Your Good Digestion Guide

The digestive tract is miles long, with plenty of chances for things to go awry along the way. Find out how to take better care of your digestive system and cope with many common gastrointestinal conditions.

The gastro-intestinal tract is a food-processing system that accepts complex food molecules at one end and breaks them down into simpler components for absorption.

Waste products are disposed of – usually in neat packages – at the other end. Altogether, the gut is around four metres in length which gives plenty of room for things to go wrong. We take a look at some common digestive problems and the self-help approaches worth trying.

Indigestion and heartburn
Indigestion, or dyspepsia, describes any discomfort that results after a meal, including feelings of distension from swallowing air, flatulence from excessive wind, nausea, heartburn, acidity, abdominal pain and sensations of burning. Heartburn is a more specific term, referring to a hot, burning sensation felt behind the chest bone or centrally in the upper abdomen, which may spread up towards the throat.

Discomfort is mainly due to stomach acids and enzymes regurgitating up, to come in to contact with the sensitive lining of the oesophagus (the tube connecting the mouth and stomach) but painful spasm of muscles in the lower oesophagus may also be involved. The symptoms of gastro-oesophageal reflux disease, or GORD, can mimic angina or a heart attack and it is estimated that 20% of people admitted to coronary care have GORD rather than heart disease.

Several measures to control symptoms include:
•Avoid hot, acid, spicy and pastry foods
•Avoid tea, coffee and acidic fruit juices
•Eating little and often – avoid heavy meals, especially in the evening
•Not stooping, bending or lying down immediately after eating
•Cutting back on alcohol intake
•Losing any excess weight
•Giving up, if you are a smoker
•Wearing loose clothing, especially around the waist
•Elevating the head of the bed 15-20 cm (eg by putting books under the top two legs) to help reduce heartburn at night

TIP: If you are prone to indigestion when taking vitamin C, switch to non-acidic ester-C. Supplements that may help: Ginger to relieve indigestion. Flaxseed and omega 3 fish oils provide essential fatty acids which help to reduce inflammation caused by excess acid. Vitamin B supplements may be recommended if indigestion is thought to be a symptom of B vitamin deficiency. Aloe vera has a soothing antacid and analgesic action.

Excess wind
This can cause bloating, distension pain and embarrassing intestinal noises known as borborygmi. Bowel gases come from several different sources, including fizzy drinks (avoid) and swallowing air, but most are produced in the large bowel from bacterial fermentation of dietary fibre.
Interesting facts:
•You produce between one and 2.5 litres of intestinal gas per day
•Most people pass gas 12-20 times per day
•The amount of residual gas remaining in the bowels at any one time is around 200ml

Some people lack the right enzymes to digest certain foods, especially dairy products which require the enzyme lactase to break down milk sugar (lactose).

If you don’t produce enough lactase, then lactose sugar is not absorbed and instead passes down to the large bowel where it is fermented by colonic bacteria to produce wind and loose motions. If symptoms improve dramatically on cutting out milk products, seek medical advice.

Some foods contain compounds that increase gas production in everyone, so try avoiding ‘windy’ foods such as beans, lentils, onions, celery, carrots, cabbage, broccoli, brussel sprouts, raisins, bananas, apricots and wheat-germ. Supplements that may help: Ginger and peppermint oil help relieve flatulence.

Helicobacter pylori 
Helicobacter pylori is a motile form of bacterium found in the stomachs of at least 20% of younger adults and 50% of those aged over 50. It burrows into the mucous lining of the stomach, leaving a small breach in the wall through which acids can reach the wall. Helicobacter then coats itself with a small bubble of ammonia gas which protects the bacterium from the acid attack and at the same time irritates and inflames the stomach lining. Although it doesn’t cause symptoms in everyone, virtually all patients with duodenal ulcers are infected, plus three quarters of those with gastric ulcers. H. pylori infection is also associated with an increased risk of gastric cancer. If you have recurrent indigestion or heartburn, you will usually be checked for the presence of this intestinal infection; if present, it can be eradicated with a course of powerful antacids and antibiotics.

Supplements that may help: Cranberries have anti-adhesion properties that reduce the bacterium sticking to cell walls. Although it is best known for reducing urinary tract infections, preliminary research suggests cranberries may help to stop Helicobacter pylori sticking to cells in the stomach lining, this may help to flush it from the stomach so it is expelled more easily to help reduce the risk of gastritis and peptic ulcers.

Irritable bowel syndrome (IBS)
IBS is believed to affect at least a third of the population at some time during their lives, even if only mildly. According to the criteria used to diagnose it, there must be at least twelve weeks (which need not be consecutive) in the preceding twelve months of abdominal discomfort or pain that has two of three features:
1.Relieved with defecation
2.Onset associated with a change in frequency of stool
3.Onset associated with a change in form (appearance) of stool
The following symptoms also cumulatively support the diagnosis of IBS:
•Fewer than three bowel movements a week
•More than three bowel movements a day
•Hard or lumpy stools
•Loose (mushy) or watery stools
•Straining during a bowel movement
•Urgency (having to rush to have a bowel movement)
•Feeling of incomplete bowel movement
•Passing mucus (white material) during a bowel movement
•Abdominal fullness, bloating or swelling

Some people have predominantly loose bowels, some have predominantly constipation, while some have intermittent episodes of both.
IBS is not a condition you should diagnose yourself, as similar symptoms can occur in other more serious bowel problems needing medical or surgical treatment. If you think you may have IBS or notice changes in your bowel habit, always seek medical advice as soon as possible.

Supplements that may help: If you are told you have IBS, it is worth trying probiotic ones containing friendly digestive bacteria which replenish the bowel with healthy bacteria and discourage the presence of other less beneficial microbes. Probiotic bacteria produce lactic acid which improves intestinal health, promotes good digestion, boosts immunity and increases resistance to infection. Cynara artichoke improves digestion of dietary fats by stimulating bile flow. It has been shown to reduce IBS-like symptoms by over 70% within an average of ten days. Aloe vera has a soothing effect on bowel function. It normalises bowel contraction, improves protein digestion and absorption, aids stool bulk and promotes a healthy balance of bowel bacteria. Psyllium husks provide additional fibre that can help overcome both diarrhoea and constipation. Peppermint oil improves digestion by stimulating secretion of digestive juices and bile and also relaxes excessive spasm of the smooth muscle lining the digestive tract. Peppermint helps to relieve intestinal cramps and flatulence and is widely prescribed for IBS.