What’s your gut trying to tell you?
Tummy trouble? Dr Sarah Brewer is here to help
On the cover
Who thinks of their stomach as a problem area? Not because of the way it looks (that’s another story), but because of the physically uncomfortable way it can make you feel? As your gut is around eight metres long, there’s plenty of room for things to go wrong, and once you reach middle age, your bowel function does tend to change. You may be more prone to indigestion, bloating, constipation, wind and discomfort. According to a recent survey by the Taymount Clinic, the world’s first faecal microbiota transplant (FMT) clinic, one in five think their gut health is not up to scratch. But there are things you can do to help improve it. However, always seek medical advice about persistent digestive symptoms to rule out more serious conditions, which are easier to treat when detected early.
It hurts after meals!
Indigestion and heartburn are common after eating. Indigestion is felt in the upper abdomen and includes feelings of distension, flatulence, nausea, acidity or burning. Heartburn is a more specific term referring to burning sensations behind the chest bone, which may spread towards the throat. Here’s how to ease them…
Digestion starts in the mouth, so chew your food thoroughly to break it down.
Choose bland foods – try white rice, oats, scrambled eggs, ripe bananas and chicken broth. Milk and yogurt provide calcium to neutralise excess acid.
Avoid acidic fruit juices, coffee, alcohol and large meals that are rich
(eg with cream sauces) or heavy.
Eat little and often to avoid overfilling your stomach.
Losing any excess weight will really help, especially if you tend to store fat around your waist.
Avoid stooping, bending or lying down immediately after eating.
Ginger, peppermint and artichoke extracts help to relieve indigestion.
Irritable bowels?
Irritable bowel syndrome (IBS) is the most common condition to affect the gut, with at least one in five people experiencing symptoms at some point. IBS is associated with symptoms including intermittent pain, bloating (with or without distension) and diarrhoea or constipation. It may also involve changes in the way the gut and brain interact. Imbalances in bowel bacteria are also thought to be involved, as symptoms often come on after food poisoning, taking antibiotics and experiencing stress or surgery. These factors may affect intestinal permeability (so-called leaky gut, which lets food particles and bacteria out) or alter the balance of digestive bacteria to increase gas production and cause bloating.
What else could it be?
Always tell your GP if you experience recurrent abdominal pain or a change in stool frequency or form. The diagnosis of IBS isn’t always clear cut, as there’s no single diagnostic test for it. Your GP will consider other conditions, such as inflammatory bowel disease, coeliac disease or lactose intolerance, and exclude problems affecting other organs. But it’s also important to avoid unnecessary tests if you don’t have ‘red flag’ symptoms such as a family history of bowel or ovarian cancer, unexplained weight loss or blood in the motions. Regular follow-ups are also important, so go back to your doctor if symptoms persist, worsen or change.
Get things moving
Constipation can occur as a result of health conditions such as IBS, depression, an underactive thyroid and neurological conditions or as a side effect of medication – especially opioid painkillers (eg codeine). And women are more likely to be affected by it than men due to the female hormone, progesterone, slowing bowel movements. Straining can lead to problems in the form of hernias, ‘piles’ or diverticular disease, where pouches bulge out from the bowel lining. Often, however, no obvious cause is found, and this is referred to as functional constipation. There may be some truth in the old wives’ tale that it’s associated with ‘a change of water’. If you live in a hard water area, where water has higher levels of dissolved calcium and magnesium, you may adapt less well to soft water areas, as these minerals are needed for muscle contraction. Here’s what you can take to help…
Magnesium is needed for muscles to work properly. Increase your intake of magnesium-rich foods (eg nuts, seeds, dark green leaves). A supplement will also help.
Fibre helps to get things moving. As well as eating more fruit, veg, beans, salads, nuts and seeds, supplements such as psyllium will ‘feed’ bowel bacteria and absorb water to add bulk. However, it can take up to four weeks to notice the benefit.
Prunes and prune juice are an excellent source of soluble fibre, and also contain a laxative substance (dihydroxyphenyl isatin) that stimulates secretion of fluid into the bowel.
Probiotics also help to improve digestion, stool consistency and bowel regularity as they ferment undigested fibre and bulk up the stools.
Beat the bloat
Bloating can result from reduced production of bile or pancreatic enzymes, so that fat is less easily digested. Globe artichoke extract stimulates bile production in the liver to improve digestion of fats and relieve bloating. It’s also a source of inulin, a prebiotic fibre that stimulates the growth of beneficial digestive bacteria. Artichoke supplements have also been found to reduce symptoms of bloating, flatulence, abdominal pain and constipation in people with irritable bowel syndrome.
If you experience persistent bloating, it’s important to see your doctor. This symptom can sometimes result from other conditions
including fibroids or an ovarian cyst or tumour, so don’t ignore it if digestive changes don’t help.
Ease a rumbling tum
Audible bowel sounds are a sign that gases have built up in the intestines. This can result from an imbalance in bowel bacteria (dysbiosis), poor delivery of bile (eg due to gallstones) or a reduced ability to process certain foods (eg gluten intolerance in coeliac disease, or poor production of lactase enzymes needed to breakdown lactose). If rumbling continues, do see your doctor for a check up, especially if you also experience bloating or abdominal pain.