Expert: Dr. Kristina Conner - 12/8/2009

Question
Hi
I am a guy(41) with bloating in my lower abdomen, usually NOT accompanied by gas.My waist size can change by two belt buckles in a day and I'm not a big eater, I am 5'7", 175 lbs.
There is a lot of info about female bloating issues but nothing for guys.
My doctor had me try elimination diets for gluten and lactose but I still remained bloated, so,I dont think  it is a food issue.
He said I should try Beano and or yogurt.
Beano didnt help, but after a week of eating Activia I felt a lot better.
However, I dont like yogurt and had to gag it down and I also dont like sweets.
I am thinking about probiotic capsules but dont know where to start.
I have heard they are useless and get killed in your stomach before they reach your intestine? Also unless refrigerated they are no good?
Any thoughts on this truly appreciated!  

Answer
Hello Terry,
Thanks for your question.  You've already made a good start by doing a trial elimination.  There are other common sensitivities (eggs, fish, nuts, peanuts, soy, corn, sugar) so you might consider another trial eliminating those foods at some point.   Diets that are overall supportive for GI health are higher in water, fiber, such as fruits, veggies, whole grains, legumes, and low in refined foods & carbs, excess animal proteins, sugars, and additives.  So if your diet is not ideal startign to correct that will not only help with your current symptom but also ensure better health in the future.  
But if it occurs with all foods then it's likely some imbalance in the GI flora, and improvement when taking the fortified yogurt lends evidence to that idea. Taking a probiotic supplement is probably a better idea if you dislike yogurt, also the fortified yogurts still contain sugars & other ingredients that are not the best.  You want to look for a refrigerated supplement if possible, because they will decrease in numbers of bacteria if left at room temp, with a few exceptions.  It's not useless but certainly not as useful.  Same as for enteric coated probiotics--it's a better idea but regular caps are still effective.  You can find brands that offer either coating, so go with what your preference is or your budget allows.  I would suggest though you get through a health food store-- they tend to carry the better brands--rather than a drugstore, regular grocery store, or internet.  A combination of multiple strains, like Lactobacillus acidophilus, L. bifidus, and Bifidobacterium longum or lactis, is suitable for most people.  
Most people find that the probiotics will help within a couple of weeks, but if you take them for awhile & there's no major change, you may want to consider doing something more active to balance the GI flora (further dietary changes, or the use of agents to eliminate the harmful bacteria & re-establish the beneficial ones).  That would be the next step.  
In health,
Dr Conner