Why a swollen stomach after 60 is not normal aging
It is treated as a fact of getting older. Dr. Martin does not treat it that way. He treats it as a signal with a cause, and on this episode he names three things that change as we age.
Dr. Martin on the first one:
Dr. Martin, The Doctor Is In, Episode 684But one of the things that happens when we're older is we don't absorb as well.
He is not sentimental about it either. Asked what happens when you get older, his answer is that not that many good things do. This is one of them, and it is the premise of everything below.
What people actually describe
The pattern is usually the same. The stomach is flat enough in the morning. It swells after a meal, sometimes after every meal. By evening the waistband that fitted at breakfast does not. Often there is gas with it.
Before anything else on this page, say the obvious thing plainly. A stomach that stays swollen, swells quickly, or comes with pain, weight loss or a change in your bowels is something to have a doctor look at. This page is about the everyday after-meal kind, not a substitute for that appointment.
Change one: absorption drops
Absorption happens in the small intestine, and it can only work on food that has already been broken down properly on the way there.
He points out that the breakdown starts before any of that, in the mouth. Chewing. He says a lot of seniors do not chew properly because of their teeth, and that the food arrives at the stomach in worse shape than it should. It is not a glamorous observation, and it is the first link in the chain.
He calls the upper part of the digestive system one of the biggest problems he sees in older people, and in senior homes especially.
Change two: fewer enzymes
Dr. Martin on the enzymes:
Dr. Martin, The Doctor Is In, Episode 684We don't make as many enzymes as we used to, digestive enzymes, pancreatic enzymes.
Enzymes are what take food apart. Your body makes its own, from the gut and from the pancreas. Fewer of them and the same meal takes longer and gets further down the line in bigger pieces than it should.
Undigested food sitting where it should not be is what feeds the gas. That is the mechanical version of what a swollen stomach after a meal actually is.
Change three: less stomach acid
Dr. Martin on what follows from that:
Dr. Martin, The Doctor Is In, Episode 684And therefore, one of the things that happens, we don't have as much acidity in our stomach.
This is the one that runs against what most people assume, because heartburn makes everyone think the problem is too much acid. His reading is the other way around.
Dr. Martin on what a stomach should be:
Dr. Martin, The Doctor Is In, Episode 684You want your stomach to be like a furnace, very, very acidic.
A furnace mulches the food, as he puts it, so that by the time it reaches the small intestine there is something there to absorb. Without the acid you get the whole cluster he describes in older people: digestive trouble, and deficiencies in B12, vitamin A and trace minerals like zinc, because the food never got opened up. He makes the same point about people who have had gastric bypass surgery.
None of that is a reason to stop a medication. If you are on something for reflux, that is a conversation with the doctor who prescribed it.
The fibre mistake
The standard advice for a bloated stomach is more fibre. He says the opposite, and he says it from thousands of patients.
Dr. Martin on fibre when the gut is already unhappy:
Dr. Martin, The Doctor Is In, Episode 684One of the worst things you can do is eating too much fiber.
His line to patients with IBS, bloating and digestive trouble was to lay off the vegetables. Have a few, do not live on them. His reasoning is that you are irritating a gut that is already irritated, and he is blunt that you do not get a prize for the biggest amount of gas.
He is not telling anyone to give up vegetables permanently and he says so directly. The advice is for a gut that is currently bloating. Why some people bloat and some do not is its own episode: why do some people bloat and some don't.
Give the gut a rest
Dr. Martin on what to do, said twice on the episode:
Dr. Martin, The Doctor Is In, Episode 684Give your gut a rest.
That is what he means when he takes vegetables and fruit out for 30 days. Not forever. Long enough for the irritation to settle. Taking them out cuts the oxalates, the lectins, the insoluble fibre and the gluten all at once, which is why he does not try to work out which one is the culprit first.
Alongside that, the things that help the breakdown itself: chew properly, keep the meal smaller, and consider a digestive enzyme with food rather than hours after it. If constipation is in the picture too, he covers that in chronic constipation, what do I do.
Nothing here is a reason to start or stop anything a doctor has prescribed. Talk to your doctor first.
Common questions
What causes a swollen stomach in the elderly?
He points at three changes: we absorb less, we make fewer digestive and pancreatic enzymes, and we carry less stomach acid, so food is not broken down properly.
Is a bloated stomach normal as you age?
He treats it as a signal with a cause rather than something to accept. A stomach that stays swollen or comes with pain or weight loss should be seen by a doctor.
Does fibre help bloating?
He says the opposite for many people. If you already have gas, bloating and digestive trouble, he calls too much fibre one of the worst things you can do.
Do we make fewer enzymes as we age?
He says directly that we do not make as many enzymes as we used to, both digestive and pancreatic.
Should your stomach be acidic?
He says you want your stomach like a furnace, very acidic, so it mulches the food before it reaches the small intestine where absorption happens.
Read next: The Best Probiotic For A Woman Over 60, By Dr. Martin's Standard and Do Seniors Actually Need A Probiotic?.
Settle the gut down
Gut-Ease Formula is what Martin Clinic makes for a gut that needs calming, alongside the rest he describes rather than instead of it.
60-day money-back guarantee. See a doctor about any swelling that is persistent, painful, or comes with weight loss or a change in your bowels.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
