American Journal of Gastroenterology found that mild physical activity enhances intestinal gas clearance and reduces symptoms of abdominal bloating.
Your move? “Find a way to safely engage in regular physical activity, including aerobic exercise (like walking, swimming, or cycling) and strength training,” suggests Richards. If you are currently sedentary or have any pre-existing mobility constraints, other physical limitations, or health issues, talk to your healthcare provider. They can help you create a fitness routine that works for your body and needs.
If you’re having a tough time staying motivated once you start, The National Institute on Aging recommends exercising first thing in the morning, combining movement with something you enjoy (like talking on the phone, listening to music, or being outdoors), and keeping track of movement and progress with a fitness journal or tracker.
4. Side Effects Of medications
Lastly, the cause of your bloat could be hiding in your medicine cabinet. Bloating is a common side effect of many prescription and OTC medications folks are more likely to take as they age, according to Greenberg. “Common medications that can cause bloating include nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, calcium channel blockers, metformin, corticosteroids, antidepressants, and certain antibiotics,” she says.
The exact mechanism through which medications interfere with GI function varies. Some medications slow down digestion and thus contribute to constipation and bloating, she says. Opioids and anticholinergic agents, for example, have been shown to lessen movement of the gut muscles. Meanwhile, recent research published in Cureus found that other medications—such as neuropathic pain agents, dopamine agonists, antipsychotics, nitrates, nonsteroidal anti-inflammatory (NSAIDS), steroids, angiotensin-converting enzyme (ACE) inhibitors, and insulin—cause fluid retention (medically known as edema), which is a form of bloating.
“If you experience bloating as a side effect of a drug you’re taking, speak with your doctor,” says McKinney. And do it before making any edits to your medicine line-up. “They will be able to help you come up with an action plan to relieve bloating, which may include increasing, decreasing, or changing medications, as well as recommend additional lifestyle interventions,” he says.
When To See A Pro
If you regularly experience symptoms of bloating, talk to a gastroenterologist or other healthcare provider, suggests Greenberg. They can help you figure out the underlying cause of your unwanted ballooning.
Depending on your specific symptoms and individual factors like age and sex, the diagnostic process could include skin or blood allergy testing, a blood or urine sample for estrogen or other hormone testing, or imaging testing (like a CT scan or MRI) to look for any underlying gastrointestinal diseases or conditions.
At some point, your beat-bloat journey might involve consulting with a nutritionist to parse through dietary factors that could be contributing to your discomfort and make a plan for deflating. This could include switching up what’s on your plate, incorporating supplements that support gut health (these are particularly beloved for their bloat-busting effects), and more.
In the event that your bloating is accompanied by additional symptoms, such as abdominal pain that wakes you from sleep, vomiting, severe abdominal tenderness, unintentional or extreme weight loss, and/or blood in stool, don’t wait for the next available appointment at your local gastroenterologist, says Greenberg. Instead, go to the emergency room or otherwise seek immediate medical advice. These additional symptoms could signal a serious underlying issue, such as cancer, chronic infection, or bowel obstruction.