Aoife Hearne: My teenage son feels bloated after eating 

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My 15-year-old is complaining about feeling bloated after eating, particularly after breakfast. He eats reasonably well, and his weight is average. What changes should I make to his diet?

Your first port of call should be to your GP’s office. There may be an easy fix to your son’s symptoms, but ruling out more serious conditions is a critical first step. Prior to this visit, it would be helpful to keep track of his meals and symptoms. This will provide your medical practitioner with some evidence and context for the bloating.

There are myriad supplements on the market selling solutions for bloating, and just as many offering diagnosis and treatment. Gut symptoms such as bloating, cramping, and irregular bowel habits can be symptomatic of irritable bowel syndrome (IBS) but also of a far more serious autoimmune condition, coeliac disease. The only way to diagnose coeliac disease is via a blood test for screening followed by a gut biopsy. According to the medical journal The Lancet, IBS is one of the most common functional bowel disorders and while prevalence between countries varies, 9% of people worldwide will experience symptoms.

Many non-regulated health professionals claim to diagnose food hypersensitivity via an IgG blood test. This blood test looks at IgG antibodies to specific foods in your blood. While this may seem like sound science, it is important to note that IgG antibodies are found in all healthy children and adults, even those who do not report sensitivities to food. According to the British Dietetic Association, no conclusive evidence supports this type of testing, and it is not recommended as a diagnostic tool.

Assuming the tests with your GP are negative, the next step is to visit a registered dietitian to get personalised support. Often a food exclusion and reintroduction approach will be implemented. According to a review by Christopher Black and Heidi Staudacher, this approach is superior to all other treatments for IBS. However, due to the complexity of this approach and the fact that well-balanced meals are still required, it is essential to get professional support and not go it alone. Evidence from The Journal of Gastroenterology and Hepatology suggests that this approach is most effective when under the guidance of a specifically trained dietitian.

Outside of any food-related changes, we also know that psychological factors such as stress and anxiety can play a role in some gut symptoms. This is because the gut and brain ‘communicate’ with each other through the gut-brain axis. Therefore, addressing any stresses or anxieties can also help minimise symptoms and be brought to the table when you meet with your GP.

Your homework, for now, is to start keeping a food and symptom diary and visit your GP for personalised support.

The two references below may be helpful:

• exa.mn/FODMAP-diet-IBS
• exa.mn/FODMAP-diet
  

• If you have a question for dietitian Aoife Hearne, please send it to [e-mail]