Tag Archives: Perth digestion dietitian

Bowel function and the Microbiome simplified

I came across this terrific article and video about your stool consistency, bowel function and the microbiome by CSIRO researcher Dr. Trevor Lockett.

The article explains how our bowel functions at many levels and the embedded video below explains what the Microbiome is and why we may each want to pay some attention to our own, individual bugs and the food we provide them.

https://theconversation.com/what-the-consistency-of-your-poo-says-about-your-health-65106

What is the human microbiome ? is a 4 min 29 sec video that is well worth watching.

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How is your toilet positioning ?

The seating position on the toilet may affect how easy our bowel can empty. For those with constipation/straining issues altering position can be helpful along with dietary food and fluid changes. Some people find the standing or ‘squat’ toilet, more common in Asian countries, is one on which they are more easily able to have a bowel action. Given that we don’t have many ‘sqaut’ toilets in Australia a change in how we sit on our ‘European toilets’ could be in order.

The following descriptions are provided on the Australian government bladder and bowel website , bladderbowel.gov.au and clearly outline the best approach.

  • ‘Using a good toilet position – Lean forward while sitting on the toilet, with a straight back and your forearms on your thighs. Your feet should be raised so that your legs are angled slightly upward and away from your body. A footstool may help you to find the best angle’
  • I would also suggest that if at first you don’t have success then get up from the toilet and walk around. It may help to try having a warm/hot drink and waiting till the next urge is felt.

A picture is worth a thousand words………….

this image is from allofpregnancy.com

Diverticular Disease

 

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Diverticular Disease is a common disorder of the large bowel and is usually diagnosed after middle age. It is thought to occur where aging muscles weaken in the large bowel and small bulges develop where the intestine wall starts pushing out into the weakened areas, these bulges may be called pouches. Many people only find out they have this condition after a routine colonoscopy rather than from developing symptoms as they do not get inflamed diverticular pouches. Others find that the pouches formed in the intestinal wall get faeces trapped in them and infections develop. This is called diverticulitis or inflammation of the diverticular and can causes diarrhoea and pain. Recovery from this painful condition may involve a special diet and antibiotics.

With the general condition condition, in the non-inflamed state, having a regular and easy-to-pass stool is essential as straining puts pressure on the intestinal wall pouches and can make them larger and more likely to trap food. Maintaining a high fibre diet as your regular diet when your diverticular pouches are inflamed is the best way to reduce the likelihood of this occurring. If you experience the inflamed pouches known as diverticulitis however a reduction in fibre intake and medical treatment is commonly required. An Accredited Practising Dietitian can help you with this, ask your GP or Specialist to refer you.

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Coffee and digestion – what is the story?

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Some folk with digestive upset swear that coffee does not affect them and others found they had to give up that delicious beverage to reduce some symptoms. Those who experience only constipation find a morning coffee has a beneficial laxative effect.

So your relationship with coffee probably all depends on the type of symptoms you experience.

It is not just caffeine that is the issue so just changing to decaffeinated coffee is not the answer usually. There are a myriad of naturally occurring chemicals in coffee that make it taste as it does and many of these may act on secretion processes in the gut, increase inflammation and intestinal content movement. Remember too that our love of coffee and strong coffee at that has increased enormously in the last five years and many guts are feeling the consequences.

Actual scientific evidence is variable though probably due to the different effects on different gut segments. It is known however that drinking coffee makes stomach symptoms worse in general – it can lead to inflammation of the stomach (gastritis) as well as making reflux (gastro-oesphageal reflux) worse. The laxative effect of coffee makes those with rapid gut transit /diarhoea symptoms worse though as mentioned above constipated individuals benefit from this. Coffee itself is however low in FODMAP’s it may be that you can include some in your daily plan…so again, it depends on your individual symptoms.

I am often asked ‘How do I know if coffee affects my symptoms?’ . The simple answer is to do a two week trial and see what happens, a diary helps. This is not as hard as it sounds as because chances are you are feeling off with digestive symptoms and a if a limited time without coffee could see some improvements most people manage this. If that is too much try just one fairly weak cup per day and have it with food, not on an empty stomach. Alternative hot beverages include black/milk tea , lemon and ginger tea or chamomile tea for example.

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‘Heartburn’ a.k.a. Gastro-oesophageal reflux (GORD)

Once we swallow food/fluids they passes down our throat/oesophagus and through a valve/sphincter to the stomach where it mixes with acid stomach digestive juices. If some of the stomach contents flow back into the throat/oesophagus and results in a burning sensation in the throat. If this happens regularly the lining of the throat becomes inflamed.

If it is just occasional then an antacid can be used to relieve the condition but if you are regularly reaching for the antacids it is time to get some help as long-term this condition has some serious consequences. If you are pregnant it is a special case where the baby can push your stomach contents higher and into the oesophagus so see your GP.

Help comes in the form of :

  • Dietary change to reduce meal size and make it more easily digestible until the inflammation subsides- temporarily lowering fat intake in particular is important as well as minimising alcohol, chocolate and coffee intake.
  • avoiding peppermint flavoured sweets/gum/tea etc as this relaxes the oesophageal sphincter more.
  • managing anxiety if your symptoms are worse duet to this.
  • Sleeping with your head/neck elevated to reduce ‘back-wash’ to the oesophagus.
  • possibly medication to assist till symptoms reside as the inflammation reduces
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  • Reducing/Quitting Smoking and losing weight if overweight is also be very helpful.

An Accredited Practising Dietitian can get you started on the road to increased comfort.

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Gastritis

Gastritis is the name given to the inflammation of the stomach lining and is a very common condition.In some cases there may be no symptoms and people find out they have it after a routine biopsy. In most cases though individuals are aware of pain in the upper abdomen, nausea, indigestion and loss of appetite and at times vomiting.

Gastritis can be caused by a variety of factors including:

  • regular taking of aspirin or other non-steroidal anti-inflammatory medications
  • a bacterial infection called Helicobacter pylori
  • excess/regular alcohol or coffee
  • protracted vomiting
  • when there is an overproduction of gastric juices

It can be that people notice this when they are stressed or anxious as for some this is the time they will have some excess gastric juice production.

Treatment for this condition may include medication to reduce the gastric juice production or treat helicobacter infection if present. Reducing alcohol and coffee intake will usually help and for some the introduction of a temporary low fat, easy to digest diet will result in the required relief. Talk to a GP and an Accredited Practicing Dietitian about resolving your condition.

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Accurate Diagnosis

Vector-Entrepreneurship-WomanAccurate Diagnosis of the problem is the opposite to random diet trials which sufferers may be experimenting with.

Diagnosis is essential because just improving symptoms through dietary restriction may just be a band-aid measure. Incomplete investigation can hide serious intestinal or other  problems and these need excluding. Unnecessary restrictive diets also threaten nutritional status and overall health, definitely something we want to avoid.

Diagnosis will usually involve an Accredited Practising Dietitian specialising in digestive issues, your Doctor, and in many cases a referral to a Gastroenterologist (Gastrointestinal Specialist) whose specialist knowledge can determine essential tests and interpret the results.

Putting a finger on the exact digestive issue can be surprisingly difficult in many cases and needs a concerted plan to escape the treadmill and frustration of unstructured trial and error.

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Why is my Digestion Dodgy

As you see from the digestion image there are many parts and processes digestion partsinvolved in digestion between the mouth and the anus. Given the complex nature of digestion it is no surprise that a large percentage of the population experience poor digestion on a regular basis.

Gastrointestinal(GI) disorders occur when one or more parts of the GI tract work poorly and may result in  nausea/ reflux, early fullness, altered intestinal transit time(diarrhoea/constipation), bloating, excess passage of wind, pain and discomfort. Ouch!

There may be an underlying disorder such as Coeliac Disease, Diverticular disease or Chrohn’s disease for example or it may be that the symptoms are not explained by any of these disorders and Irritable Bowel Syndrome is thus diagnosed- a functional GI disorder.

Improving your digestive comfort and quality of life will occur once diagnosis is confirmed and careful investigation of your individual gut response to dietary food components is determined. As an Accredited Practising Dietitian Specialising in Digestion Issues I see the benefit of a targeted plan for diagnosis daily and encourage you to go this path for eventual better control of your symptoms and get back to some of the activities you used to enjoy.

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Fibre and your Bowel

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The fibre content of your diet refers to the part of what you eat that is the carbohydrate fraction of your diet resistant to the digestion and absorption in the small bowel. Some types of fibre are called polysaccharides, oligosaccharides and lignins. The dietary fibre part of our diet promotes actions that are laxative (increasing movement of bowel contents) ,improve our bodies blood glucose response after eating, lower blood cholesterol as well as promoting the action of gut bacteria to make substances that improve bowel health.

Fibre types vary in the degree to which they will be fermented in the large intestine by the action of the bacteria there so some result in a lot of wind production and others less so. Because of this the use if high fibre diets or fibre supplements to treat constipation may cause bloating and pain if the fibre type is a fermentable one such as wheat bran or psyllium. The low FODMAP plant foods and the non-fermentable fibres found in the Sterculia plant (Normafibe supplement) and Methylcellulose (Citrocel) can improve symptoms of constipation more gently.

Those with diarhoea-dominant bowel symptoms may need a total lower fibre intake and some other dietary modifications to slow the transit of gut contents.

Modifying the types of fibre in your diet can assist to control your bowel symptoms and sorting out which diet and supplement best suit your condition can be very helpful.

 

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Bowel Symptom Monitoring

Bowel symptom monitoring ,by keeping a four week daily food and symptom diary, is a great way to keep track of changes in your gut symptoms and identify potential trigger food groups/ food molecules. Use our page ,attached below, or an electronic diary if you prefer.

The bowel symptom/bowel habit section is particularly useful so don’t be shy about getting down to the nitty-gritty there. I find it very helpful if bathroom events are noted in the bottom (no pun intended) row and the feelings of digestive upset noted anywhere on the daily column that they occur so the timing of these around foo and drink consumption is noted.

Tip: a week at a glance diary shows symptom change very clearly. Download a copy and modify it if needed to suit your needs.

Food and Symptom DIARY

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