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Tag: Digestive symptoms

  • What to expect with food and digestion

    What to expect with food and digestion

    Back in the summer of 2001, I was obsessed with a certain regional brand of diet iced tea, and I would drink a few gallons of it a week. It was so good! That summer I also developed a problem with gas and diarrhea. My flatuence was so bad that I tried to keep people out of my cubicle at work because I was sure that the whole place had to stink. This coincided with a very stressful period in my life, so when I Googled my symptoms and read that irritable bowel syndrome could be caused by stress, I diagnosed myself with IBS. “Great,” I thought, “things are going badly and now I’m sick on top of it. That’s all I need.”

    Fortunately, I wasn’t “sick” — I was just drinking too much sucralose sweetener. Sucralose feeds certain types of intestinal bacteria, which in turn produce the smelly gas, and it also pulls water into the intestines, causing diarrhea. The caffeine in the tea probably added to the diarrhea by moving my meals through my large intestine too quickly for even the usual amount of water to be absorbed from the stool. Later I would realize that my summer of embarassment did not constitute a chronic illness like IBS, which needs to be going on for at least 6 months to meet the Rome III diagnostic criteria [1] — I had simply eaten too much of something that would be hard for any body to handle, and the same thing could have happened with fructose if I had been drinking the same, excessive amount of regular cola or juice.

    Direct link: The ‘What to expect with food and digestion’ infographic

    The point of my story is that sometimes a food will just do it to you. We might say that it “disagrees with you,” but if a food disagrees with you, odds are that it disagrees with a lot of other people, too. That’s why it’s important to understand that normal digestion varies, and it’s not always perfect. If you have a healthy gastrointestinal system — which puts you in only a modest majority, since almost a quarter of Americans suffer from digestive disorders [2] — this is good news. When the equipment is in working order, what you get out of it depends on what you put in. Leslie Bonci, MPH, RD, calls this an “investment in intestinal well-being” in the American Dietetic Association Guide to Better Digestion [3]:

    “To make an investiment in intestinal well-being, one should consider food choices, portions, and meal timing. Food is one of the few things in life that we can control, and it is important to use food in a positive and intestinally friendly way. Experimenting with food choices as well as eating habits can help achieve a more balanced eating pattern, a healthier lifestyle, and very often, symptom relief.” (p. 4)

    Notice that there is no mention here of food intolerance or food sensitivity: better digestion comes down to food choices and eating habits. In other words, no one can eat any amount of any food at any time without opening themselves up to the possibility of constipation, bloating, or gas. In her book, Ms. Bonci does an excellent job explaining the common effects of certain foods and supplements for anyone who wants a better handle on their digestive symptoms.

    I am also struck by Ms. Bonci’s idea that “it is important to use food in a positive…way.” We too easily throw around the term “food sensitivity” — which actually isn’t a legitimate medical term — to describe the problems that food has caused. This recent habit doesn’t foster a positive relationship with food: it amounts to making a diagnosis, a claim that you have a disorder — that there is something wrong with you, not with what you have eaten. However, there is a big difference between being ill and making poor food choices.

    The infographic

    Some foods cause the same problems in everyone when we eat too much of them or in the wrong combination. Maybe for you it’s a pepperoni pizza that will sit like a lead weight in your stomach and then cause diarrhea later on, or maybe your attempts at eating healthier — like adding whole wheat, prebiotics, beans for protein, and lots of fruits and vegetables to your diet — have backfired with gas and bloating. This is not necessarily a sign of food intolerance. Your symptoms might be normal considering what you have eaten. You can see what I mean in my infographic, “What to expect with food and digestion.”

    Sources of information for the infographic:

    Putting it together

    Managing digestive symptoms requires planning, patience, and a lot of information on how different foods can affect digestion. Talking with your doctor is the best place to start so you know that you are not dealing with any serious medical issues. Do not try to diagnose yourself. An accurate diagnosis helps you to know whether you should just change your eating habits or whether you should avoid certain foods because of a food hypersensitivity.

    To quote Leslie Bonci again, “it is important to find the correct balance regarding food choices and quantities, so that you can make a meal pleasurable and healthful, not painful.” A registered dietitian can help you restructure your eating so that food can always be a source of enjoyment.

    References

    1. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional Bowel Disorders. Gastroenterology. 2006 Apr;130(5):1480–91. http://dx.doi.org/10.1053/j.gastro.2005.11.061

    2. National Institutes of Health, U.S. Department of Health and Human Services. Opportunities and Challenges in Digestive Diseases Research: Recommendations of the National Commission on Digestive Diseases. Bethesda, MD: National Institutes of Health; 2009. Report No.: NIH Publication 08–6514. Available from: http://www.niddk.nih.gov/about-niddk/strategic-plans-reports/Pages/opportunities-challenges-digestive-diseases-research-recommendations-national-commission-digestive-disease.aspx

    3. Bonci L. American Dietetic Association Guide to Better Digestion. John Wiley & Sons; 2003. 259 p.

  • Is it food intolerance or are you just getting older?

    Is it food intolerance or are you just getting older?

    Our bodies like to remind us that we aren’t as young as we used to be. The good news is that our digestive systems aren’t affected by aging as much as the other parts of us [1]. The bad news is that we can’t abuse our stomachs like we used to if we want to maintain the pleasure of eating. Does this mean that we have developed food intolerance? Not necessarily. To see why, let’s first look at the normal gastrointestinal signs of getting older, along with some age-related complications.

    Age-related changes in digestion

    Age brings with it certain changes in digestive function that some healthy people may notice more than others, including [2]:

    • Decreased lactase production. Older adults are more likely to be lactose intolerant and experience bloating, gas, or diarrhea after eating dairy products.
    • Decreased elasticity and slower emptying of the stomach. Some people cannot eat as much as they used to in one sitting without feeling fullness or bloating.
    • Overgrowth of certain bacteria in the small intestine. Our gut bacteria is mostly confined to the large intestine, and this is normal (although some bacteria are more desirable than others). As we age, the chance of bacterial overgrowth in the small intestine increases, producing pain, bloating, and weight loss.
    • Slowing or weakening of contractions in the large intestine. Constipation is more likely as we age.

    If any of these points sound familiar, speak with your doctor to make sure that your symptoms are simply age-related and not part of a more serious problem. Be sure to discuss any signs of small intestinal bacterial overgrowth, because even though you can find plenty of Internet advice about “healing your gut” on your own, this condition may need medical treatment.

    Other gastrointestinal symptoms are not caused by aging per se, but by things that go along with age [3], such as:

    • Medications. These can increase or decrease the time it takes for food to pass through us, resulting in either constipation or loose stools.
    • Age-related illnesses. Certain illnesses can also affect the proper functioning of the digestive system.
    • Obesity. Obesity makes heartburn more likely.
    • Continuing bad eating habits. Late-night fast food or too much coffee can cause heartburn and affect intestinal transit time.

    In these cases, something as simple as a change in medication could provide much relief. As I said before, talk with your doctor about your concerns.

    Relationship with food intolerance

    If someone experiences a bad reaction after eating a certain food, it’s easy to understand why they might conclude that they have food intolerance – after all, it’s almost impossible to escape the association between food and digestion. But true food intolerance is a hypersensitivity reaction to food (emphasis on hyper-sensitivity) that most people will not encounter.

    Continuing with our original question, are any age-related symptoms actually food intolerance? Well, there are three types of food intolerance [4,5]:

    • Enzymatic food intolerance – when the body does not make enough enzymes to digest or properly use a nutrient, as in lactose intolerance or phenylketonuria.
    • Pharmacological food intolerance – drug-like effects of mostly non-nutritive food chemicals (and the subject of this blog).
    • Toxic reactions – mainly histamine toxicity from spoiling fish (scombroid poisoning)

    According to this classification, lactose intolerance is a type of food intolerance, but the other age-related digestive symptoms are not. This is an important distinction to make with regards to how we think about (and act on) our current state of health – in other words, do we continue to view ourselves as “normal” for our age, or do we start to feel like we have a “problem”?

    What does this mean?

    When food-related symptoms occur more frequently with age, this does not necessary mean that we have developed a medical problem – food intolerance – that needs to be treated by completely avoiding certain foods. It might just mean the we need to change our eating habits, like when we eat, how much we eat, and how much we can expect to indulge. For example, an adult with lactose intolerance may still be able to eat small amounts of dairy products (like yogurt) throughout the day, but they shouldn’t expect to go out after a soccer game and eat an ice cream sundae on an empty stomach like the rest of the kids. That said, if you are experiencing any of the symptoms mentioned in this article, see your doctor before attributing them to age.

    Last updated January 14, 2015

    © 2014-5 Anna (Laurie) Laforest. All rights reserved.
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    FoodConnections.org – Food intolerance resource with a scientific twist

    References

    1. Russell RM. Changes in gastrointestinal function attributed to aging. Am J Clin Nutr. 1992 Jun 1;55(6):1203S–1207S. PubMed

    2. Effects of Aging on the Digestive System: Biology of the Digestive System: Merck Manual Home Edition [Internet]. [cited 2014 Apr 20]. Available from: http://www.merckmanuals.com/home/digestive_disorders/biology_of_the_digestive_system/effects_of_aging_on_the_digestive_system.html

    3. Karen E. Hall, Wiley JW. Age-Associated Changes in Gastrointestinal Function. In: Hazzard W, et al. editors. Principles of Geriatric Medicine and Gerontology. 4th ed. New York: Mcgraw-Hill; 1998. p. 835–42.

    4. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report. J Allergy Clin Immunol. 2010 Dec;126(6):1105–18. http://dx.doi.org/10.1016/j.jaci.2010.10.008

    5. Bruijnzeel-Koomen C, Ortolani C, Aas K, Bindslev-Jensen C, Björkstén B, Moneret-Vautrin D, et al. Adverse reactions to food. Allergy. 1995;50(8):623–35. PubMed