Dr Libby Weaver

The health of the gut is central to every aspect of health. It is through our digestive system that we absorb all of the goodness from our food, a process that is essential for life. Our gut is (obviously) also one of our key elimination channels as well, and it’s important that we keep our bowels moving regularly.

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Yet today, many people suffer with an array of gut-based illnesses or dysfunction, which can have broad-reaching impacts on many other areas of our health – here are some gut friendly tips to incorporate into your daily life and help you avoid constipation.

USE LEMON JUICE/APPLE CIDER VINEGAR TO STIMULATE DIGESTION

Due to numerous components in lemon juice and apple cider vinegar, they help to stimulate stomach acid production. The digestive qualities of lemon juice/apple cider vinegar can also help to relieve symptoms of indigestion, heartburn and bloating. Begin your day with the juice from half a lemon in warm water or up to one tablespoon of apple cider vinegar (start with half a teaspoon) diluted in water for digestive support. It can be wise to avoid brushing your teeth for at least 30 minutes afterwards to minimise any potential disruption to tooth enamel.

BITTER FOODS

One of the most detrimental changes to our diet over the last century has been the continual sweetening of our foods, the result being that many people are now particularly sensitive or averse to bitter foods. Bitter foods stimulate the liver to produce bile, which is an important part of optimal digestion. Bile emulsifies fats and renders nutrients — especially fat-soluble ones such as vitamins A, D, E and K. A great way to eat more bitter foods is to include leafy greens, turmeric – and even a couple of squares of good quality dark chocolate.

MOVE REGULARLY

Healthy (as opposed to excessive or inadequate) movement such as walking, increases blood flow to our organs and increases lymphatic flow. Bringing more blood to the gastrointestinal tract results in stronger intestinal contractions and increase in digestive enzymes. The stronger the contractions and the more those digestive juices flow, the more quickly and easily food waste will move through the colon and be excreted out of the body. A 10 to 20 minute walk can be incredibly helpful to promote a bowel movement and is a great option if you suffer from constipation. Strengthening your core muscles through exercises such as yoga and Pilates is also great for healthy gut function.

FIBRE

Dietary fibre appears to have varied affects. For some, it is incredibly helpful for the gut. Soluble fibre essentially acts like a sponge, absorbing fluid and making the bowel contents softer. It also binds to toxic waste products, allowing them to be eliminated efficiently. Insoluble fibre acts as like a “bulking agent” which, like soluble fibre, helps to keep our bowel regular (although bowel regularity is often more complex than just dietary fibre consumption, movement and water, and for some people, certain types of fibre can aggravate constipation; take notice of your own response).

Fibre may be of particular benefit for our gut bacteria; both insoluble and soluble fibres have been shown to positively alter our gut bacteria in as little as two weeks. Obtain your dietary fibre from whole food plant sources.

STAY HYDRATED

Consuming adequate water also helps to promote healthy elimination, and it reduces the likelihood of constipation, as one of the primary functions of the large intestine is to absorb water from digested food. When water consumption is low, stools tend to become dry, hard and more difficult to pass, and the longer this waste remains inside the body, the more waste will be reabsorbed back into the bloodstream. Drink adequate amounts of pure water each day. Keep a large glass at your desk to ensure you stay hydrated over the day. Let your body guide you on how much water it needs by noticing your response to the water you drink. As you drink, observe if your thirst becomes awakened and your body actually seems to draw in the water. This is your body letting you know that it needs more water.

Be sure to use your bowels every day. If you don’t, make daily bowel motions a health focus for you as the gut is central to every aspect of our wellbeing.

The impact that gut health has on overall health never ceases to amaze me, and the bacteria living in the gut is an important part of this. We have anywhere from one to three kilograms of bacteria residing in our large intestine, and this is collectively known as the gut microbiome. It could almost be considered an organ given its vital role in so many aspects of human health. From digestion to immune function, to our mood and our body shape and size, a healthy gut bacteria profile is key.

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It’s therefore not surprising that people want to enhance their gut health (who wouldn’t, considering how central it is to every aspect of our health!). And it’s not surprising that companies want to create food and supplement products to help us do this. Probiotics, prebiotics and synbiotics are three such products that are often confused despite playing different roles for gut health. So what are they and are they worth your while?

PROBIOTICS

Probiotics are beneficial bacteria. Or, more specifically, they are live microorganisms that benefit the host (you) when consumed in adequate amounts.

For probiotic supplements to have any potential benefits, they must be scientifically proven to survive digestion (meaning they need to survive exposure to stomach acid) and reach the large intestine alive. They also need to be in a sufficiently high dose to have an effect, plus the pH level of the local environment (inside the intestines) needs to be appropriate for the bacteria. Whether or not a probiotic supplement is scientifically proven to survive digestion is therefore an important consideration – in other words, the quality of the supplement matters.

But there isn’t just one universal probiotic. Different strains of bacteria have different actions and health benefits, and the actions of a particular strain cannot be extrapolated to other strains, even within the same species. So supplements can contain different probiotic strains as well as different doses of the strains, which influences their effect in the body. Adding to this complexity is the fact that we don’t all respond to probiotic supplementation in the same way – our individual response can depend on the species that are already residing in our gut, as well as our own health status.

Research has shown that within about two weeks of ceasing probiotic supplementation, the strains that were present in the supplement are no longer detectable in the waste leaving the body, indicating that they don’t colonise the gut and therefore may not have long-lasting effects.

We know that our gut microbiome is greatly impacted by our food choices, so rather than supplementing probiotics, I prefer to encourage people to focus on eating real whole foods (including some fermented foods) to support and maintain a healthy gut bacteria profile.

Probiotic supplements aren’t necessarily needed for good gut health, however there is some encouraging evidence that suggests they can be beneficial for certain gut conditions:

Antibiotic-associated diarrhoea

There is good evidence that certain strains of probiotics can help to prevent antibiotic-associated diarrhoea; specifically Lactobacillus rhamnosis GG (LGG) and Saccharomyces boulardii (S. boulardii).

Irritable bowel syndrome (IBS)

There is emerging evidence that probiotics may reduce IBS symptom severity. However, given that IBS can manifest as different symptoms depending on the person, probiotics are unlikely to be a magic fix and a probiotic supplement may or may not benefit you. What helps one person may not help another, and in fact, could actually worsen their symptoms. If you decide to trial a particular probiotic supplement, it should be taken for at least four weeks to assess how it affects you. Remember, your body is your best barometer.

However, if you have IBS and you are currently in the elimination or challenge phases of a low FODMAP diet, I do not recommend taking a probiotic supplement, as this could cloud your results and make it more difficult to identify which (if any) of the high FODMAP foods you react to.

Ulcerative Colitis

In patients with mild to moderately active ulcerative colitis, studies suggest that specific probiotics may help to induce and maintain remission. The specific probiotics that may assist include E. Coli Nissle 1917 and a mixture of eight strains, similar to those showing promise in IBS.

Generally, probiotics are safe for adults to take, however those with food allergies should always check that the probiotic is free from their specific allergen, and they shouldn’t be taken by immunocompromised or critically ill people unless medically supervised. 

PREBIOTICS

Prebiotics are non-digestible carbohydrates that act as food for probiotic bacteria. They pass through the gastrointestinal tract undigested, which stimulates the growth and/or activity of certain ‘good’ bacteria in the large intestine. While all prebiotics are considered fibre, not all fibre has prebiotic effects.

Prebiotics are naturally present in foods such as onion, garlic, leeks, asparagus, Jerusalem artichokes, chickpeas, lentils, peas, oats and cashews – yet another reason why a plant-rich way of eating is so important for our health and wellbeing. While some people choose to take a prebiotic supplement if they do not consume enough prebiotic-containing foods, there is no substitute for a ‘real food’ way of eating when it comes to our health and vitality.

SYNBIOTICS

Synbiotics is the term used to describe a food or supplement that contains both probiotics and prebiotics; a food example is unpasteurised sauerkraut.

In summary, if you already take a probiotic and feel you benefit from it, then by all means continue to do so. I simply wanted you to appreciate yet another health-enhancing offering of eating whole, real foods.

Many people tell me they experience their tummy getting more and more bloated as the day goes on, leading to extreme discomfort by the evening.

Table of Contents

1. Can stress cause bloating?
2. Is coffee your culprit?
3. Support stomach acid
4. The benefits of apple cider vinegar
5. Chew your food
6. Menstrual cycle-related bloat
7. Is it a parasite?
8. Why do I bloat after eating?
9. Be your own detective
10. Thoughts to consider

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Can stress cause bloating?

There are many reasons why you may be getting bloated in the afternoon; one of the first to explore is stress. The production of stress hormones causes blood to be diverted away from digestion to your periphery so that your arms and legs are powered with a good blood supply to help you get out of danger.

However, too many people are stressed regularly due to their pace of life or perception of pressure and urgency. When we eat in this state digestion may be compromised so if you’ve had a hectic morning or you’re feeling far from calm, this could be why you’re experiencing bloating as the day wears on.

Read more: The link between stress and poor digestion

Is coffee your culprit?

You might want to block your ears for this part 🙉. Coffee can be the sole reason someone experiences bloating. Biochemically, coffee triggers the adrenals to secrete adrenaline, a stress hormone, which communicates danger to the body, diverting blood away from digestion.  This mechanism alone can be the driver. With a milk-based coffee, it may be the cow’s milk or, less often, the soy (soya) milk, but even black coffee will cause some people to bloat. Try switching to herbal tea or green tea and give coffee a rest for four weeks to see if this makes a difference for you.

Support stomach acid

Whether the result of stress or lifestyle choices, some people don’t produce adequate stomach acid, or the pH is not acidic enough. This can affect optimal digestive processes right from the outset. Think of your food as a big, long string of circles, or pearls on a string. Your teeth and saliva go to work first on breaking the circles apart and stomach acid then continues that breakdown process.

Poor stomach acid production alone can lead to bloating. When food is not broken down sufficiently it can arrive in the intestines in a form that is still too large. Here the bacteria that inhabit the large intestine will begin to ferment whatever food is delivered to them. As gut bacteria break down the larger fragments of food they produce gas, which can lead to that uncomfortable bloated feeling.

The benefits of apple cider vinegar

Apple cider vinegar or lemon juice in warm water before meals can help to stimulate stomach acid production, which promotes the proper digestion of food. It is also a good idea to drink water away from meals rather than with them to maximise the action of stomach acid.

Chew your food

Chewing food really well is the first step to help reduce bloating. Sit in a calm state and focus on chewing well and eating slowly, rather than inhaling your food. Do your best to not be distracted while you eat your meals. No more eating on the run or in front of your computer screen if you can help it! You might be surprised how much of a difference these small changes can make.

Menstrual cycle-related bloat

If your tummy only bloats in the lead-up to your period, it is likely to be caused by estrogen dominance – too much estrogen or not enough progesterone, or both.

Read more: Are you estrogen dominant?

Is it a parasite?

Did your bloating only begin after you had food poisoning or gastroenteritis or a holiday where the water or food was very different from what you usually consume? If so, a lingering unfriendly organism, such as a parasite, may be driving your bloating. There are numerous ways to treat parasites including the medicinal herbs Chinese wormwood and Black walnut. These are best prescribed by an experienced health professional who would likely arrange for a stool test, as well.

Why do I bloat after eating?

In my experience working with clients, I have learned that there are some foods that are better eaten on an empty stomach if you have challenges with your digestive system. Fruit is one of them. If bloating is an issue for you, only eat fruit first thing in the morning on an empty stomach — none for lunch and none mid-afternoon. This includes dried fruit. You may find the same thing happens with starchy carbohydrates such as bread. Some people bloat no matter what time of day they eat bread and, if that is the case, they will usually do well omitting all gluten-containing grains for a four-week trial period. Others are fine with bread/toast for breakfast but for lunch it is a disaster in their digestive system. Bread is a highly processed food, after all.

All foods containing casein (foods derived from an udder; cow, goat, or sheep, although the latter two tend to be tolerated better than cow’s milk) can be significant contributors to a bloated stomach. Remove all sources from your diet for a trial period of four weeks and observe how you feel. If you omit foods for more than four weeks, it is important you consult an experienced health professional to ensure you are not missing out on critical nutrients.

Be your own detective

Sometimes bloating is caused by the consumption of foods that your body cannot digest efficiently. It can be challenging to pinpoint a food sensitivity as we can experience symptoms up to 48 hours after consuming something that doesn’t agree with us, depending on the mechanism through which you react. If you have a feeling that something you’re eating isn’t working for you, it can be helpful to keep a note of your symptoms and everything you eat for a couple of weeks to try and track the culprit/s.

Thoughts to consider

To find out why you bloat as the day goes on, ask yourself:

1. Is it worse when I’m stressed? Did it only begin after I went through a great deal of change – supportive change or challenging change?
2. Does it only happen after I eat lunch? If so, what do I usually eat for lunch? And how do I eat – am I rushing (hurrying)?
3. Does my tummy bloat only after an afternoon snack? What do I usually choose at this time of day?
4. Is it related to my menstrual cycle only?
5. Did my bloating only begin after I had food poisoning or gastroenteritis or a holiday where the water or food was very different from what I usually consume?

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For MUCH more information on bloating:

Dr Libby recently presented a 90-minute online event event called Bloating and fluid retention, and now you can now watch the replay online!

In this replay, Dr Libby teaches you the reasons why we can experience fluid retention and bloating, and the steps to take to ease this suffering, naturally.

Watch and learn:

• The reasons behind why we can retain fluid
• What drives bloating and why it happens
• Ways to decipher what’s driving your fluid retention or bloating
• Why cellular health is so crucial to maintaining optimal fluid levels
• Reasons excess gas can be the problem and what to do about this
• Which foods commonly trigger bloating
• Nutrients and supplements that can help the body excrete excess fluid
• Ways to alleviate fluid retention
• Quick tips to ease discomfort from bloating

WATCH NOW: Bloating and fluid retention – Online Event Replay

Irritable Bowel Syndrome (IBS) affects around one in five New Zealanders and Australians, with women being twice as likely to be affected than men.  This common condition is not normal—food is not supposed to bloat you—and it doesn’t have to be this way. Here are a few of the common reasons people experience IBS and how to address them.

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Common symptoms of IBS

• Abdominal pain or cramping that tends to be relieved by passing wind or faeces
• Diarrhoea, constipation, or alternating between the two
• A sensation of “incomplete evacuation” – a feeling that the bowels are not fully emptied after passing a motion
• Bloating
• Mucous present in the stools
• Nausea

What causes it?

Getting to the heart of why someone is experiencing IBS is critical, as the road into any condition is the road that needs to be taken out. At the heart of IBS can be a range of triggers including:

• Relentless stress hormone production, anxiety or excessive worrying
• Food intolerances, poor digestion, low digestive enzyme production
• Sex hormone imbalances
• Gut bacteria disruptions, possibly after an episode of food poisoning, antibiotics, or an upset holiday tummy

Stress-related IBS

If your gut function has changed after a challenging time in your life, your bloated abdomen may have initially been due to poor stomach acid production. Now, however, if poor stomach acid production has been ongoing because of an almost low-grade (or high-grade) anxiety inside you, the changes in digestion that were initially due to poor stomach acid production may have altered your gut bacteria profile and the pH of the large bowel. It is important to focus on stimulating stomach acid production by slowing down your meal consumption, avoiding drinking water 20 minutes either side of eating and chewing your food really well. It’s also important to eat mindfully, in other words, focus your attention on consuming your meals without looking at your phone, television, laptop/computer or book and do your best to eat in a calm state. To help reduce the stress and anxiety your body is experiencing, integrate a breathing exercise into your daily routine.

IBS caused by food intolerances

Observation is the key to this process, as your body does not have a voice. Your body communicates through symptoms, and lets you know if it is happy or not. A food that bloats you is, in that moment (not necessarily long term), not your friend, and your body is simply letting you know. So take a break from whatever you suspect and notice if it makes a difference. You will feel so different when you feed your body precisely what it wants. Common irritants include substances found in processed foods, gluten, dairy (all foods that come from an udder) and coffee. Even too much fruit can irritate some people’s digestive tract. Remember that just because it bloats you today does not mean you will never eat that food or drink that drink again (unless you have a true allergy). It simply means that right now, in this moment, it does not serve you. If you restrict your diet long term it is important to consult a health professional to ensure you are not missing out on vital nutrients.

Sex hormone imbalance IBS

If your tummy only bloats and gets sensitive in the lead-up to your period, it is likely to be related to estrogen dominance in the second half of the cycle. An imbalance in your sex hormones could be the result of poor digestion, stress, a liver that needs support, or a nutrient deficiency, specifically those nutrients required to build your sex hormones. It’s advisable to work with a health professional who can ascertain your specific sex hormone imbalance picture, however, ensuring your liver is functioning efficiently is a wonderful place to start. Dark leafy greens and vegetables from the Brassica family (including broccoli, cabbage, kale, Brussels sprouts and cauliflower) contain specific nutrients our liver needs to transform harmful substances prior to elimination. Reducing your consumption of liver-loaders (alcohol, trans fats, refined sugars and artificial substances) will also be helpful.

IBS caused by gut bacteria disruptions

Despite negative stool tests, I have seen this health picture frequently. Where once they had an iron gut, this person now feels like they react to everything.  Discuss with your GP about having a Helicobacter pylori test. Depending on your symptoms, a health professional may guide you to take a herbal anti-parasitic tablet or liquid, even if your stool test has come back negative. Dietary changes can be very useful in this situation, until the gut has healed.