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What's up with our guts? Dodgy digestion is an increasingly common complaint

Dodgy digestion is an increasingly common complaint in doctors' surgeries. Lisa Salmon reports on the latest expert advice

Gut inflammation can be reduced by eating foods with a low glycaemic index (GI) plus increasing the consumption of anti-inflammatory foods

YOUR gut feeling might be that your digestive system will process whatever you throw down it. But all too often, our food choices result in bloating, wind, heartburn, indigestion, constipation and irritable bowels – symptoms that, figures suggest, are becoming more and more common.

A recent survey by the nutritionist Patrick Holford found two-thirds of people feel bloated after eating, eight out of 10 don't go to the toilet every day, and a quarter of women complain of irritable bowel syndrome (IBS).

The results are supported by a 2015 Swansea University report, which found there have been increases in most gastrointestinal disorders across Europe, plus the latest national Diet and Nutrition Survey, which found the population is still consuming too much saturated fat, added sugars and salt, and not enough fruit, vegetables, oily fish and fibre.

Holford, whose new book Improve Your Digestion has just been published, believes most digestive problems are easily resolved. In the book, he suggests different measures for different complaints, such as reducing gut inflammation, which causes symptoms including indigestion, fatigue and headaches, by eating foods with a low glycaemic index (GI), which are antioxidant-rich but contain low sugar, caffeine and alcohol, plus increasing the consumption of anti-inflammatory foods, like oily fish, red onions, turmeric, olives and ginger.

For inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, his recommendations include identifying foods that you're allergic to, or intolerant of, and eliminating them, along with eating anti-inflammatory foods and following a low GI diet, and consuming rich sources of beta-glucans, from shitake mushrooms, oats or supplements.

While IBS isn't considered an IBD, advice around managing the condition is similar.

The most common kind of immune reaction against foods isn't food allergy but food intolerance, which leads to the production of IgG antibodies, explains Holford.

A common cause of bloating, he says, is eating food you're unknowingly intolerant to.

It's estimated one in five people are intolerant to gluten (which is not the same as having coeliac disease, an incurable autoimmune condition which causes the body's immune system to attack healthy cells when even the smallest amount of gluten is consumed), so avoiding wheat is appropriate for them. Dairy is another common food which some people are intolerant to.

If someone follows healthy eating messages – eating plenty of fruit and veg and oily fish, keeping an eye on red meat consumption, and eating little processed food and saturated fats – they're much less likely to suffer digestive health issues.

He explains that in older people, stomach acid production, which is needed to help absorb nutrients, goes down, and two in five people over 60 have insufficient B12 in the blood, due to poor absorption.

"This leads to accelerated brain shrinkage and a greater risk of dementia," he says. "A lack of stomach acid can also lead to bloating and indigestion."

To maximise absorption, don't drink tea or coffee with food, as substances in them can reduce absorption. Alcohol can also irritate the digestive tract and interfere with the amount of nutrients taken in.

Healthy digestion depends on healthy elimination, says Holford, and people should go to the toilet twice a day.

"Contrary to popular belief, eating lots of fibre such as bran, doesn't make much difference. However, increasing soluble fibres, which are the kind found in oats and also chia seeds, does."

Oats are both gluten-free and high in soluble fibres, which absorb water and are good for digestive health and regular bowel movements.

Holford also recommends people drink the equivalent of six glasses of water a day – which could be in tea or other hot drinks – to aid digestion and help 'move things along'.

While most of the time, digestive symptoms won't be due to anything serious, it's worth talking to an expert who can advise on how to best manage them, says gastroenterologist Julian Walters.

"Gut complaints appear to be increasingly reported," Prof Walters says. "And people shouldn't have to suffer in silence, their lives extremely restricted in some cases by their symptoms, when good treatments and cures for everyday symptoms exist."

:: Improve Your Digestion by Patrick Holford is published by Piatkus.

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