Digestive and Bowel Health

What about digestive and bowel health?

Normally digestion should work without problems, although the frequency of bowel motions can vary from person to person. However, if something goes wrong, your normal bowel movements can change, becoming loose, watery and frequent (diarrhoea); or hard, dry and infrequent (constipation) at the other extreme.

What causes diarrhoea and constipation?

• Gastroenteritis (inflammation of the gut): this is a common cause of diarrhoea due to an invasive organism such as  bacteria, viruses or parasites that get into your digestive system from raw food, unwashed vegetables, undercooked chicken, raw eggs and poorly-kept cooked food (food poisoning). Contaminated  water and unwashed hands (especially in cooks) are other ways to get gastroenteritis. Sometimes it can be spread directly from person to person. The resultant diarrhoea may be accompanied by vomiting
• Traveller’s diarrhoea: is the same problem, except that it’s due to a change in bowel bacteria associated with being in a different country
• Anxiety can cause loose and more frequent bowel motions
• Change in daily routine of life is a common cause of constipation
• Antibiotics can cause diarrhoea by changing the balance between good and bad bacteria in your gut when the bad guys win, producing toxins which can irritate your gut
• Narcotic analgesics like codeine can slow down gut motility (the movement of food through your digestive system) and cause constipation
• Artificial sweeteners can have a laxative effect and can cause diarrhoea.
• Diet: Not enough water or fibre in the diet causes hard stools
• Overuse of laxatives can cause lazy bowel syndrome with resultant worsening of the constipation.
• Imbalance in the gut, where bad bacteria outweigh the good, causing digestive discomfort.

What are the symptoms?

Diarrhoea:

• Uncomfortable feeling in the stomach
• Gurgling and passing wind
• Frequent loose watery stools, sometimes of an “explosive” nature
• Stomach pains and cramps, especially on the left side of your abdomen and usually a few minutes before passing the loose bowel motion.

Constipation is signalled by:

• Bloating and abdominal discomfort
• Strain with bowel movement
• Passing hard dry stools less than three times a week.

Prevention and treatment

There are plenty of things you can do to maintain a healthy digestive system and bowel health. Most cases will clear up on their own without treatment, but if either persists (more than a week) you may have a medical problem and should probably see your doctor.

1. Keep your bowels healthy

• Eat a healthy diet with lots of fruit and vegetables and whole grains, to provide fibre, which helps the food in your bowel retain water as it is processed, keeping the stools bulky and easier to pass
• Always wash your hands after a visit to the toilet and before handling food
• Exercise helps keep the bowels moving
• Drink plenty of fluid to lubricate the whole process of digestion and prevent hard stools
• Don’t ignore body signals and do go to the toilet when you need to. Everyone has a different body rhythm and frequency of toilet visits vary between individuals.

2. When should you see a doctor?
Chronic or recurrent diarrhoea may signal a more serious condition like food intolerance, irritable bowel syndrome, inflammatory bowel disease or occasionally bowel cancer.

Dehydration may occur with severe diarrhoea especially when accompanied by vomiting in infants or the elderly and infirm.

If you have been travelling in countries where water and sanitary conditions are not what you are used to, you may have an infection that needs medication to clear it up.

Blood or mucus in the stools is a sign that something is wrong.

If constipation continues, you cannot pass stools and your stomach becomes bloated with perhaps some nausea and vomiting, then you may have blocked bowels (faecal impaction) which means you need medical help.

3. What is causing the problem?
Your doctor may ask you to obtain a stool sample to be analysed in the laboratory for signs of infection or other problems. You may also need to have a physical examination or an investigative procedure, such as a barium enema, to see if you have a blockage in your bowels.

4. Treating the problem

• Anti-diarrhoeal agents: these slow down gut movement which means that visits to the toilet are less frequent. However they do not cure gastroenteritis and should not be used in children
• A natural digestive aid can support bowel regularity and digestive health
• Oral rehydration fluids: these may be prescribed by a doctor to treat dehydration if a person has been vomiting a lot
• Laxatives: Bowel stimulants increase the activity of the bowel muscles to move stools  through the intestines
• Stool softeners: such as a lactulose or docusate softens hard stools and makes them easier to pass
• Anti-parasitic agents: may be prescribed for parasitic infections like giardia that cause diarrhoea.

5. Self-care

• While recovering from diarrhoea or gastroenteritis, try and eat a normal diet with a preference for “long chain” carbohydrates: rice, pasta and vegetables. Sometimes you will have a bowel motion shortly after eating, however this is due to a reflex where food entering the stomach stimulates your bowels to move. Rest assured, it takes food at least 24 hours to go through your 28 feet of intestines
• Keep hydrated by drinking plenty of fluids for both diarrhoea and constipation
• Take fibre supplements for constipation.