Q: Thanksgiving is my favorite holiday, but it always leaves me feeling bloated, gassy and uncomfortable afterward. Are there any ways to avoid those symptoms while still enjoying the best meal of the year?
Every Thanksgiving, I find myself staring at the dining table, suddenly helpless in front of the steaming potatoes au gratin, sizzling glazed turkey and God’s gift to digestive juices, my mother’s corn pudding.
I’m a gastroenterologist who should know how to avoid the inevitable belly pain, bloating, nausea and heartburn that follows, but even I am no stranger to holiday-induced gastrointestinal distress.
Health care workers have long observed, at least anecdotally, that emergency room visits increase on Thanksgiving and the following days for stomach-related issues (as well as cooking injuries, heart attacks and alcohol-related accidents).
“People always feel bloated and uncomfortable after holiday meals,” said Dr. Baha Moshiree, a gastroenterologist at Atrium Health in Charlotte, N.C., who studies how the stomach empties. But with a little planning, she said, you can keep those symptoms at bay.
What can I do during the meal to avoid stomach problems later?
The key, Dr. Moshiree said, is to take care with how and what you eat and drink.
Chew well and slow down. After you chew your food, it travels down your esophagus and into your stomach, where it is further broken down by stomach acids and muscle contractions before passing through a tiny sphincter into the small intestine.
But if you don’t chew your food into tiny enough pieces, your stomach will take longer to break them down and empty itself and will stretch to accommodate the food. If stretched for too long, your stomach will send fullness and nausea signals to the brain.
To avoid this feeling, experts recommend chewing your food well and slowing yourself down. “Try to eat smaller amounts every two to three hours throughout the night,” Dr. Moshiree said. “That’ll be better than one big binge, because a huge meal will sit in your stomach for a long time.”
Eating slowly will also give your gut time to send fullness signals to the brain, said Dr. Nicholas Talley, a professor of medicine at the University of Newcastle Australia and an expert on the gut-brain connection. It takes about 20 minutes for the hormones that control appetite to get released from the small intestine and travel to the brain, where they lead to “sensations like feeling full,” he said.
Mindful eating — a technique that encourages you to slow down and savor the textures, aromas and flavors of your food — can also help.
Limit high-fat, high-fiber foods. Foods that are high in fat (cheesy, butter-soaked potatoes) and fiber (brussels sprouts, peas) take longer to digest than carbohydrates, so loading your plate with too many of them can lead to stomach pain or nausea.
Foods rich in insoluble fiber, like broccoli, beans, onions and fruits, are also classic offenders for bloating, so limiting them can help, especially if they’ve given you trouble in the past. Diet sodas cause bloating too, Dr. Talley said — “they’re the absolute worst” — so he advised steering clear of them.
If the menu has soup, starting with it can help because liquids make you full, but they also empty quickly and are easy on the stomach, Dr. Moshiree said. The same can be said of the holiday’s main attraction. “Turkey has lots of protein and is easily digestible,” Dr. Moshiree said, so in normal portions it is not an issue. Protein is also a key factor in signaling to your brain that you are full, so loading up early on turkey can help prevent you from overeating by making you feel full sooner.
Constipation can also play a big role in bloating, Dr. Talley added, so getting into a regular bowel pattern well before Thanksgiving Day can help ensure that food keeps moving along after it passes through the stomach. Ramping up your exercise or increasing your fiber intake can help you become regular well before the big day.
Imbibe carefully. Dr. Moshiree also recommended thinking twice before that next glass of wine. “Alcohol can delay gastric emptying, so you may have more symptoms if you add that into to the mix,” Dr. Moshiree cautioned. Studies suggest that red wine and beer can delay gastric emptying after even just one or two standard drinks.
Load up on water. Drinking lots of water is essential. If you don’t drink enough water during a big meal, your small intestine must pull fluid from the rest of your body into the gut, leaving you dehydrated and sluggish.
It’s too late. I overate. Now how can I feel better?
One of the most common symptoms of overindulgence is heartburn, a burning sensation in the chest that results from acid reflux, or stomach acid hitting the esophagus.
“Most of us have acid reflux when we eat a lot,” Dr. Moshiree said. “The valve between the esophagus and stomach becomes overwhelmed, and there’s nowhere else for this food and acid to go but up.” She said that over-the-counter antacids like Gaviscon (she prefers the liquid formulation, which coats the esophagus) or histamine-2 blockers (like Pepcid) that reduce acid production can help with heartburn.
Peppermint oil, commonly taken in capsule form, can relax the muscles in the gut and has been shown to relieve bloating and discomfort. There haven’t been any studies on peppermint tea, though it is often recommended by gastroenterologists. And one small study found that smelling peppermint extracts and oil can reduce nausea. Just take care if reflux is your main issue, since peppermint can sometimes trigger heartburn (as can coffee, tomatoes and chocolate).
Evidence also suggests that ginger — in candy, capsule and tea form — can be effective for nausea.
Dr. Talley said that gentle exercise after the meal can relieve your bloating and discomfort by propelling digestion. Tempting though it is, lying down soon after a big meal can lead to heartburn, he warned. (If you do, elevating your head with additional pillows to at least 30 degrees can help.)
“A leisurely walk would be a suitable thing to do to help move things along rather than go lie down,” Dr. Talley said. Nonetheless, he doesn’t advise vigorous exercise after a Thanksgiving meal. Strenuous movement like jogging shunts blood away from the digestive system, potentially leading to cramping, nausea and a sudden urge to “go.”
When should I be worried?
Regularly feeling ill after meals is a common problem, Dr. Talley said. At least one in 10 people in the United States has a chronic disorder called functional dyspepsia, which causes constant stomach pain, bloating and a feeling that is so full and uncomfortable that you can’t finish a meal. If you fit that description, he advised, speak with a physician about treatment options.
More urgently, vomiting within a few hours of dinner could be a sign of food poisoning. While food poisoning usually resolves on its own within days, you should go to the emergency room if the vomiting is so severe that you can’t keep water down. You should also seek medical help if you start to see blood in your stool, as it could mean a bacterial infection from something you ate.
But with a little foresight and planning, Dr. Talley said, you can enjoy a delicious meal on Thanksgiving without thinking about the meal’s plans for you instead. “Obviously, we’re going to eat more than normal on Thanksgiving,” he said. “But if we’re careful, that doesn’t mean we have to get ourselves into trouble.”