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What’s your gut feeling?

Abdominal pain, bloating, constipation, diarrhoea, wind… do any of these symptoms make your stomach churn? Unfortunately, most people do not pay attention to their digestive system (or gut) until something goes wrong.

It is important to take care of your gut, as many factors, including the food you eat (or don’t eat), the way you eat and your lifestyle in general can play a role in how your gut is feeling.

The digestive system

Everything you swallow is processed by your digestive system which converts it into the nutrients needed to fuel the body, and then rids it of the waste it doesn’t need. The digestive tract is a long tube running all the way from the mouth to the anus that is around 9-10 metres long. It includes the mouth and throat, oesophagus, stomach, small and large intestines, and the anus. Other organs involved in digestion include the liver, gallbladder and pancreas. Depending on what has been eaten, it takes between 12 and 48 hours for food to travel the length of the digestive tract.

Common gut conditions

If you think you have any of the below-listed conditions, it is important to speak to a health practitioner for diagnosis and treatment.

Food allergy and intolerance

Food allergy is when the immune system overreacts to a food that for most people is quite harmless. Food intolerance is a reaction to chemicals within the food (either natural or additives). Symptoms of food allergy and intolerance are often difficult to tell apart; however food intolerance is more common. Symptoms of food allergy often present immediately after eating, whereas intolerance can take longer as symptoms tend to present during the digestion process. Common symptoms of allergy and intolerance include headaches, breathing problems, bowel upsets, skin rash and nausea.

Constipation

Constipation (the passing of hard, dry and often painful bowel motions) is not usually a topic people like talking about; however many people suffer from and put up with it unnecessarily. Causes include insufficient fibre, low fluid intake, a change in routine, lack of physical activity, and some medications. “Making dietary changes, increasing physical activity and allowing yourself adequate time for a bowel motion so you don’t rush or strain, can help prevent constipation,” says Jean Hailes naturopath Sandra Villella. See your health practitioner if you experience any rectal bleeding.

Reflux

Reflux (indigestion or heartburn) occurs when stomach acid rises, entering the oesophagus. This can cause pain, a burning sensation and discomfort. Many people with reflux have symptoms regardless of what they eat; however some may identify certain foods that worsen their reflux such as alcohol, caffeine, fatty or spicy foods. Eating smaller meals and eliminating trigger-foods can help manage reflux. Antacids may give some relief; however if you need to take these often, see your health practitioner to eliminate other possible causes including gastric reflux, an ulcer or an underlying heart condition.

Jodie’s Story

I had symptoms for some time before I acted on them. I was constantly bloated and experiencing abdominal pain, but it wasn’t until I suffered from wind as well that I went to see my doctor. After ruling out various causes, she suggested I see a dietitian as it may be food-related. For two weeks I recorded everything I ate and drank in a food diary, as well as when I felt symptoms. The dietitian suspected fructose intolerance. Fructose is a type of sugar commonly found in various fruits, vegetables and honey. She asked me to eliminate all fructose rich foods from my diet for one week – then re-introduce one item to see if the symptoms returned. Sure enough, they disappeared for a week and returned after eating an apple. Whilst my intolerance can be a hassle when eating out, knowing means I can plan around it if need be. Occasionally I indulge in foods containing fructose, but while I enjoy it at the time – generally it isn’t worth the pain!

Diarrhoea

Another little-discussed topic is diarrhoea (loose, watery or frequent bowel motions). Often accompanied by nausea, vomiting, cramping or fever, diarrhoea can be caused by a bacterial or viral infection, food poisoning, drinking contaminated water, parasites, stress or food intolerance. Treatments vary, but may include diet modifications, antibiotics or other medications, rehydration and rest. If persisting for more than 2-3 days, or accompanied by severe pain, blood or high fever, see your health practitioner immediately.

Irritable bowel syndrome (IBS)

IBS is characterised by constipation or diarrhoea (or alternating between both), abdominal bloating or cramping (especially before a bowel motion) and flatulence. IBS is diagnosed by exclusion, meaning other digestive disorders and possible causes are ruled out first. Gut conditions such as food intolerance and coeliac disease, are sometimes misdiagnosed as IBS.

Management includes avoiding or reducing foods that may aggravate symptoms, increasing soluble fibre, use of antispasmodic (anti-cramping) medication, or use of gut-relaxing herbs (e.g. peppermint or chamomile tea). Foods that may aggravate IBS include caffeine, alcohol and fried, fatty or yeasty foods.

Coeliac disease

Coeliac disease is a condition where gluten (a protein found in wheat, rye, barley and oats) damages the lining of the small intestine, interfering with the absorption of important nutrients. Common symptoms include chronic diarrhoea, abdominal pain and bloating. The primary treatment for coeliac disease is to remove all gluten-containing foods from the diet.

Diverticular disease

Diverticular disease is common in adults over the age of 40 (especially those with a low fibre diet), where pockets are found in the muscle wall of the large intestine or bowel. Symptoms may include abdominal pain, bloating, constipation or diarrhoea. If bowel pockets become infected it is called diverticulitis. Symptoms may include nausea, loss of appetite, diarrhoea and rectal bleeding. Diverticulitis is usually treated successfully with antibiotics.

Inflammatory Bowel Disease (IBD)

IBD is a chronic condition of the bowel of which there are two forms: Crohn’s disease and ulcerative colitis. Crohn’s disease causes inflammation of the bowel wall and may affect any part of the digestive tract; whereas ulcerative colitis is inflammation of the inner lining of the bowel. Symptoms tend to occur at random intervals with periods of relief between flare ups. Symptoms vary, but may include diarrhoea (often containing mucus or blood), abdominal pain, fever, fatigue and nausea.

Tara’s story

I have always experienced constipation, but I was too embarrassed to talk to my doctor about it. Eventually I saw my GP, as I was experiencing intense pain and light bleeding after going to the toilet. The doctor told me I had fissures (tearing of the lining of the anus) and prescribed a cream. This worked, but the fissures kept returning. Years later, I mentioned the problem to a naturopath. She asked me a lot of questions about my diet and bowel habits, and it became clear that whilst I had treated the fissures, I had not addressed the cause of the problem – the constipation. We discussed introducing fibre-rich foods into my diet, as well as increasing my water consumption. Whilst initially I found it difficult to reach my daily fibre intake, my improved diet is now part of my routine and has made an enormous difference.

Talking to your health practitioner

Many people feel uncomfortable describing gut and bowel-related symptoms to their health practitioner. “Your doctor needs to know all your symptoms to help diagnose your condition,” says Jean Hailes GP Dr Vivienne Whitechurch. “Don’t feel embarrassed answering your doctor’s questions. Use the language you feel most comfortable with.”

Food for thought

Fibre

Good fibre intake is essential for a well-functioning digestive system. Lack of fibre is one of the primary reasons for gut issues, and most Australian adults don’t get the recommended daily intake (30g per day). Fibre is classed as insoluble or soluble, both of which are necessary for a healthy digestive system. Wholegrain cereal products, nuts and seeds are examples of insoluble fibre; soluble fibre includes oat products, legumes, fruit and vegetables.

Tips to increase fibre:

Eat 2-3 pieces of fruit and 5-7 vegetables daily
Replace refined grains with wholegrains
Include legumes such as kidney beans and lentils
Eat wholegrain cereal or oats for breakfast
Add linseeds, sunflower and pumpkin seeds (pepitas) to cereal and salads

If your diet is low in fibre, it is best to increase fibre gradually to avoid wind or abdominal discomfort. Too much fibre may lead to bowel upsets, so give your body time to adjust. Whilst it is preferable to obtain fibre from whole foods, it may help to have a fibre supplement at home to use if needed. Avoid using laxatives, which can make the bowel lazy and therefore reliant on continual use.

Water

“Dietary fibre absorbs water, so it is important to drink around two litres of water per day,” says Sandra. To increase water intake, aim to always have a water bottle nearby (on your desk at work, in your bag, on the bench or beside your bed). Start the day with 1-2 glasses of water, and drink a glass of water for every caffeinated drink.

Bowel flora

The gut contains billions of good bacteria called bowel flora. Some of these bacteria may be destroyed by repeated antibiotic use, long-term oral contraceptive pill use, stress and poor diet. “We can replenish good bacteria by regularly eating yoghurt containing live cultures,” says Sandra. “It may also be appropriate for some women to be prescribed a supplement containing several billion of these organisms, to replenish good bacteria.”

Healthy lifestyle

Keeping active

Being physically active every day can help keep your digestive system functioning at its best. The Australian National Physical Activity Guidelines for adults recommends a minimum of 30 minutes of moderate activity, most days of the week to benefit your health. Brisk walking, Yoga, Pilates and belly dancing are excellent workouts for the gut as these activities strengthen the abdominal muscles and stimulate the intestinal muscles, helping to push food through the digestive system.

Stress

Stress can affect the nerves of the digestive system and upset digestion, causing long-term health issues. Try to identify what makes you feel stressed and try to make changes to lessen stress. Seek help from a psychologist or health practitioner if needed.

Stress busting tip: A good belly laugh can help to ease stress and is an excellent stimulant of the gut.

Top ten tips for maintaining a healthy gut

1. Drink lots of water

2. Aim for at least 30g of fibre each day

3. Reduce alcohol and stimulants (caffeine, smoking)

4. Don’t overeat or rush eating

5. Allow adequate time for a bowel motion – don’t rush or strain

6. Do regular physical activity

7. Eat a healthy, balanced diet

8. Regularly eat yoghurt containing live cultures, to replenish good gut bacteria

9. Reduce/manage stress

10. Seek help if needed

Further resources

Healthy Gut Guide (Link to Shop)
by naturopath Jill Thomas (to purchase call 1800 151 441)

Gastroenterological Society of Australia
www.gesa.org.au

Dietitians Association of Australia
www.daa.asn.au

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Content Updated November 25, 2008