Gut feeling: it’s time to speak out about bloating, constipation and heartburn | From the inside out


The British stiff upper lip has a lot to answer for, not least our reluctance to talk about intimate bodily functions without feeling squeamish. Take gut health, a term that covers how well our stomach and intestines are working. Increasingly, experts believe there are important health benefits to be gained from talking openly about how well our guts are, well, performing. Everyone needs to stop worrying about divulging “too much information”.

Gut health matters because research indicates it can affect many of our body’s systems and functions, from our metabolism to our mental health, to our digestive system.

The gut microbiome is a complex ecosystem of trillions of micro-organisms (mainly bacteria) that live in the digestive tract, mainly the large intestine. These bacteria are thought to play a role in regulating the immune system and protecting against disease. The microbiome may influence digestive problems including bloating, constipation and gas, as well as other conditions, from fatigue to anxiety and depression. There is now evidence that chronic conditions such as Parkinson’s and dementia can be related to changes in the nature of gut microbes.

The good news is that your gut is great at telling you if it’s not working well; the bad news is that people tend to be less keen on sharing details of their symptoms. “Usually, people find it embarrassing because it involves talking about things like constipation or the need to hurry to the toilet. These aspects are difficult for patients to talk about,” says Dr Fernando Azpiroz, an expert on digestive diseases who was previously chair of the gut microbiota for health section of the European Society of Neurogastroenterology and Motility.

The really good news is that guts are hugely adaptable. What you eat can quickly change your gut microbiota, says Azpiroz. Guts are very clever – some 100m neurons line the gastrointestinal tract, about nine metres end to end from the oesophagus to the rectum.

“The gut is the entry door for nutrition,” says Azpiroz. “If your gut is giving you trouble, the first thing to do is to pay attention to your diet. You have to be careful to eat regularly and to eat a balanced diet, avoiding overconsumption of fats and spices. Eating breakfast, lunch, and not too much for dinner are the sort of obvious things that help.”

He estimates that as many as one in three people suffer from poor bowel function, such as loose stools. “It’s a very common complaint,” he says.

The trouble is that most of us don’t want to talk about it, or about feeling bloated or suffering from flatulence. But we’d benefit if we found the courage to speak up, says Azpiroz, as there may be ways to ease the symptoms.

But if symptoms persist, it’s important to get them checked to rule out conditions such as irritable bowel syndrome or something more serious.

Many aspects of modern life have been shown to contribute to an unhealthy gut, not least stress, fatigue, poor dietary habits and overuse of antibiotics. If you’re not feeling your best, the idea of making adjustments can seem overwhelming, but even simple changes can help. Eating your food more slowly can help digestion and absorption of nutrients, while staying hydrated helps the mucosal lining of the intestines as well as the balance of good gut bacteria.

Ultimately, though, experts agree that eating more dietary fibre and upping our intake of plants is a great way to help keep our guts happy. For example, a review commissioned by the World Health Organization found that people who ate the most fibre were less likely to suffer from colorectal cancer and many other conditions. In a nutshell, a high-fibre diet can have an enormous protective effect.

So the message couldn’t be clearer. Eating the right foods doesn’t just keep our gut healthy, it helps ensure that our whole body is on top form. All the more reason to make sure we never again shy away from those important – and gutsy – conversations.


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