Bloating and Water Retention: Understanding the Causes and How Osteopathic and Manual Therapy Can Help

Welcome!

Hello and welcome to our holistic health newsletter! If you’ve ever felt uncomfortably bloated or noticed your rings or shoes fitting a bit too snug, you’re not alone. Bloating and water retention are common complaints that can leave us feeling sluggish, puffy, and out of sorts. But what causes these symptoms, and what can you do about them—beyond just waiting for them to pass? In this issue, we’ll explore the most common dietary, hormonal, and lifestyle contributors to bloating and water retention. Then, we’ll take a deep dive into how osteopathic manual therapy and other hands-on approaches can help you feel lighter, more comfortable, and more in tune with your body. Whether you’re curious about lymphatic drainage, visceral manipulation, or myofascial release, we’ll break down the science and practicalities in a warm, accessible way. Let’s get started!

Understanding Bloating and Water Retention

What Are Bloating and Water Retention?

Bloating is that uncomfortable sensation of fullness, tightness, or swelling in the abdomen. It can be accompanied by visible distension, gassiness, or even pain. Water retention, also known as edema, refers to the accumulation of excess fluid in the body’s tissues, often leading to swelling in the hands, feet, ankles, or face. While these symptoms are often temporary, they can be distressing and sometimes signal underlying health issues.

Why Do They Happen?

Both bloating and water retention can result from a complex interplay of factors—what you eat, how your hormones fluctuate, your activity level, stress, sleep, and even certain medications or medical conditions. Understanding the root causes is the first step toward lasting relief.

Common Causes of Bloating and Water Retention

Dietary Contributors

Sodium and Processed Foods

One of the most significant dietary culprits behind water retention is excess sodium. When you consume salty foods—think canned soups, deli meats, packaged snacks, and restaurant meals—your body holds onto extra water to maintain a healthy sodium-to-water balance. This can lead to puffiness, swelling, and that “heavy” feeling.

Refined Carbohydrates and Sugary Foods

Refined carbohydrates (like white bread, pasta, and pastries) and sugary foods can also promote water retention. These foods spike blood sugar and insulin, signaling the kidneys to reabsorb more sodium and, consequently, more water. Additionally, carbohydrates are stored as glycogen in your muscles and liver, and each gram of glycogen binds several grams of water.

High-FODMAP Foods

Certain carbohydrates known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are poorly absorbed in the gut and can be fermented by bacteria, producing gas and drawing water into the intestines. This is a common trigger for bloating, especially in people with irritable bowel syndrome (IBS).

Dairy and Food Intolerances

For those who are lactose intolerant or sensitive to certain foods (like gluten), consuming these items can lead to digestive upset, bloating, and sometimes water retention. The undigested components ferment in the gut, producing gas and drawing in water.

Alcohol and Caffeine

Both alcohol and caffeine can act as diuretics, initially increasing urine output but paradoxically leading to dehydration and subsequent water retention as the body tries to compensate.

Hormonal Influences

Menstrual Cycle and PMS

Many women experience bloating and water retention in the days leading up to their period. This is largely due to fluctuations in estrogen and progesterone. Estrogen promotes sodium and water retention, while progesterone has a natural diuretic effect. When progesterone drops before menstruation, water retention can increase, leading to puffiness and abdominal bloating.

Menopause and Perimenopause

Hormonal changes during menopause can also disrupt fluid balance, sometimes leading to persistent bloating and swelling. Declining estrogen levels can affect how the body regulates sodium and water, and may also slow digestion, compounding the problem.

Other Hormonal Conditions

Conditions like polycystic ovary syndrome (PCOS), thyroid disorders (especially hypothyroidism), and adrenal imbalances can all contribute to bloating and water retention. For example, low thyroid function slows metabolism and can cause puffiness, while high cortisol (the stress hormone) increases sodium retention and fluid buildup.

Lifestyle Factors

Physical Inactivity and Sedentary Behavior

Sitting or standing in one position for long periods can impair circulation and lymphatic drainage, causing fluid to pool in the lower extremities. This is especially common in people with desk jobs, during long flights, or in those who are less physically active.

Poor Posture

Slouching or poor “alignment” as some would say and lack in range of motion, can compress abdominal organs and restrict both blood and lymph flow, contributing to bloating and swelling. Good posture supports optimal digestion and fluid movement.

Lack of Sleep

Insufficient sleep disrupts hormonal regulation, including those hormones that control fluid balance. Chronic sleep deprivation can increase cortisol and promote water retention.

Stress

Chronic stress raises cortisol, which, as noted, increases sodium and water retention. Stress also affects gut motility, potentially leading to constipation and bloating.

Digestive Causes

Irritable Bowel Syndrome (IBS)

IBS is a common functional gut disorder characterized by abdominal pain, bloating, and changes in bowel habits (constipation, diarrhea, or both). People with IBS often have heightened sensitivity to gas and distension, making even normal amounts of intestinal gas feel uncomfortable.

Small Intestinal Bacterial Overgrowth (SIBO)

SIBO occurs when excess bacteria populate the small intestine, leading to fermentation of food, gas production, and bloating. SIBO can be acute or chronic and often overlaps with IBS.

Constipation and Dysmotility

When stool moves slowly through the colon, water is reabsorbed, and fermentation by gut bacteria increases, leading to gas and bloating. Constipation is both a cause and a consequence of bloating and water retention.

Food Intolerances and Dysbiosis

Imbalances in gut bacteria (dysbiosis) or intolerances to foods like lactose, gluten, or FODMAPs as mentioned above can disrupt digestion, leading to bloating, gas, and sometimes swelling.

Medications and Medical Conditions

Medications That Cause Edema

Several common medications can cause water retention as a side effect, including:

• Calcium channel blockers (for blood pressure)

• NSAIDs (like ibuprofen, naproxen)

• Corticosteroids (prednisone)

• Certain diabetes medications (pioglitazone, insulin)

• Hormonal therapies (oral contraceptives, hormone replacement)

• Antidepressants (SSRIs, MAOIs)

• Gabapentinoids (gabapentin, pregabalin)

  
  

These drugs may increase capillary pressure, alter kidney sodium handling, or affect vascular permeability, leading to fluid accumulation. Therefore if taking any of these medications it is best to speak with one's General Practitioner (Family Physician) if you are noticing water retention and how best to proceed or complement with alternative treatments.

How Osteopathic and Manual Therapy Can Help

Now that we’ve explored the many causes of bloating and water retention, let’s turn to the hands-on therapies that can help restore balance, comfort, and vitality.

What Is Osteopathic Manual Therapy?

Osteopathic manual therapy (OMT) is a holistic, hands-on approach that views the body as an integrated whole. Osteopaths use a variety of gentle techniques—stretching, mobilization, soft tissue work, and manipulation—to restore optimal function to the musculoskeletal, nervous, circulatory, and visceral (organ) systems.

Key Principles:

• The body is a unit; structure and function are interrelated.

• The body has self-healing and self-regulating mechanisms.

• Manual therapy can support these processes by removing restrictions and restoring balance.

  
  

OMT is used for a wide range of issues, from back pain and headaches to digestive complaints and fluid retention. It is safe, non-invasive, and tailored to each individual’s needs.

Manual Therapy Techniques for Bloating and Water Retention

1. Visceral Manipulation

What Is It?

Visceral manipulation is a gentle, hands-on technique that treats the framework with a hypothetical intention to help address the internal organs (viscera) and their supporting connective tissues. The goal is to restore normal mobility and motility (natural movement) of the organs, reduce adhesions, and improve blood and lymph flow.

How Does It Work?

Organs are meant to glide and move with each breath and movement. Surgery, inflammation, infection, or chronic tension can cause adhesions or restrictions, limiting this movement. Visceral manipulation uses precise, gentle pressure to release these restrictions, allowing organs to move freely and function optimally.

Physiological Effects:

• Improves organ mobility

• Enhances blood and lymphatic circulation

• Reduces inflammation and congestion

• Supports the autonomic nervous system (especially the vagus nerve)

• Relieves pain and restores gut motility

  
  

Evidence: Some clinical studies have shown that visceral manipulation can reduce symptoms of IBS, constipation, bloating, and even chronic pain syndromes. For example, randomized controlled trials have found significant improvements in abdominal pain, distension, and diarrhea in IBS patients following visceral osteopathic treatment, with benefits lasting up to a year. Other studies report improved gastric emptying, reduced constipation, and enhanced quality of life in people with functional digestive disorders.

2. Lymphatic Drainage Techniques

What Is It?

Manual lymphatic drainage (MLD) is a specialized, gentle massage technique designed to stimulate the flow of lymph—a clear fluid that carries waste, toxins, and excess water away from tissues and back to the bloodstream.

How Does It Work?

The lymphatic system is a crucial part of fluid balance and immune function. When lymph flow is sluggish—due to inactivity, surgery, illness, or chronic inflammation—fluid can accumulate, causing swelling and discomfort. MLD uses light, rhythmic strokes to encourage lymph movement, reduce swelling, and support detoxification.

Physiological Effects:

• Reduces fluid retention and swelling (edema)

• Enhances immune function

• Promotes removal of metabolic waste and toxins

• Relieves pressure and discomfort in swollen tissues

• Supports healing after injury or surgery

  
  

Evidence:MLD is well-established for managing lymphedema (chronic swelling), especially after cancer treatment, but it’s also helpful for mild to moderate fluid retention, post-surgical swelling, and even cosmetic puffiness. Studies show that MLD can improve symptoms, reduce limb circumference, and enhance quality of life in people with edema.

3. Myofascial Release and Abdominal Fascial Techniques

What Is It?

Myofascial release (MFR) targets the fascia—a web of connective tissue that surrounds muscles, organs, nerves, and blood vessels. Restrictions in the abdominal fascia can compress organs, impair circulation, and contribute to bloating, pain, and sluggish digestion.

How Does It Work?

MFR uses sustained, gentle pressure to stretch and release fascial restrictions. In the abdomen, this can relieve tension around the digestive organs, improve their mobility, and support healthy gut function.

Physiological Effects:

• Releases tension and adhesions in the abdominal wall and fascia

• Improves organ mobility and blood flow

• Reduces pain, bloating, and digestive discomfort

• Supports the gut-brain axis and parasympathetic (rest-and-digest) activity

  
  

Evidence:Research and clinical reports indicate that abdominal myofascial release can reduce bloating, improve digestion, and even help with post-surgical adhesions or scar tissue. It’s also beneficial for stress-related digestive symptoms, as it helps shift the body into a more relaxed state.

4. Other Manual Therapy Techniques

Soft Tissue Mobilization and Massage:These techniques target muscles, ligaments, and connective tissues to relieve tension, improve circulation, and support lymphatic flow. They can be especially helpful for stress-related bloating or when muscle tension is contributing to digestive symptoms.

Joint Mobilization and Spinal Manipulation:By improving alignment and mobility of the spine and pelvis, these techniques can relieve pressure on nerves that influence gut motility and fluid balance. For example, mobilizing the thoracic spine can enhance diaphragm movement and support both digestion and lymphatic drainage.

Cupping and Other Adjuncts:Cupping can be used to release fascial restrictions and promote blood and lymph flow in the abdomen. It’s sometimes incorporated into manual therapy sessions for additional benefit.

How Do These Techniques Work? The Science and Physiology

Manual therapy works through a combination of biomechanical, neurological, neuroimmune, neurovascular, and endocrine mechanisms:

• Biomechanical: Releases physical restrictions, improves tissue mobility, and restores normal movement patterns.

• Neurological: Modulates pain signals, enhances vagal tone (rest-and-digest), and supports gut-brain communication.

• Neuroimmune: Reduces inflammation by modulating cytokine levels and supporting immune function.

• Neurovascular: Improves blood and lymphatic flow, supporting tissue healing and fluid balance.

• Endocrine: Influences stress hormones (like cortisol), promoting relaxation and reducing water retention.

  
  

Clinical Evidence:A 2025 living review of systematic and narrative reviews found that manual therapy evokes complex, multisystem responses, including improved tissue mobility, reduced pain, enhanced lymphatic and blood flow, and modulation of inflammatory and stress-related pathways. While more research is needed to clarify exactly which mechanisms are most important for each condition, the overall evidence supports the use of manual therapy for a wide range of symptoms, including those related to bloating and water retention.

Self-Care Strategies to Complement Manual Therapy

Manual therapy is most effective when combined with healthy lifestyle habits. Here are some practical tips:

• Stay hydrated: Drinking plenty of water helps flush excess sodium and supports lymphatic flow.

• Eat a balanced diet: Focus on whole foods, potassium-rich fruits and vegetables, and limit processed, salty, and sugary foods.

• Move regularly: Gentle exercise (walking, yoga, swimming) stimulates circulation and lymphatic drainage.

• Practice deep breathing: Diaphragmatic breathing supports both digestion and lymph flow.

• Manage stress: Meditation, mindfulness, and relaxation techniques can help regulate hormones and reduce bloating.

• Elevate your legs: If you experience swelling in your feet or ankles, elevating them above heart level can help move fluid out of the tissues.

• Wear compression garments: Compression socks or sleeves can support circulation and reduce swelling, especially during travel or long periods of sitting.

Key Takeaways

• Bloating and water retention are common symptoms with many potential causes, including diet, hormones, lifestyle, digestive health, medications, and medical conditions.

• Osteopathic and manual therapy techniques—such as visceral manipulation, lymphatic drainage, and myofascial release—can help relieve these symptoms by restoring tissue mobility, improving circulation, and supporting the body’s natural healing mechanisms.

• These therapies work through multisystem effects, including biomechanical, neurological, immune, and hormonal pathways.

• Manual therapy is generally safe when performed by trained professionals, but certain conditions require caution or medical supervision.

• Combining manual therapy with healthy lifestyle habits—hydration, balanced diet, movement, stress management—offers the best results.

• If you’re in Oakville, Ontario, a range of skilled practitioners are available to support your journey toward feeling lighter, healthier, and more comfortable in your body.

Final Thoughts

Bloating and water retention can be frustrating, but they are not inevitable. By understanding the underlying causes and embracing a holistic approach—including hands-on therapies, lifestyle changes, and self-care—you can reclaim comfort, confidence, and vitality. If you’re curious about how osteopathic or manual therapy might help you, reach out to a qualified provider for a personalized assessment. Your body has an incredible capacity to heal and rebalance—sometimes it just needs a gentle, skilled hand to guide the way.

Thank you for joining us on this journey to better digestive and whole-body health. Stay tuned for more tips, insights, and inspiration in our next issue!

Disclaimer: This newsletter is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before starting any new therapy or if you have concerns about your health.