Author: Dr. Joanna Krzeslak-Hoogland

Common digestive problems are often related to our lifestyle and our diet. Sometimes, however, they can have other causes, such as hormonal problems, neurodegeneration, autoimmunity or chronic infection. In these cases, dietary interventions may have less therapeutic effect but are still worthwhile.In this article we will talk about bloating, diarrhea, constipation and heartburn.But before we begin, I want to point out that in getting the best and long-term results, it’s important to be consistent and think about building a solid, healthy foundation. If we rely on ‘quick and dirty’ solutions, digestive problems can get worse eventually leading to systemic health issues.

 #1 Tips for bloating

Bloating is associated with a feeling of tightness in the abdominal cavity and is often described as a ‘balloon in the stomach’ feeling. The cause can be as simple as eating and drinking too fast and eating too large portions. Excessive consumption of starchy foods such as cereal products, seeds and nuts can also promote bloating. A common bloating bomb is eating a pizza and drinking a large dose of Coca-Cola or another carbonated beverage. Abdominal bloating can also be caused by low stomach acid, dyspepsia (indigestion), impaired pancreatic function or impaired bile production and release, constipation, food allergies, food intolerances, celiac disease, gallstones, Small Intestinal Bacterial/Fungal Overgrowth (SIBO) or Small Intestinal Yeast Overgrowth (SIFO), dysbiosis of the intestinal microbiota, Helicobacter pylori infection, parasitic infections, inflammatory bowel disease (IBD), use of medications that affect the digestive process, hormonal changes, reproductive problems, or the presence of fluid in the abdominal cavity. People with irritable bowel syndrome also often experience bloating.

What can you do? Firstly, eat slowly, chewing each bite well, avoid drinking a lot of liquids during meals, do not eat processed and unhealthy foods, limit sugar, fizzy drinks, artificial sweeteners, and lactose. If you are a fruit lover, reduce your fruit intake to one portion a day. A very simple tip, don’t overeat. Don’t overload your stomach with more food than it can handle. For occasional bloating, you can drink peppermint, ginger, fennel, chamomile tea or take stomach drops.

If, after following the basics, you still experience persistent bloating, consult your doctor. Waiting too long and experimenting may aggravate the problem and not have the desired effect.

#2 Tips for diarrhoea

Diarrhoea occurs when there are loose and watery stools and when the intestinal passage is too fast. Diarrhoea is defined as acute when it lasts less than four weeks, as in the case of viral gastroenteritis. Diarrhoea is chronic when it lasts four weeks or longer. Everyone will have diarrhoea once in a while for a few days that resolves on its own and this is usually not a serious problem.

Acute diarrhoea. Acute diarrhoea is usually a sign that the body wants to get rid of something; it could be microorganisms, parasites, nutrients or toxins, such as during food poisoning. In this situation, the toilet is your best friend. It’s a smart way to eliminate infectious and undesirable agents, and it usually subsides within a few days. During acute diarrhea, you are not very hungry. Just make sure you stay adequately hydrated (10 glasses a day) by frequently drinking small amounts of fluids (water, electrolytes, vegetable juices, broths, soups). If you feel like snacking, let it be easily digestible, cooked and soft foods such as cooked rice, cooked vegetables, banana, apple mousse.

Chronic diarrhoea. Chronic diarrhoea, on the other hand, can be the result of food allergies, food intolerances (lactose, fructose, histamine), celiac disease, persistent bacterial, parasitic, fungal or viral infections, bacterial overgrowth (SIBO) or yeast overgrowth (SIFO) in the small intestine, inflammatory bowel disease (IBD), irritable bowel syndrome, diverticular disease, gall bladder problems, consumption of sugar substitutes (sorbitol, mannitol, xylitol), alcohol abuse, malabsorption, hyperthyroidism, excessive fluid secretion through the intestines or use of medications and supplements (magnesium citrate, vitamin C). Stress is also an important factor. It is worth mentioning that when you have chronic diarrhoea, you run the risk of not digesting your food well and not absorbing all the nutrients well, which can end up in nutritional deficiencies.

Because chronic diarrhoea can have serious health consequences, you need to have a good look at your case. Your doctor may refer you for a stool test to rule out parasitic or bacterial infection, the presence of latent blood or inflammatory bowel disease; they may order a blood test to rule out allergies, celiac disease or refer you for a colonoscopy. You may also choose to have a comprehensive stool test to look at functional markers of the gut and the balance of the gut microbiota. The test results will dictate the best approach. Also, eat foods with binding properties such as bananas, rice, potatoes, cooked chicken or meat, yoghurt or oatmeal. It will also help to avoid processed foods, excess sugar, sweeteners, caffeinated beverages (coffee, green tea), alcohol, fruit juices, or excess dried fruit.

If you have diarrhea accompanied by severe abdominal pain, severe weakness, blood in your stools, fever, or signs of dehydration (dry mouth, restlessness, excessive thirst, low urine volume), contact your doctor immediately. Take special care with elderly people and young children suffering from diarrhoea, as they are at greater risk of dehydration.

#3 Tips for constipation

Constipation is defined as prolonged retention of intestinal contents in the digestive tract (large intestine, rectum) and stools are often hard in consistency.

Constipation is usually a result of poor diet, lack of exercise, low intake of fibre and water (fluids). Fibre absorbs water and makes stools larger, softer and easier to pass. Constipation can also be caused by dysbiosis of the intestinal microbiota, use of medications (opioids, iron supplements, antacids, sedatives, antidepressants, bismuth salts, diuretics), hypothyroidism or neurodegeneration. Interestingly, one of the first non-specific symptoms of Parkinson’s disease is constipation. Constipation affects women (possible thyroid connection) twice as often as men and is more common for elderly people (possible neurodegeneration, lack of fibre in the diet and less physical activity). Constipation can also occur when we repeatedly ignore the signals to defecate, our reflex to defecate may then weaken and the accumulated stool will harden, creating a vicious circle.

Before we move on to tips you can follow to deal with constipation, I would like to briefly highlight the bowel passage. The optimal frequency of bowel movements is considered to be at least one bowel movement every 1-2 days, with a bowel transit time in the range of 12-48 hours. People with constipation often have a bowel passage that lasts longer than 48 hours.

It is normal for everyone to experience some variation in bowel frequency, but ideally most bowel movements should take place within 12-48 hours. Menstruation, vigorous exercise, diet, travel and stress can also temporarily affect faecal output. As well as considering the number and frequency of bowel movements, also pay attention to their consistency, the effort required to pass them and any associated symptoms. To assess how long it takes from eating food to digesting it and eliminating it as stool, you can count your intestinal transit time, read below how to do this.

Intestinal transit time test

To do the test, you need to consume something that you can later find in your stool, either in the form of colour or pieces of food. You can take activated charcoal tablets (about 1000 mg), or eat red beets (3-4 whole beets, cooked or raw), or consume sesame seeds (1 tablespoon mixed with a glass of water), or eat corn kernels (one cup of cooked kernels).

Note exactly when you took the charcoal or ate one of the suggested foods. Then look at your stools until you see what you are looking for. That is, when you see a darkened stool (charcoal will turn your stool black), a dark purple-red colour (after beetroot), or you see sesame seeds, corn kernels – note the time and count how many hours have passed since you consumed the product. This will be your intestinal transit time.

It is believed that the optimal passage time is between 12 and 48 hours. Passages longer than 72 hours indicate constipation and the possibility of other intestinal problems.

It is important to know that some foods naturally move slower or faster through the digestive tract, depending on their fibre and water content and hydration levels. Therefore, it may sometimes be necessary to repeat this test to get your average time for food content to travel through the digestive system. Caffeine and alcohol tend to speed up transit times. Studies show that men tend to have shorter transit times than women.

Coming back to constipation, adequate hydration and fibre are the colon’s best friends and are essential to its health, which is why they are one of the best solutions for constipation.

There is no one magic remedy for constipation that works for everyone. Effectiveness may depend on the cause of constipation, but below I give some tips that should help in most cases.

Here they are:

• Drink enough water/liquids (2.5 – 3 litres a day).
• Be physically active if possible.
• Use a toilet footstool to make bowel movements easier.
• Eat plenty of vegetables (up to 800 – 1000 grams per day), fruit, whole grains and pulses as a source of fibre.
• Consume 1-2 tablespoons of olive oil (optionally with a squeeze of lemon juice) upon waking and before going to bed.
• You can take 200 mg to 600 mg of magnesium citrate per day, in 3 divided doses.
• You can take vitamin C (preferably buffered vitamin C, liposomal form or ester-c), 2,000 to 4,000 mg per day, along with magnesium citrate. A simple rule applies here: if you start having loose stools, reduce the dose.
• Try psyllium. Follow the directions on the label and drink plenty of water, this is very important.
• Consume berries, chia and flax seeds, cooked leafy vegetables, artichokes, sweet potatoes and pumpkin.
• Drink 1-3 cups of coffee or green tea a day if you can tolerate it and if you don’t suffer from insomnia.
• Stimulate vagus nerve function (to improve brain-gut axis function and bowel peristatlty) by regular throat gargles, loud singing or enemas (with water and coffee).
• If you use laxatives, do so as prescribed and choose products that are safe to use.
  
  

#4 Tips for heartburn

Heartburn is associated with a burning sensation in the chest and is a common symptom of gastric reflux.

Gastroesophageal reflux disease most commonly develops as a result of abnormalities in the adequate tone of the lower oesophageal sphincter and the adequate tone of the circular smooth muscles in the distal part of the oesophagus, and/or as a result of changes in the mechanisms that neutralise gastric contents.

Common triggers for reflux include overweight, pregnancy, smoking, hiatal hernia, overtraining, overeating, wearing tight clothing, lying down, bending over, certain medications and supplements (antibiotics muscle relaxants, blood pressure medication, ibuprofen, hormones, potassium and iron supplements), Helicobacter pylori stomach infection, low magnesium levels, chronic cough, stress, old age or food sensitivities and allergies.

Certain foods and drinks can also aggravate reflux, these include alcohol, coffee, caffeinated products, cocoa, soda, onions, garlic, citrus fruits, tomato products, high fat foods and fried foods.

The good news is that heartburn and gastric reflux can often be alleviated and cured through dietary and lifestyle interventions, especially if you have not developed esophageal inflammation.

So, before you start reaching for stomach acid-lowering agents (H2-receptor antagonists, aginates or proton pump inhibitors), invest in your diet and lifestyle. Reflux medications have side effects and usually do not solve the underlying problem.

What can you do? Eat regular but smaller meals, chew your food well, try chewing gum, avoid foods that make heartburn worse (spicy and hot foods), stop smoking, lose weight, avoid tight clothing, avoid unnecessary medication and exercise sensibly. Also try chamomile, ginger, dill or liquorice tea; liquorice extract, cabbage juice or yoghurt to relieve heartburn symptoms.

If symptoms do not resolve after consistent application of the above tips, seek medical attention to properly assess the cause. Long-term gastric reflux can lead to complications such as esophagitis, Barrett’s esophagus and eventually swallowing disorders.

The information provided here is for educational purposes only and is not a substitute for medical or nutritional advice from a qualified specialist.

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• Book: Textbook of Natural Medicine, 4th Edition. Joseph E. Pizzorno & Michael T. Murray. 2012, Elsevier.
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Dr Joanna Krzeslak-Hoogland

Having seen the incredible benefits of a healthy lifestyle and nutrition on the health of her family as well as her clients, Joanna is inspired to pass on her knowledge to others and help them make informed health choices.

The main focus of her advice is to strive to create balance in the body. Firstly, by looking for signs of certain imbalances in the body (based on symptoms and lab test results); and secondly, by introducing lifestyle interventions, nutritional interventions and dietary supplementation to help regain greater balance. Education, motivation and the right attitude also play an important role. Everyone has different needs and challenges, so Joanna takes the time to listen and understands the value of communication.

Joanna graduated with a master’s degree in biology at the University of Warmia and Mazury.

Joanna completed her Master’s degree in Biology (at the University of Warmia and Mazury) after which she came to the Netherlands to continue her academic journey. In the Netherlands she did her PhD research in molecular microbiology at the University of Groningen, defending her PhD in 2009. Her next step was to start working for a renowned biotech company, where she worked in the clinical research department and then in the medical information department. In 2015, she started an exciting new chapter in her life by starting her own business while pursuing her passion for spreading knowledge about healthy lifestyles and gut health, combined with helping others. In the Netherlands, Joanna gained higher professional training in nutrition and nutritional supplementation (HBO) and I am registered as a natural health therapist. Joanna also holds qualifications in basic medical knowledge (Con Amore, Netherlands), functional medicine (Functional Medicine University, USA) and the basics of traditional Chinese medicine (Shenzhou University, Amsterdam). Joanna continuously invests in her personal and professional development, extends her knowledge by participating in training and reading scientific literature. Apart from individual consultations, Joanna also provides consulting services for companies in the field of human intestinal microbiota, nutrition and dietary supplements. Joanna is an author of scientific publications and has had the honour of contributing to Polish translations of American bestsellers on gut health.