From the gut: Cramps, constipation and other tummy troubles explained
Tummy troubles are very common, but knowing what's causing them isn't always clear. Gut expert Dr Ayesha Akbar highlights the key culprits
WHETHER it's warming up with stodgy comfort food, or carb-loading for some extra winter fuel and padding, it's not unusual for appetites to increase at this time of year.
But this can be troublesome for sensitive digestive systems. Even healthy-seeming foods, like broccoli and lentils, can cause havoc if you're prone to bloating.
Gut issues are extremely common and often – whether due to a serious, underlying condition like crohn's or coeliac disease, or a minor intolerance or irritable bowel syndrome (IBS) – the symptoms can be very similar, and sometimes very distressing.
If you are experiencing persistent problems, or any alarming changes in your bowel habits, make an appointment with your GP and get them checked – they'll be able to advise you on how to manage the problem too.
Meanwhile, Dr Ayesha Akbar, consultant gastroenterologist at St Mark's Hospital, explains the common problems our digestive systems experience, and which foods to avoid if you're suffering.
WHY AM I CONSTIPATED?
"Constipation usually occurs when waste remains in the intestines for too long. This causes it to ferment, producing wind, as well as making your tummy feel hard and painful," says Dr Akbar.
"Numerous factors are linked to constipation, including stress, anxiety and depression, side effects of medication, lack of exercise, not drinking enough fluids and a change in routine.
"In addition, if you aren't getting enough sleep, your body releases the stress hormone cortisol, which can also lead to constipation and bloating."
WHY DO I HAVE THE RUNS?
"Diarrhoea is extremely common if you suffer with IBS, often occurring soon after eating. Due to our stomachs being formed of a complex system of nerves, IBS occurs because of a loss of co-ordination, which causes diarrhoea and/or constipation and stomach discomfort," says Dr Akbar.
"In addition, IBD [inflammatory bowel disease] conditions – crohn's disease and ulcerative colitis – normally trigger an urgency to go to the loo, and uncomfortable and painful cramps. Alongside this, you may experience weight loss, bloating and blood in your faeces.
"Gastroenteritis causes short-lived diarrhoea," she adds.
"Food allergies and intolerances, including coeliac disease and lactose intolerance, and bile salt malabsorption can result in diarrhoea."
WHAT ABOUT CRAMPS AND BLOATING?
Dr Akbar says: "Cramps, bloating and wind can be a sign of IBS, IBD, a food intolerance or food allergy, or a general infection. By keeping hydrated and drinking large amounts of water, you can potentially reduce these problems, because dehydration and electrolyte imbalances can stop digestion and cause your body to hold on to excess water.
"If you eat too fast, you inhale air which can cause bloating and result in excess gas. In addition, PMS makes you susceptible to constipation, and water retention bloating increases as ovulation takes place, as more fluids and blood builds up."
WHEN SHOULD I WORRY?
Dr Akbar says: "You should never ignore any continuing or persistent stomach problems – especially if they get worse, you have an alteration in your bowel movements, or it is waking you up in the night.
"If you find blood in your faeces, you should get checked by your GP straight away, as this could be a sign of bowel cancer. Weight loss, loss of appetite, or a family history of bowel cancer should all be reasons to seek medical advice."
Most of the time, your symptoms won't be due to anything serious, but it's always best to get things checked sooner rather than later – so if there is something going on, it can be addressed and treated as necessary. Also, peace of mind can make a huge difference – especially as stress is known to exacerbate gut symptoms.
WHAT FOODS TYPICALLY CAUSE BLOATING?
"There are numerous foods that can cause bloating, and this very much depends on the person," says Dr Akbar.
"However, there are certain key items that often cause bloating in many people."
:: Fruits, including apples and watermelons, cause bloating because they contain fructose. You may suffer from 'fructose malabsorption' and find you bloat after eating them. Apples aren't as bad if they've been cooked.
:: Although garlic is a great antibacterial, it contains bloating-producing fructans.
:: Beans contain alpha-galactosidase sugars which can cause gas, and broccoli can cause bloating for some people, as it belongs to cruciferous vegetable family.
:: Fizzy drinks are the most common cause of bloating, due to the high amounts of carbon dioxide they contain.
:: Lentils are very high in fibre that can make you gassy if you consume too many. To avoid this, you should soak lentils well and opt for light coloured ones, as they're a little lower in fibre than the darker ones.
:: Some sweeteners, such as sorbitol, mannitol and xylitol, can cause digestive problems.