Gut Health Conditions

 

 

Gut Health Symptoms

Many common health complaints are linked to the lower part of our digestive system – the large intestine. Our diet can play an important part in managing some of these conditions.

However, if gut symptoms like bloating, constipation, diarrhoea, or stomach cramps, persist, worsen, or are accompanied by other symptoms such as unexplained weight loss or blood in the stools, it’s crucial to see your GP. These could be a sign of other illnesses, so it’s vital to seek medical advice from qualified health professionals.

This article looks at diet and gut health conditions - for more information about how food affects our gut see our article on food and gut health.

Never self-diagnose or rely on the results of testing kits purchased online. Don’t trust advice from the internet or non-qualified individuals, either. These sources of information are often misleading or wrong. Using them to make health decisions can lead to problems such as:

  • Attempting to treat the wrong condition, making symptoms worse rather than better
  • Relying on over-the-counter remedies that mask symptoms without addressing the cause
  • Missing an underlying serious health problem that goes undetected and untreated
  • Making unnecessary diet changes that result in nutrient deficiencies and long-term avoidance of foods that don’t need to be restricted.

Your GP will arrange appropriate tests and treatments or refer you to a specialist if needed. It can also be useful to keep a food and symptoms diary to share with your GP to help with diagnosis.

This section provides basic information about some common gut health problems. Remember, you should always see your GP if symptoms persist or worsen.

Constipation

Constipation is estimated to affect around one in seven adults and one in three children in the UK and causes symptoms such as stomach pain, bloating, nausea and feeling generally unwell. Constipation also increases the risk of piles or haemorrhoids, a problem that affects around one in 10 adults.

There are many causes of constipation, including a lack of fibre and fluid in the diet, inactivity, ignoring the urge to go to the loo, changes to diet or daily routines, and stress and anxiety. Constipation is also a side effect of some medications.

Eating more fibre-rich foods and drinking more fluid can help to prevent and treat constipation. It’s important to gradually increase fibre to avoid symptoms of bloating or excess wind.

Fibre, particularly from non-fermentable (insoluble) sources such as wheat bran, helps to prevent constipation because it adds bulk to stools. This makes stools move more quickly through the gut, helping with regular bowel movements. This works in part because these fibres pull water into stools, which is why it is important to be well hydrated as well as increasing fibre intake.

Sorbitol

Sorbitol is a compound found naturally in fruits such as apples, apricots, grapes (and raisins), raspberries and strawberries. Sorbitol helps to soften stools by drawing water into the gut, which can also help to reduce constipation. Including these fruits as part of getting at least 5  A DAY may help with constipation.

Bloating

Bloating is a common problem that affects around four in 10 people, and is characterised by an uncomfortable feeling of fullness, distension, stomach rumbling, pain or discomfort, and excessive wind.

The most common cause is having excess gas in the gut, due to what we’ve eaten and drunk – and how we’ve consumed it. For example, eating quickly or when we’re on the move may mean we swallow more air, which ends up in the gut.

This can also be due to fermentation of foods by gat bacteria producing gas, which can cause bloating. So, limiting foods that you find cause gas such as cabbage, beans or lentils (containing fermentable carbohydrates) may help. For people suffering from bloating and IBS, studies have shown that the low FODMAP diet is the most effective approach for improving symptoms.

 

 

There has also been some research on the interaction between our gut microbiome, foods and bloating. Studies suggest that people suffering from bloating may have a less diverse gut microbiome and lower levels of ‘good’ gut bacteria such as Bifidobacterium and Lactobacillus compared to strains that can be harmful. These differences could affect gut function and so be linked to an increase risk of bloating.

Bloating can also be a symptom of conditions such as constipation, irritable bowel syndrome (IBS), indigestion, a food intolerance, or coeliac disease. It may also be linked to hormonal changes. If it’s persistent, it could indicate ovarian cancer. Find out more about ovarian cancer on the NHS website.

Enjoy a plant-rich diet

A plant-rich diet (also sometimes called a plant-based diet) is one where plenty of different plant foods are included but can also include some animal foods such as meat, fish and dairy.

 

Plant foods such as vegetables, fruits, beans, lentils, chickpeas, nuts, seeds, and wholegrains benefit gut health because they add fibre to diets.

Lactose intolerance

Lactose intolerance occurs when the body produces insufficient amounts of an enzyme called lactase. This enzyme digests lactose – the natural sugar in cow’s, goats and sheep milk. If this enzyme is missing, lactose isn’t digested so moves into the large intestine where gut bacteria ferment it. This causes symptoms such as bloating, wind, stomach discomfort or pain, nausea, vomiting, and diarrhoea or constipation.  

In the UK, lactose intolerance is more common in people of Asian or African-Caribbean descent. Lactase production decreases with age and so lactose intolerance is often diagnosed in adulthood and older adults have a higher risk of lactose intolerance.  

Lactose intolerance can be caused by other conditions such as coeliac disease and inflammatory bowel disease.  It may also be temporary (called secondary lactose intolerance), following illnesses like food poisoning or gastroenteritis.

The main treatment is to reduce or avoid foods that contain lactose such as milk, yogurt and some cheeses. As dairy products provide many nutrients, it’s important to replace them with nutrient-rich alternatives such as lactose-free options or plant-based milks fortified with calcium. Some people with lactose intolerance can also tolerate some lactose-containing foods without symptoms. Lactase supplements can help to digest lactose containing foods and drinks.

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a common digestive complaint. The cause is unknown, but it’s thought stress, a family history, oversensitive gut nerves, and food travelling through the digestive system too quickly or slowly may play a part.

Symptoms can come and go and may last days, weeks or months. They include bloating, stomach pain or cramps, diarrhoea, constipation, flatulence, nausea, fatigue, and backache. As similar symptoms are seen with other gut disorders, a diagnosis from a doctor is important to rule out other conditions such as coeliac disease and inflammatory bowel disease.

Tips for managing IBS

While there’s no cure, making diet changes and taking medication can help. Try these tips:

 

  • Record your food and symptoms in a diary to help identify patterns that may trigger IBS symptoms. If there seems to be a link between specific foods and symptoms, eliminate the suspected food temporarily. If symptoms improve, reintroduce the food to confirm whether it’s a trigger. Ask your GP to refer you to a registered dietitian for guidance if multiple foods seem to cause problems.

  • Eat regularly and take time over meals.

  • Don’t have too many caffeine containing drinks, for example, stick to a maximum of two mugs or three cups of tea and coffee a day, and limit fizzy drinks and alcohol.

  • Cut back on high fat/fried foods such as fried chips, pies, samosas, burgers, sausages, biscuits and cakes.

 

 

  • Don’t have more than three portions (80g) of fruit a day.

  • We don’t yet know whether probiotics help with IBS symptoms but some studies have suggested that strains such as lactobacillus or bifidobacterium may have beneficial effects, especially for IBS with diarrhoea. If you do try probiotics, stick to one type for 4 weeks so that you can see whether it has an effect.

  • Get professional support from a registered dietitian – if symptoms persist despite making the above changes, a low-FODMAP diet may be worth exploring. FODMAPs are fermentable carbohydrates found in foods like fruit, vegetables, milk, pulses, and wheat that can trigger symptoms such as bloating, excessive gas and stomach cramps in sensitive individuals. A FODMAP diet is highly restrictive though, so should only be tried with medical supervision to ensure diets remain nutritionally adequate.

Coeliac Disease

Coeliac disease is an autoimmune condition where the body’s immune system reacts abnormally to gluten – a protein found in wheat, rye and barley. This damages the lining of the small intestine, so the body can’t properly absorb nutrients.

 

It affects around one in 100 people in the UK. Symptoms include bloating, stomach pain, constipation, diarrhoea, nausea, wind, indigestion, tiredness, weight loss, and an itchy rash. If undiagnosed for many years, it can increase the risk of osteoporosis and anaemia.

 

While there’s no cure for coeliac disease, it can be managed by sticking to a lifelong gluten-free diet. This means avoiding all foods made with wheat, rye, or barley, such as pasta, bread, most breakfast cereals, cakes, and biscuits. Gluten-free alternatives are widely available to help with diet variety.