If I told you that there was a health complaint that swathes of people all over the UK were suffering with, but despite their recognition of the impact it was having on their lives - their relationships, their jobs, their hobbies, their happiness - they weren't talking about it, you'd be forgiven for calling my bluff. Sadly, this isn't the case.
Indeed, if you suffer with digestion or digestive health issues then you're certainly not alone, though you'd be forgiven for thinking so; a recent survey commissioned by Johnson & Johnson, the makers of Immodium, has highlighted the culture of embarrassment and resultant silence and misinformation surrounding symptoms of gut ill-health. And, despite 25% of digestive health sufferers experiencing symptoms at least once a week, 36% do not seek treatment. Our stiff upper lip is often referred to as a badge of national pride, but it seems to me - and other experts in the field - that it's impacting not only our physical but mental health. Talking about health issues are often missed opportunities to seek a solution - in this case avoiding pain, lessening discomfort and truly taking a step towards a healthier and happier life.
So many people that come to see me have been suffering in silence for years or - similarly - have felt brushed off by health professionals, left with the feeling that they just have to accept their symptoms and get on as best they can. Actually a combination of lifestyle changes, dietary measures and medication can result in much better management of symptoms, many finding they can totally eradicate their symptoms of digestive distress. So often people are afraid to talk about their struggles with digestive health, as they find it embarrassing or just not 'the done thing'. Don't suffer alone - start talking about it and seek ways to improve your digestive health and quality of life.
So, how can you adapt elements of your life to support better gut health?
- Stress really does affect our digestive health and why we often refer to the gut as the second brain. It is difficult to avoid all life stress but try to develop coping strategies and make time to relax each day. Techniques such as mindfulness, cognitive behavioural therapy, counselling, regular exercise, and taking time each day to do something you enjoy such as reading, walking or listening to music can all help. Making time to see friends is also important. If you suffer from depression, low mood or anxiety it is worth talking to your GP as all these will impact on your gut symptoms.
- Regular exercise can help improve symptoms of digestive discomfort. This doesn't mean you have to sweat it out down at the gym every day but anything to raise your heart rate can be beneficial such as walking, swimming, swapping the car for a bike ride, gardening or even a bit of shaking your body at a dance class (or if your anything like me having a dance by yourself to the kitchen radio!).
- Taking ownership over your symptoms and self-managing them alongside support from health professionals such as pharmacists or dietitians is the ultimate goal. There are support websites available and lots of forums for people with gastrointestinal issues where you can share tips and experiences with others and offer and receive encouragement. Making small and sustainable changes to your diet can go a long way as can feeling equipped with medication to use if you need it.
- Don't feel afraid to trial over the counter medications for digestive symptoms such as bloating, wind and discomfort. If you're not sure where to start you can speak to your pharmacist about what over the counter medications are available to help with your specific symptoms. For instance if you're suffering with abdominal discomfort or pain an antispasmodic, such as mebeverine or Peppermint oil capsules, may help bring relief.
- If diarrhoea leaves you feeling trapped and unable to leave the house or nervous about social engagements and work commitments you may want to equip yourself with antidiarrhoeals such as loperamide to have on hand. All too often I hear people tell me that they are unable to leave the house in the morning or have to leave social engagements early because of their diarrhoea. Symptoms are often worsened by the stress and anxiety this brings and worrying about when you will next need the toilet, so it feeds into a vicious circle of anxiety exacerbating symptoms and symptoms causing increased anxiety. Feeling prepared can help tackle this cycle of anxiety and diarrhoea.
- Increase fluid especially if you suffer from constipation. Most of us don't drink enough non-caffeinated fluid. You need to be aiming for at least 8 glasses of fluid a day, if you suffer from constipation you will likely benefit from upping this to 10 cups a day i.e. at least 2L per day. Any non-caffeinated fluid counts, you can try herbal or fruit teas, squash or cordial or of course water has a multitude of benefits!
- Most of us have heard that increasing our fibre intake can help digestive health symptoms. However, there are 2 different types of fibre. Insoluble fibre; found in wholegrain products such as wheat bran, brown pasta and rice and wholegrain cereals, and soluble fibre, found in fruit, vegetables, oats and pulses. Increasing your soluble fibre is likely to help your symptoms more.
- Oats are generally well tolerated and replacing wheat fibre with oat fibre may help with bloating, constipation, wind and diarrhoea. Oats contain soluble fibre which will help soften stools and help with effective elimination, as well as helping lower cholesterol levels and stabilise blood sugars - so a great 'all-rounder' addition to your diet!
- Most of us don't eat enough fruit and vegetables. Aim for at least 5 x 80g portions per day. Bear in mind that large portions of fruit in one sitting can worsen gastrointestinal symptoms especially bloating and diarrhoea so it is best to spread fruit out throughout the day and limit to a maximum of 3 portions of fruit per day. Concentrate on increasing your vegetables. Although official advice is that fruit juice can count towards 1 of your 5 a day I wouldn't recommend counting it towards your 5 if you are targeting your digestive health symptoms. Fruit juice can flood your gut with poorly absorbed sugar (fructose) and actually worsen diarrhoea and bloating, it also doesn't contain any of that wonderful fibre you get from eating the whole fruit. Beans and lentils also contain soluble fibre but they can make symptoms of bloating wind and discomfort A LOT worse so I wouldn't focus on increasing these unless you know you can tolerate them.
Limit processed foods & avoid irregular eating patterns
- As a nation we eat too many processed foods laden with fat and sugars. These foods can worsen digestive health symptoms for a variety of reasons. Cutting down on fatty foods and processed foods can help improve digestive health symptoms. As can eating regular meals spaced throughout the day.
- Linseeds are a really helpful addition to your diet if you suffer from digestive health symptoms such as wind, bloating, abdominal pain and constipation. You need to aim for 1 tablespoon a day; they are great sprinkled on porridge, salads, yoghurt or soups. It is important that you have a large glass of non-caffeinated fluid alongside these to help them do their job.
- You may want to trial decreasing your intake of wheat containing products such as breads, pasta, cakes and biscuits. Replacing with other starchy foods is important to stimulate proper gut motility. Naturally wheat free alternatives include oats and porridge, rice, buckwheat, quinoa, potatoes, sweet potatoes. This is not a gluten free diet, and you does not involve cutting out wheat altogether, small amounts are unlikely to affect your symptoms.