Dietary wise, what are the important factors to consider in terms of what needs to be removed from the diet and why?

The key culprits for digestive problems can include refined foods where there is a lack of natural fibre which should be contained within the foods.  This can cause problems with constipation and affect the gut microbiome.  Other culprits can include fizzy drinks, too much alcohol, too much coffee or tea, spicy and high fat foods, like chocolate and drinking lots of liquids with meals which dilutes the digestive fluids and makes it harder for food to be digested,

Wheat can also be a problem for some people as ‘modern’ wheat has been grown to be high in gluten to make mass production easier and cheaper. If someone gets a lot of digestive problems like indigestion, flatulence, bloating, constipation or diarrhoea then it is worth eliminating wheat for a week to see if it makes any difference.  Watch out for wheat added to soups, sauces or gravies (it may appear as ‘starch’ on the label and will most certainly be refined).  If they find that they feel much more comfortable without wheat, then they could try a grain called spelt (which is far lower in gluten) which was the original form of wheat and many people who can’t tolerate wheat can digest spelt perfectly well.

I think gut related conditions have changed from a generation ago as the quality of our diet has declined.  It is not only that people are eating more refined, processed, high fat and high sugar fast foods and drinks than they did years ago.  But the quality of our food has declined even when someone is trying to eat well. 

Also stress levels have increased from a generation ago and particularly at the moment and that can have a massive negative impact on gut health.

What are the best supplements to suggest and why?

I would always think of probiotics when dealing with digestive problems.  There is good evidence to show that probiotics can help with diarrhoea and can be beneficial for IBS.

Your overall health depends on the healthy functioning of your digestive system; not only does it pull nutrients from food to nourish your body, but it participates in protecting it against disease.   I think it is much better for probiotics to be taken in supplement form than as a probiotic drink which can be loaded with sugar. 

Of course, probiotics are important and digestive enzymes can also be helpful for improving absorption.

There are some herbs which can be particularly useful for soothing the digestive system.

Ginger

Ginger has a number of digestive benefits in that it can help to prevent indigestion, gas and bloating.  Ginger also acts as an anti-spasmodic and it relaxes and soothes your intestinal tract. It is also known to reduce anxiety which for some people can worsen gastrointestinal symptoms.

Slippery Elm

Slippery elm helps calm and soothe the digestive tract by coating the lining of the intestines to reduce irritation and to calm the inflamed mucous membranes in the intestines.  Slippery elm has this calming and soothing effect because it contains mucilage which becomes a gel when combined with water.

Marshmallow

Like slippery elm it contains mucilage which can reduce irritation in the digestive system and can form a protective coating over irritated and inflamed intestinal mucosal membranes.

Liquorice

Liquorice helps to heal the irritated surfaces of the intestines and also has an anti-spasmodic effect so lessening abdominal cramps. 

Chamomile

Chamomile can reduce spasms and control ‘nervous’ reactions in your gut, making it less sensitive to food and other triggers.  It also has an anti-inflammatory effect and can improve peristalsis (the muscular movement of the stool through your intestines).

Fennel

Helps prevent and relieve flatulence, as well as soothing your digestive tract and reducing cramps and spasms.

Peppermint

This herb has had the most research and it can help eliminate or reduce your spasms, bloating, trapped wind, constipation and diarrhoea.

Indigestion

Indigestion does have a number of causes, but most digestive upsets can be traced to the type of food you have eaten and the way you have eaten it. Listed below are the most common causes of indigestion:

Eating too fast

Eating too much

Drinking lots of fizzy drinks

Drinking too much coffee or tea

Eating high fat foods

Drinking lots of liquids with meals, which dilutes the digestive fluids and makes it harder for food to be digested

Smoking

Eating when you are under stress

Anxiety and pent-up feelings

Excess weight, which puts pressure on your stomach and can cause indigestion and stomach acid reflex.

Medications that can irritate the stomach lining, such as aspirin, ibuprofen and antibiotics.

Natural indigestion beating tips:

Drink plenty of fluids but not with your meals as this will dilute the digestive juices and stop them working properly.

Chew your food slowly and thoroughly to give your body time to digest it properly.

Avoid too much caffeine, which is known to trigger indigestion. No more than one or two cups of tea or coffee a day – herbal teas are of course fine.

Avoid high fat foods like chips and crisps.

If foods that are spicy, like curry, set off your symptoms avoid them.

Take a daily walk or practice some regular gentle exercise on an empty stomach.

If you feel full after a meal a twenty minute brisk walk after your meal will ease feelings of fullness.

Relax more! Stress is a trigger for digestive upsets so try some gentle yoga postures, meditation or deep breathing all of which have been shown to help relieve stress related digestive problems.

Avoid taking aspirin and ibuprofen and if you must take them, take them on a full stomach.

Sleep in a more upright position, propped up on a pillow, to ease digestion pain at night and to lessen the pressure on the stomach and prevent its contents coming back to remind you of what you ate during the day.

Try a cup of peppermint tea after eating to help settle your stomach. Peppermint reduces inflammation in the digestive tract, relieving flatulence, heartburn and indigestion.

Camomile tea also has antispasmodic, anti-inflammatory, gas relieving properties. Enjoy a cup when your stomach feels sore.

Digestive Health Tips

Chew Well

The first part of digestion happens in your mouth, so to have a healthy digestion it is really important to chew well.  So, take your time when you eat, slow down and your food will be digested better. Chewing also signals the other parts of your digestive system to get ready to receive food.  So, if you are not chewing well, the first part of breakdown in the mouth doesn’t happen, the digestive system does not get the signal to prepare itself and the food will drop down to the stomach in larger molecules than the stomach can really manage.

Another advantage of eating slowly is you are less likely to overeat. Once you start eating it takes 20 minutes for your brain to register that you are full.  So, if you eat slowly you will end up eating less food because your brain will tell you that you have had enough.  If you eat quickly, you can consume a lot more food than you actually need before your brain realises.  There is a big difference between hunger and appetite.  Hunger is when your stomach rumbles and you need to eat.  Appetite is when you want to eat because fancy some ice cream because you just saw an advert on the TV.

Don’t eat on the run

Try not to eat on the run or when stressed.  When your body thinks it is under stress and adrenaline and cortisol are released, the energy necessary for digestion is diverted elsewhere so your body can concentrate on saving your life.  This means that your levels of stomach acid and digestive enzymes will be lower than they should be.  So, if you are eating on the run, grabbing a sandwich at lunchtime but still working at your desk or rushing off to meet someone and eating the sandwich on the way, then you won’t digest that food properly. You won’t adequately absorb the goodness from that food and you’ll end up feeling bloated and uncomfortable.  You may also get loose bowel motions or even diarrhoea as the stress hormones continue to make the rectum muscles relax.

One in four British workers do not take a full lunch hour and many will even skip lunch.  People are worried about taking time to eat because they feel it gives negative impression to their bosses.  They can then end up with heartburn and feeling bloated. 

But stress can do even more to upset your digestive system.  In the gut, you have a delicate balance of bacteria and yeasts.  There are some five hundred different species of microflora in your gut and as many as nine times more bacteria than there are cells in your body.  Unfortunately, stress interferes with the levels of beneficial bacteria in the gut, causing them to be lower than they should be.  This means that other bacteria and yeasts can grow out of control.  A good example of this is the yeast candida albicans which is present in the intestinal tract and in normal healthy circumstances does not cause any problems.  But if it grows out of control then it can give symptoms such as food cravings, especially for sugar and bread, fatigue, a bloated stomach with excess flatulence, a ‘spaced out’ feeling or ‘brain fog’ and becoming tipsy on a very small amount of alcohol.

Although we tend to only think of the gut in terms of digestion it does a lot more than that.  It acts as an efficient barrier to invading organisms – up to 70% of your immune system is in your gut. So, it is really important to have good levels of beneficial bacteria.  I would suggest taking a probiotic.

Don’t drink with food

Don’t drink with food as this dilutes the digestive enzymes in the saliva in the mouth which makes the first part of the digestive process less efficient.  Also the next part of digestion after the mouth is the stomach and this needs acid to break down the food.  Having water with the food makes it harder for the stomach to do its job and may end up producing more acid.

Fibre

Everybody tends to think of fibre in relation to the bowels and alleviating constipation.  But it has a much more important job in controlling blood sugar swings and weight.  The fibre in wholefoods helps control your blood sugar swings and so reduces the amount of cortisol being released by slowing the rate of food leaving the stomach. Slow digestion means you do not get a fast release of sugar into the bloodstream and no high levels of insulin pumped out.  Fibre can also give you a sense of fullness so can help with appetite control by making you feel less hungry.  There are two main types of fibre: 

• soluble – found in fruits, oats, vegetables and beans
• insoluble – found in whole grains and nuts

Soluble fibre is better for controlling blood sugar swings as it has the biggest impact on controlling insulin.  Soluble fibre also helps to control cholesterol because it binds

If you would like to explore whether a consultation with an expert nutritionist at the Glenville Nutrition Clinic could help you, please contact us on 01892 515 905 or send us an email at reception@glenvillenutrition.com

Non-Coeliac Gluten Sensitivity

Over the last few years there has been recognition that a person can be sensitive to gluten but not have full-blown Coeliac disease. So you might have symptoms that are similar to those experienced in Coeliac disease but antibodies in the blood are negative and it does not cause damage to the small intestines.

When this is the case, you might still benefit greatly from a gluten-free diet, seeing dramatic improvements in your symptoms and your sense of health and wellbeing in general.  (Volta U, De Giorgio R, 2012, New understanding of gluten sensitivity, Nat Rev Gasstroenterol Hepatol, 9, 5, 295-9). 

Symptoms of non-coeliac gluten sensitivity can include not only gastrointestinal ones like bloating, abdominal pain or discomfort, diarrhoea, constipation but also tiredness, lethargy, migraines, headaches and joint pains.

Research is suggesting that gluten sensitivity is extremely common and could affect up to 10% of people compared to 1% for Coeliac disease (Hogg-Kollars S et al, 2011, Gluten sensitivity a new condition in the spectrum of gluten-related disorders, Complete Nutrition, 11, 4, July/August).

It is thought that the toxic peptides of gluten may actually trigger auto-immune conditions in different parts of the body e.g. Hashimoto’s thyroiditis, Lupus etc.

Research shows that non-coeliac gluten sensitivity can upset the balance of bacteria in the gut, cause inflammation in the brain, increase cognitive dysfunction and increase a person’s vulnerability to Alzheimer’s. (Daulatzai MA, 2015, Non-celiac gluten sensitivity triggers gut dysbiosis, neuroinflammation, gut-brain axis dysfunction, and vulnerability for dementia. CNS Neurol Disord Drug Targets, 14, 1, 110-31)

Wheat Allergy

I will mention wheat allergy briefly just to make clear the difference between a wheat allergy, Coeliac disease and gluten sensitivity.

A wheat allergy is the type of allergy where you would have an IgE antibody reaction to one of the proteins in wheat as measured on a blood test.  Symptoms can include nausea, bloating, hives and also breathing difficulties.  And like other IgE reactions to other foods, such as peanuts and shellfish, it can cause a life-threatening anaphylactic allergic response.

When a person has a wheat allergy they only have to eliminate wheat from their diet, not other grains such as rye and barley (which a Coeliac would have to eliminate).

Gluten

Gluten is a protein found naturally in grains. Over the years the gluten content of wheat has been altered to be increasingly high so that the grain does not fall apart as it goes through commercial bakery machines. Obviously, commercial bread is not made by hand and so the grain has to be robust enough to endure the factory process.

Gluten acts like glue, it is stretchy and sticky (think of how a mixture of flour and water is often used as a paste for gluing papier-mâché). The problem is that it has the same effect inside your body, making it hard to digest and also absorb nutrients. You may also suffer from symptoms such as abdominal pain, bloating and diarrhoea as well as other non-digestive related symptoms such as tiredness, headaches and joint pains.

Grains like rye and barley also contain some gluten, but in much smaller amounts than wheat. Oats don’t naturally contain gluten but they can often become contaminated with gluten during growing because the oats can be next to the wheat fields and can also be contaminated during the milling process.

There are now gluten-free oats available but some people who react to gluten can also react to a protein in the oats called avenin which is similar to gluten.

Spelt is another grain that contains gluten and is often called ‘ancient wheat’ because it is one of the original strains of wheat. The gluten in spelt is different from the gluten in wheat in that it is much easier to digest and a number of people who find wheat a problem can tolerate spelt.

Get used to reading the ingredients of foods like condiments. For example, lots of soya sauces contain wheat so it is often better to look for wheat-free tamari. I know you can buy gluten-free breads and other baked foods but the ingredients have, in general, appalled me. The aim seems to be to make the food ‘gluten-free’ and disregard the health aspects of the food, so other ingredients like sugar, artificial colours and flavours are often added. If you have Coeliac disease you have to avoid gluten but still to eat healthily.  Again, read labels carefully.

If you would like to explore whether a consultation with an expert nutritionist at the Glenville Nutrition Clinic could help you, please contact us on 01892 515 905 or send us an email at reception@glenvillenutrition.com