Tummy trouble-shooter: Your guide to digestive health
Have you had a gutful of stomach complaints, digestive problems and stomach pain? Dietitian Bobbie Crothers addresses some of the most common digestive health issues to help you pinpoint – and treat – the problem.
Indigestion, upset stomach, bloating, gas… do any of these sound familiar? If so, you’re not alone. Many Australians experience these symptoms every day. In fact, 1 in 5 of us over the age of 30 experiences constipation during our lifetime, and 7 in 10 Australians suffer reflux at some point.
Digestive health issues are those related to, or occurring along, our digestive tract, which runs all the way from our mouth to our anus. While the most obvious causes of digestive problems stem from the food we eat, there are many other factors that can throw the digestive tract out of balance, including stress, some medications, alcohol, smoking, inactivity or simply eating too quickly. While digestive health issues don’t always warrant a trip to the doctor, they can make you feel lethargic, uncomfortable and make it difficult to focus on daily tasks. Read on to identify what’s troubling your tummy – and how to fix it.
Bloating
Symptoms
A feeling of fullness, tightness or pain accompanied by distension of the stomach, particularly below the waist. You may also experience constipation. Bloating is more common in women than men, and is most often experienced in the afternoon or evening.
What causes it?
Bloating is usually the result of excess gas in the bowels. Undigested nutrients (usually fibre) in the bowel are fermented by the bacteria in our gut, which produce gas. A change in diet or a sudden increase in fibre can lead to an increase in gas and thus, bloating. It is also thought that bloating may be a result of an abnormality in the nerves that control gut contractions, which could make it more difficult to pass gas.
How do you fix it?
Gas production is a normal process, however high-fibre foods can aggravate bloating symptoms. To help reduce gas and flatulence, introduce fibre into your diet gradually – this allows your body time to get used to the extra gas.
When to see a doctor
While bloating itself is not usually severe, it can be a symptom of a food intolerance or allergy; irritable bowel syndrome (IBS); Crohn’s disease; diverticulitis; polycystic ovarian syndrome; parasites such as worms; aerophagia (swallowing too much air); menstruation or, in extreme cases, tumours. If your bloating is persistent and painful, and stops you from focusing on daily tasks, see your doctor or dietitian.
Diarrhoea
Symptoms
Frequent passing of very soft, liquid stools. Depending on the cause, it may be accompanied by stomach pain, an urgency to go to the toilet and incontinence.
What causes it?
Diarrhoea can be the result of infection, meaning you may have picked up a bug that has disrupted the environment in your gut. Symptoms can last for a day or two, however persistent diarrhoea can be related to long-term issues, such as IBS or coeliacdisease.
How do you fix it?
In many cases the symptoms will resolve in a few days. During this time, be sure to drink plenty of fluids to avoid dehydration. Until the symptoms pass, it’s a good idea to avoid food and drinks that can aggravate the bowel further, such as very high fibre foods, spicy foods, coffee and alcohol.
When to see a doctor
If diarrhoea lasts for more than two days, or is accompanied by other symptoms such as severe stomach pain, fever, vomiting or nausea, make an appointment to see your doctor.
Constipation
Symptoms
Constipation occurs when you have trouble going to the toilet (or strain when you do so) and pass small or hard stools. While there is no set rule for how often you should go to the toilet, going less often than you usually do is an indication you might be constipated.
What causes it?
A common cause is a lack of dietary fibre. Fibre adds bulk to your stool so it can pass easily. Other factors include a low fluid intake, lack of regular exercise, certain medications, pregnancy, advancing age and simply putting off going to the toilet.
How do you fix it?
Dietary changes can help – gradually increase the amount of daily fibre you eat, especially grains and cereals. Adding psyllium to your meals (add it to cereal, smoothies or baked goods) or taking a daily fibre supplement can help. Ensure you are drinking enough water and exercising regularly. Simply moving more could help move other things, too! Laxatives can also help, but check with your doctor before using them.
When to see a doctor
In the case of severe constipation (e.g. you usually go to the toilet daily, but haven’t been in four or five days), see your doctor. If you have constipation on and off, see a dietitian to have your diet assessed.
Reflux or heartburn
Symptoms
A burning sensation in the chest that works its way upward toward the neck and is often accompanied by a sour or bitter taste in the mouth. It’s common if you are overweight, over 50, and during pregnancy; and is often a genetic condition.
What causes it?
The burning sensation is due to the rising of stomach acids and stomach content into the oesophagus. The stomach has to be very acidic to break down foods, and the oesophagus is not accustomed to this acidity. While some foods may exacerbate the condition, many people experience reflux no matter what they eat. The main culprits include fatty foods, chocolate, coffee, alcohol, soft drinks (especially those containing caffeine) and cigarettes. Eating large meals and lying down too soon after a meal can also cause reflux or heartburn.
How do you fix it?
Avoid foods you know trigger the symptoms and don’t eat too close to bedtime. If you are overweight, losing weight can help reduce the symptoms. Antacids are useful for relieving occasional heartburn or reflux, as they help neutralise stomach acid, but they aren’t a solution to the problem.
When to see a doctor
If you experience reccurring and persistent reflux, see your doctor. Persistent symptoms may be a sign of something more serious like a hiatus hernia, ulcers or cancer. Your doctor may prescribe medication or schedule an endoscopy to find out the underlying cause.
Cramping/pain
Symptoms
Stomach cramps, stomach ache and abdominal pain all describe pain or discomfort anywhere between your chest and groin. Research shows that 30 per cent of Australian adults experience some type of stomach discomfort every few months, or more often.
What causes it?
There are many possible causes of stomach cramps or pain, however the location of the pain may guide you to the cause. Generalised pain that is felt over more than half your stomach may be due to indigestion, gas or potentially a virus. Localised pain couldmean a problem with a particular organ, such as your appendix or gallbladder. Cramp-like pain could be due to gas, bloating or period pain for women.
How do you fix it?
While some stomach pain will ease on its own, see your doctor or pharmacist if it persists – there are some medications that can help relieve the symptoms.
When to see a doctor
Pain is your body’s way of indicating that something is wrong, so see your doctor if the pain continues for more than 24 hours or if pain is sharp and severe, and accompanied by nausea or vomiting – this could indicate appendicitis.
Nausea
Symptoms
Nausea is the sensation of needing to vomit. It may also be accompanied by dry retching or vomiting.
What causes it?
Our bodies respond in several ways to (and try to evict) intruders (i.e. bacteria, viruses, or irritants) and vomiting is one of them. Nausea can be a sign that the stomach needs to empty itself, or a sign that the stomach is not emptying properly into the intestines. It can even be caused by migraines or severe headaches. It’s common among pregnant women (usually described as ‘morning sickness’) and patients in advanced stages of disease, as a side effect of medication or radiation therapy.
How do you fix it?
Vomiting will usually relieve nausea, since you are getting rid of the irritant. Sip clear fluids such as water, clear broth or sports drinks to keep you hydrated and avoid foods that might upset your stomach further, especially if you are vomiting. Medications to ease nausea are available, so consult your doctor or pharmacist for their advice. For a natural remedy, take ginger tablets or sip peppermint tea, which may help settle the stomach and calm feelings of nausea.
When to see a doctor
If nausea lasts for more than 24 hours and/or is accompanied by severe vomiting and/or diarrhoea, see your doctor right away – this is especially important for infants and children. If you are also experiencing pain, or blood is present in vomit or bowel movements, it may be a sign of something more serious and should be investigated immediately.
For more information
To find out more about digestive health, check out these websites:
- The Gut Foundation: www.gut.nsw.edu.au
- The Gastroenterological Society of Australia: www.gesa.org.au
- Gastro Net: www.gastro.net.au
Guide to poo
Poo is a great insight into your digestive health. The table below tells you what to look for and what it might mean.
| What to look for | What’s normal and what’s not | What it means and what to do |
|---|---|---|
| Colour | Stools should be brown – they should not be white or black, nor should they contain blood. | See your doctor right away if your poo is black or appears to contain blood. If the colour changes from what is normal for you, it could simply be a change to your diet or something you have eaten, but keep an eye on it. |
| Shape | Poo should be sausage or snake-like in shape; it should not be small pellets, too thin or liquid (no shape). | Small or thin poo may be the result of a lack of fibre and fluid in the diet and is usually a sign of constipation. Liquidy stools indicate diarrhoea, so keep your fluids up. Refer to the constipation and diarrhoea sections on p39. |
| Texture | Stools should have a smooth texture. They should not be dry with cracks, or loose and mushy. | Dry and cracked stools are a sign of constipation, while loose and runny indicate diarrhoea. |
| Smell | While the smell isn’t pleasant, it shouldn’t be offensive. | Unusually bad smells could be due to diet changes, high protein diets or spicy meals. This could also be a sign of malabsorption, so see your GP if it persists. |
| Sink or float | The jury is still out on this one, normal is whatever is usual for you. | Carry on as usual! Just be sure to check your poo occasionally. |
10 foods and drinks to help with digestive health
| Product | Why it’s good for digestive health | How to use it |
|---|---|---|
| Psyllium husk | Psyllium husk is high in fibre and helps keep food moving through your system. You can find it in the health food aisle. | Sprinkle it on cereal or salads, or try adding it to muffin, cake or loaf recipes |
| Kellogg’s All-Bran Honey Almond | It’s high in insoluble fibre from wheat, which is ideal for adding bulk to your stool to help keep you regular. | Have a bowl at breakfast or as a snack. You can even use it in baking recipes to increase the fibre. |
| Metamucil/Benefibre | These fibre-rich drinks contain psyllium to help relieve constipation. | Try the capsules, or mix the powder (clear, flavoured or sugar-free varieties are available) with water and drink 1–3 times a day. |
| Yakult | Probiotic drinks add good bacteria to the digestive tract and maintain the bacterial balance in the gut. | Drink it once a day, or add it to smoothies or the milk you pour on your cereal. |
| Bürgen rye bread | Bürgen rye bread is high in fibre and contains prebiotics to help aid digestive balance. It acts as a food source for good bacteria in the gut. | Great as toast for breakfast, for sandwiches or to accompany vegie soup at lunch. |
| Peppermint tea | Sipping peppermint tea can help soothe an upset stomach. It also increases your fluid intake, which is important for regularity. | Have a cup after a meal – or whenever you feel like it! |
| Uncle Tobys Bodywise Digestive Balance Bars | With three types of fibre – resistant starch, insoluble fibre and soluble fibre – these bars help boost your fibre intake to help maintain digestive wellbeing. | Grab a bar in the afternoon to beat 3:30-itis! t will help keep you full until dinnertime. |
| Wonderwhite Hi-Fibre Plus bread |
A great solution for kids who will only eat white bread. It contains Hi-maize starch (resistant starch) which acts as a prebiotic to encourage the growth of good bacteria in the bowels. | Have it instead of your usual white toast at breakfast. |
| Pitted prunes | Prunes are high in fibre and can help relieve constipation… however, don’t eat too many (more than 2–3) in one sitting as you may end up with diarrhoea. | Prunes are a great snack on their own, or add them to porridge as a natural sweetener. |
| Nestlé Ski Activ Digestion | Ski Activ yoghurt contains both prebiotics and probiotics to help promote good bacteria in the gut and restore digestive balance. | Serve over cereal or have a tub as an afternoon snack. |
| Four-bean mix | Beans help boost your fibre intake, making them great for digestive health. | Add beans to salads, soups, casseroles and lasagne, or eat them on their own. |
Did you know?
- Very severe constipation is almost exclusively a female problem.
- Up to two-thirds of pregnant women report experiencing daily heartburn, especially in the third trimester.
- On average, an adult passes 500ml–2000ml gas daily.
- The pain of reflux/heartburn can mimic heart pain – however heartburn, unlike the symptoms of heart disease, is not usually associated with physical activity. If your pain is worse with exercise, see your doctor.
- Cold hands or feet that go ‘blue’ or ‘white’ in cold weather are commonly associated with constipation and bloating.
- Wheatbran fibre is one of the best fibres for increasing stool bulk and can really benefit your digestive health. You can find it in cereals, and you can also find it in the health food aisle of the supermarket.
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