Catherine Jeans DipION mBANT CNHC Nutritional Therapist
The family nutrition expert and author of The 30 Day Sugar Detox Programme
Around one in five people in the UK experience Irritable Bowel Syndrome (IBS) at some point in their lives, with many more of us going through spells of gut discomfort and irritability. When it comes to eating the right diet and helping relieve the symptoms, it can be difficult to know which is the right approach for you. There’s so much advice online – eat more fibre, eat less fibre, don’t eat wheat, include more wheatgerm, give up gluten, don’t give up gluten,…! It’s no wonder the majority of people who experience gut problems are confused!
Another problem is that there are so many different symptoms for IBS – more than 100 in fact! And these symptoms can change daily or weekly in an individual. This makes it very difficult to find a solution, both medically and holistically.
Having worked with hundreds of people with gut issues, I stress that it’s vital to understand your gut type, the symptoms you experience and how to address each group of symptoms. In this two-part series, you’ll find different dietary approaches for each irritable gut type, so that you can work on getting the right approach to supporting your health for the long term.
What are the different gut symptoms?
There are so many uncomfortable symptoms that you can experience in your digestive health – but here are some of the most common groups of symptoms that I see in my practice.
Bloating and cramps: bloating is very common, and for many sufferers this comes with pain and cramping, because the bowel is distended and uncomfortable. Some people feel like they start the morning with a flat belly, but by the end of the evening can’t even do up their trousers. One of the most common causes of bloating is gut fermentation.
- Bloating and constipation: not being able to pass a stool regularly is a very common bowel symptom, which can leave you feeling bloated, crampy and uncomfortable. It’s so vital that we pass a stool every day, as this is how the body clears toxins, waste and excess hormones. If stools hang around in our bowels for too long, this can make you feel sluggish, uncomfortable and may also contribute to hormonal imbalances. The main underlying causes of constipation can include imbalanced gut microflora, poor diet, stress and not enough fluids.
- Diarrhoea, cramps and urgency to go: if you experience this group of symptoms, you probably know the location of every toilet in your local vicinity, so that going out does not cause distress and panic in case you can’t find a toilet. A sudden urge to go, with or without diarrhoea is a very common symptom of gut distress that can dramatically affect the life of those who experience it. These kind of symptoms commonly start after a tummy bug such as the norovirus or gastroenteritis.
- Excess wind: even the most polite of us fart and burp sometimes, but it’s when this wind becomes uncontrollable and embarrassing, especially when it has a very strong smell that is difficult to hide. Too much gas is very common and can be an isolated symptom or experienced alongside imbalanced bowel movements. Like bloating, one of the common reasons for experiencing excess wind is due to imbalanced gut microflora and fermentation. It might also indicate poor digestion of food.
- Excessively smelly, fatty or floaty stools: if your stools tend to float and you notice drops of fat around them or a greasy appearance, this can be a sign of poor fat digestion and may point to a gall bladder disturbance.
- Painful passing of the stool: there can be many reasons why it can be painful to pass a stool, which make going to the toilet a very distressing experience. It could be due to straining from constipation, which has caused haemorrhoids, or you may get strong cramps when you pass a stool due to soreness higher up in the bowel. If you experience any type of pain when passing a stool, or you notice any blood on the tissue or in the toilet bowl, your first step is to make an appointment with your GP to discuss further.
- All of the above! Many people with an irritable gut experience a combination of all of the above symptoms, which may vary from day to day or week to week. In part 2 of this article, I’ll be giving you advice on how to support a changing bowel that goes through many different types of symptoms.
Getting a second medical opinion
If you experience any change to your bowel movements, ongoing bloating or any type of gut disturbance, you should always have this checked out by your GP. It may be IBS or just a period of gut irritability, but it’s vital just to have your GP rule out anything more serious.
Bloating and cramps: how can diet and lifestyle help?
Bloating and cramping can be very uncomfortable, and leave you feeling low in energy and lethargic. There can be many reasons why you are experiencing these symptoms, and one of the most common is gut fermentation. Inside our bowels we have billions of gut microflora, tiny organisms such as bacteria and yeast which must be kept in a delicate balance. Stress, alcohol, too much sugar and white refined carbohydrates can affect this balance and cause too much non-beneficial bacteria and yeast to overgrow. As these organisms ferment sugars and refined carbs they create excess gas, which can lead to bloating and cramping.
If you suspect gut fermentation, the best thing to do is to have a look at your diet. Do you eat a lot of white refined flour products, such as white bread, cakes, biscuits, pastries? Do you eat chocolate, biscuits and sweet things every day? Also examine how much fruit you eat, as fruit contains a lot of sugar (as fructose). Although fruit sugar is natural, it can still contribute to bowel fermentation. Stick to lower sugar fruits such as berries, apples and pears and have up to 2 portions per day, focusing instead on eating more vegetables. Switch from white products to wholemeal – such as spelt pasta, rye bread and oats.
It’s also a good idea to have a complete detox from sugar – if you have a sweet tooth, work on excluding sugar from your diet for at least 7 days. You’ll be surprised at how quickly your taste buds change and you no longer crave the sweet stuff.
Another reason you may experience bloating and cramps could be poor digestion of food. The role of our bowel is to break down and absorb the nutrients from our food, but if we’re not doing this efficiently then this can further contribute to fermentation and bloating. Think about how and when you eat: do you prioritise meal times and eat in a relaxed environment? Do you chew your food properly or gulp too fast? Don’t forget that digestion starts in the mouth.
Also have a think about your stress levels. Stress can have a dramatic impact on digestion, affecting our digestive secretions and ability to properly digest food. Find time every day to give your body some relaxation – whether it’s walking the dog, doing some gentle exercise or 10 minutes of meditation. So many IBS sufferers recognise that their symptoms get worse whenever they are stressed, so it’s vital to address this area of your life.
Constipation: what can you do with diet, exercise and lifestyle?
Many people don’t realise the importance of passing a stool daily. Just because you’ve always been a “once every 3 days” person, doesn’t mean this is a healthy bowel habit. Getting your body to excrete waste 1 to 3 times per day is a really good goal for your health.
Many of the hundreds of clients I see find their bowels work more efficiently when they don’t eat so much gluten, especially wheat. Although there haven’t been scientific trials that definitively link constipation and wheat intake, I can tell you from my experience of working with hundreds of people with IBS that in the majority of cases reducing wheat helps considerably. This doesn’t mean you necessarily need to go 100% gluten free, but if you look at your diet and see how many times a week or day you eat wheat, you’ll probably be surprised.
Wheat is found in many foods, mostly bread, cakes, biscuits, pasta, pastries and cous cous. It is the grain which contains the highest amount of gluten, a sticky protein which seems to cause digestive discomfort in many people. Try reducing your wheat intake to just a few times per week, and when you do eat wheat, pick pitta breads or wraps instead of your usual bread, which can be more stodgy and difficult to digest. Bread absorbs a lot of water, which is another reason it can be problematic for the digestive system.
Also include more soluble fibre in your diet. Traditional conventional medical advice for constipation often includes more wheat bran and wheat fibre, but this can in fact exacerbate the problem as described above. Instead, include soluble fibre from nuts, seeds, vegetables, fruit and wholegrains. One of the best ways to do this is to soak whole flaxseed (linseed) in some water, and add a teaspoon to porridge or yoghurt once or twice per day.
Do also make sure that you are drinking enough fluids, otherwise your stools will become very hard and pellet-like. Include more water and herbal teas in your diet, aiming for 1.5 litres per day.
Gentle exercise may also help to get the bowel moving, by gently encouraging movement of stools along the bowel. You can also massage your abdomen, using clockwise movements around the belly button and outwards. A good massage therapist experienced in abdominal massage can also be very helpful.
Many gastroenterologists also encourage better toilet habits, which include trying to avoid straining. Only strain up to 80%, to prevent haemorrhoids from forming, and put a small footstool in front of the toilet to bring your knees up and encourage the passage of stools along your bowel.
Magnesium may be supportive for bowel movement, encouraging the muscular push of stools along the bowel. Try taking 200mg of magnesium about half an hour before bed.
In part 2 of this article, we’ll be looking at the other 5 symptom groups and how you can work to support your bowel health on a day to day basis.