\n<\/p>\n
\u201cOur gut is a complex machine,\u201d says Dr Ajay Verma, a consultant gastroenterologist at Kettering general hospital in Northamptonshire. \u201cIt is constantly providing us with the nutrition we need, initially to grow and develop, and then for us to survive, thrive and repair from injury and illness.\u201d How can we keep it functioning well? Put simply: \u201cMake sure what you put into it is balanced, and that you clear out its waste products adequately,\u201d says Verma.<\/p>\n
\u201cIn a general gastroenterology clinic, the most common conditions we see are irritable bowel syndrome (IBS), gastroesophageal reflux disease, inflammatory bowel disease and constipation,\u201d says Dr Nisha Patel, a consultant gastroenterologist and interventional endoscopist at Imperial College healthcare NHS trust in London. \u201cA healthy gut is built on three main things: balance, diversity and routine.\u201d<\/p>\n
The starting point for good gastric health is focusing on a diet that is high in fibre, fruit, vegetables, legumes and wholegrains, says Patel, and avoiding irritants: \u201calcohol, caffeine, fatty or spicy foods and artificial sweeteners. We know that large, late meals can also trigger gastrointestinal symptoms.\u201d<\/p>\n
Ultimately it is about \u201ceverything in moderation and giving your gut a break sometimes\u201d, says Verma. \u201cIf you\u2019ve had a heavy, rich meal one day, then the next day have something a bit lighter, so it can recover from the excesses.\u201d<\/p>\n
<\/span>Kiwi is a great remedy for constipation. <\/span> Photograph: Anne DEL SOCORRO\/Getty Images<\/p>\n \u201cStudies have shown that a Mediterranean diet leads to better digestive health,\u201d says Dr Nurulamin Noor, a clinical lecturer in gastroenterology at the University of Cambridge and Cambridge University Hospitals. \u201cSo eat plenty of fruit, vegetables and fish, and try to reduce or have a low intake of processed foods, high dairy foods and red meats.\u201d<\/p>\n What are some of the best things to eat to aid digestion? \u201cKiwi is one of the most effective dietary interventions for constipation,\u201d says Verma. \u201cWe also recommend linseeds or flax seeds, because these are low-cost, natural laxatives that are very well tolerated. Stir them into yoghurt with some fruit.\u201d<\/p>\n It is likely that you aren\u2019t consuming enough fibre. \u201cOver 90% of Americans don\u2019t meet their fibre goals,\u201d says Dr Wendi LeBrett, a California-based gastroenterologist; a 2023 report found that 96% of British people aged 11 and up don\u2019t eat enough fibre, either. The accepted recommendation is 25-35g of fibre per day depending on your size, and a few servings of fruit will help you on your way, LeBrett says: \u201cAn apple has about 4g of fibre. Then for lunch or dinner, a serving of beans can get you 5-6g of fibre.\u201d From almonds to broccoli to oranges, you often have to consciously choose fibre to meet the target, says LeBrett. \u201cSome people need to take a fibre supplement to reach that goal.\u201d<\/p>\n <\/span>Say yes to high-fibre foods.<\/span> Photograph: Rimma_Bondarenko\/Getty Images<\/p>\n If you don\u2019t have digestive issues, it is still well worth trying to max out on fibre. \u201cWe know there is a strong association between how much fibre you have and a lower risk of getting colon cancer,\u201d says LeBrett. \u201cIt feeds your gut microbiome, and that plays a role in your mood, skin and many other factors around your body. Fibre has been shown to be beneficial for cardiometabolic health: it helps with blood sugar regulation, cholesterol and overall heart health.\u201d<\/p>\n For those focusing on protein, Verma says: \u201cYou may be having more protein in your diet to help with muscle building and the way your body functions, but that may mean you reduce how much fibre you have.\u201d Again, being mindful of balance is key; add more fibre where necessary, says Verma.<\/p>\n More fibre can help to deal with wind, too. \u201cWind to a degree is a normal phenomenon as we digest our food,\u201d says Verma. \u201cIf you have a lot of wind, it is probably because you\u2019ve got stuff sat in your bowels for longer than it needs to be. Increase the amount of fibre in your diet to clear your bowels as much as possible.\u201d<\/p>\n \u201cWe\u2019re in a bit of a mess with bowel cancer,\u201d says Verma. \u201cWe are seeing more and more people with these cancers under the age of 50, with high profile-cases such as Deborah James and Adele Roberts. We are still not fully sure why these cancers are rising among younger people, but some have suggested, without concrete evidence, that ultra-processed foods (UPFs) may be a component of that.\u201d<\/p>\n \u201cIt is virtually impossible to have a UPF-free diet,\u201d continues Verma. \u201cHaving a burger is not a terrible thing: having a burger twice a day, every day for a week, is<\/em> a problem. Make sure you are having regular meals, that a proportion of them are fresher, and you have plenty of fruit and vegetables, so you are getting all the vitamins and minerals you need.\u201d<\/p>\n <\/span>If you\u2019ve got it, use it \u2026 a faecal immunochemical test. <\/span> Photograph: Radharc Images\/Alamy<\/p>\n And take up bowel cancer screenings when offered, says Verma. \u201cIn the UK, individuals aged 50-74 will be sent a national screening faecal immunochemical test (a poo test for blood) every two years and, if positive (even if with no concerning symptoms), they will be offered an urgent colonoscopy.\u201d<\/p>\n What do gastroenterologists eat and avoid, knowing what they do? \u201cI eat a varied, plant-rich, low-sugar, moderate-fat, low-UPF diet, avoiding too much alcohol,\u201d says Patel. \u201cIt sounds boring, but I try not to make it boring. I never say no to things; I will eat pizza very happily. It is all about balance. Life\u2019s got to be fun.\u201d<\/p>\n \u201cI focus on a healthy, Mediterranean-style diet and try to restrict having takeaways and processed foods,\u201d says Noor. Meanwhile, LeBrett says that what she restricts is processed meats, like sausage, bacon and ham: \u201cWe know that they have a strong colorectal cancer risk, so I try to limit that. But sometimes I really want bacon in my sandwich, and once in a while is fine. I don\u2019t buy it to cook at home.\u201d<\/p>\n <\/span>Smoking is bad for your bowels too.<\/span> Photograph: fhm\/Getty Images<\/p>\n Aside from UPFs and alcohol, there are other things that <\/strong>can be harmful to the gut, says LeBrett, \u201csuch as certain types of medications, like nonsteroidal anti-inflammatory drugs (NSAIDs)\u201d. She also advises against the overuse of antibiotics.<\/p>\n \u201cSmoking can cause reflux and increase the risk of bowel cancer,\u201d says Verma.<\/p>\n \u201cWe must make sure that, when we poo, we clear out the bowels properly,\u201d says Verma. You should feel empty, and not gassy or bloated. \u201cLike any machine, if the waste product doesn\u2019t clear, then that machine might not work as well as you\u2019d want it to.\u201d Squat stools help to \u201copen up the bowel, allowing easier defecation\u201d, Verma adds. \u201cSome swear by them.\u201d<\/p>\n How often is \u201cnormal\u201d varies greatly. \u201cThis is one of the most common questions I get asked,\u201d says Patel. \u201cPeople come in saying, \u2018What is normal? Because I\u2019m sure this can\u2019t be right.\u2019 But normal really is a range, and it might vary, anywhere from three times a day to three times a week. Any of those will be healthy if it\u2019s your usual pattern.\u201d<\/p>\n \u201cWe know that the gut and brain are in constant conversation,\u201d says Patel. \u201cStress can speed up or slow down gut motility. It can heighten pain sensitivity, and trigger bloating and cramping. In some people, it can alter the microbiome as well. It is often why people feel symptoms during certain stressful periods. Managing stress isn\u2019t soft advice: it really is the core of good health.\u201d To address stress, Patel advocates \u201cslow, diaphragmatic breathing exercises that affect the nerves and signal to the gut to slow down or speed up, depending on the symptoms. Failing that, we suggest cognitive behavioural therapy and gut-directed hypnotherapy.\u201d<\/p>\n \u201cWe\u2019re only starting to scratch the surface on how important the brain-gut connection is,\u201d says LeBrett. \u201cThere are certain conditions, like IBS or functional dyspepsia, where we think that there is an issue with how the brain and the gut communicate. People always quote the fact that there are more serotonin receptors in your gut than there are in your brain. The same hormones and neurotransmitters that affect the brain can also impact the gut.\u201d<\/p>\n Hydration is one of the simplest, underrated ways to stabilise digestion, says Patel, \u201cparticularly when the gut is sensitive to stress. Water softens the stool and supports the smooth movement of stools through the colon, so low intake obviously causes harder stools, which affects draining and you get bloated.\u201d Although 1.5-2 litres a day might sound like a lot, this includes coffee, fruit, soups and other food. \u201cI have a bottle that tells me to drink 150-200ml every hour, so I maintain my hydration that way,\u201d says Patel.<\/p>\n <\/span>Yoga helps regulate the gut\/brain axis. <\/span> Photograph: Posed by models; Morsa Images\/Getty Images<\/p>\n \u201cMovement is really important in promoting digestion,\u201d says LeBrett. \u201cI always recommend walking after a meal if you\u2019re able to. I walk after dinner; it helps to promote digestion and gets your body ready for sleep and rest as well.\u201d<\/p>\n Exercise-wise, the recommendation is 150 minutes a week \u2013 \u201cnot specifically for the gut per se, but for the body generally\u201d, says Patel. \u201cCore strengthening exercises, such as pilates and yoga, help with the diaphragmatic breathing and to regulate the gut\/brain axis.\u201d<\/p>\n \u201cThe digestive tract is anywhere from your mouth to your bottom end,\u201d says Noor. \u201cWe know that oral health is really important and probably has a major role in diseases lower down the gut, but it is relatively underappreciated.\u201d To be on the safe side, good oral health care, brushing, flossing and seeing the dentist are advisable.<\/p>\n <\/span>Proper rest is indispensable. <\/span> Photograph: Posed by model; Guido Mieth\/Getty Images<\/p>\n The gastroenterologists all stress the importance of prioritising sleep. LeBrett has researched the impact of sleep on digestion: \u201cStudies show that, in patients with IBS who had poor sleep, it was associated with worsened symptoms the next day.\u201d<\/p>\n \u201cSome people swear by probiotics,\u201d says Verma, \u201cbut we don\u2019t have compelling evidence that they can be used for a wide variety of conditions. Probiotic yoghurt drinks are not expensive, so if someone taking them feels well on them, then it\u2019s not an unreasonable step.\u201d<\/p>\n \u201cIt is more important to focus on prebiotics,\u201d adds LeBrett. \u201cThe food that we eat \u2013 fruit, vegetables, wholegrains, legumes \u2013 that the microbiome thrives on.\u201d<\/p>\n <\/span>If in doubt, get it checked out. <\/span> Photograph: Posed by models; SDI Productions\/Getty Images<\/p>\n \u201cWe can all have stomach bugs and get a bit of bleeding if we\u2019ve got a sore bottom,\u201d says Verma. \u201cBut if you have rectal bleeding or a change in your bowel habits that persists for three to four weeks or more, then you should get that checked out. Another red flag symptom is unintentional weight loss. If you suddenly lose half a stone, then it is always worth seeking medical advice.\u201d<\/p>\n Patients often apologise when they\u2019re talking about digestive symptoms, says Patel, but \u201cwe talk about it every day, and there is really no embarrassment on our side. It is only a desire to help people feel better, put their mind at ease and to rule out anything serious. I always say to my patients that their symptoms really do matter, and they deserve to feel well. Getting help early is always the best step.\u201d<\/p>\n \u201cThere was a study that found scrolling on the toilet and smartphones in the toilet increases your risk of haemorrhoids, and can also cause pelvic floor dysfunction,\u201d says LeBrett. \u201cI won\u2019t say I never do it, but it is something I try not to do. Plus, it\u2019s not very hygienic to have your phone in the bathroom.\u201d<\/p>\n But Verma has a more relaxed approach: \u201cA direct link between phone use and bowel issues has not been proven and perhaps may be a simple association. Those who need to spend a lot of time in the loo will often use their phone to pass the time.\u201d<\/p>\nGet involved with fibremaxxing<\/h2>\n
Cut down on UPFs<\/h2>\n
Eat like a gut doctor<\/h2>\n
Avoid toxins<\/h2>\n
Clear out your bowels<\/h2>\n
Deal with stress<\/h2>\n
Stay hydrated<\/h2>\n
Move your body<\/h2>\n
Brush your teeth<\/h2>\n
Get enough sleep<\/h2>\n
Ditch the probiotics<\/h2>\n
See a doctor when \u2026<\/h2>\n
Don\u2019t be embarrassed<\/h2>\n