Common Digestive Conditions

Our digestive tract is considered to be the largest organ in our body, where digestion and absorption take place, immune cells are produced and it also provides a home for over 50 trillion bacteria (known as the microflora). It is not surprising that many health care professionals are linking conditions that are seemingly not directly linked to the gut, back to the digestive tract (allergies, for example).

There are many digestive conditions that can have a real impact on day-to-day life, to the point where some chronic sufferers are unable to hold down a regular job. There are lots of different factors influencing digestive conditions with diet being a major cause, but linked to this, there is also stress, general health, family history and medical history (including surgical history). Some common digestive conditions include:


Constipation

Constipation is defined by the Rome Criteria as people suffering with two or more of the following symptoms:

  • Fewer than 3 bowel movements per week
  • Hard stool in more than 25% of bowel movements
  • A sense of incomplete evacuation in more than 25% of bowel movements
  • Excessive straining in more than 25% of bowel movements
  • A need for digital manipulation in order to facilitate evacuation

Constipation is considered to have many causal factors which include:

  • Low dietary fibre intake
  • Low fluid intake
  • Side effects of medication
  • A symptom of another condition (e.g. IBS)
  • Depression
  • Stress

Although constipation can be experienced by all of the population, the elderly are five times more likely to suffer with constipation than a young adult.1 Other high risk groups include; pregnancy, children and travellers.

Depending on the severity of the constipation, you may be prescribed a laxative. However, these can cause side effects (such as stomach cramps, bloating, and wind) and a more natural approach would be to increase fibre and fluid intake and to exercise regularly.


Irritable Bowel Syndrome (IBS)

IBS is considered a syndrome rather than a disease due to the lack of evidence for the reason of its occurrence. The Rome III Criteria describes three IBS subgroups:

  • Diarrhoea predominant (IBS-D)
  • Constipation predominant (IBS-C)
  • Mixed diarrhoea and constipation sufferers (IBS-M)

IBS is thought to affect up to 15% of the population in Europe and North America,2 with many not being medically diagnosed. Sufferers of IBS can experience pain during defecation, irregular defecation, flatulence, bloating and unintended weight loss (amongst other symptoms).

Conventional treatment of IBS includes antibiotic courses, steroids, and antispasmodics for the pain, but these can have side effects as well as becoming addictive. Advice is also given on dietary habits - including the intake of fibre, regular meal times and intake of sufficient fluids.

Research has shown that there is a difference in the gut microflora of IBS sufferers compared to healthy individuals,3 indicating that the intake of live bacteria supplements for IBS sufferers would be beneficial.


Diverticular Disease

Diverticular disease is the presence of sac-like protrusions of mucosa along the colon that can become inflamed and bleed leading to  diverticulitis.

Diverticular disease is common in the elderly, although it is seen in younger adults below the age of forty4.

A lot of evidence suggests that low fibre intakes are a causal factor of diverticular disease – low dietary fibre reduces the stool size which results in less pressure along the colon wall allowing the sacs to be formed.

Management of diverticular disease includes dietary changes, potentially the use antibiotics and in some cases surgery.


Alternative management solutions

Some management strategies of digestive conditions can cause side effects (such as laxatives and antibiotics), so if the condition can be managed without the dependence of these drugs, the better for the patient. Many management options that steer clear of drugs are related to the diet. For instance, increasing daily fibre intake will have the effect of normalising stool size and regulating peristalsis (contraction of the smooth muscles to propel contents through the digestive tract) which can result in regular bowel movements.

Taking live bacteria for digestive conditions could also be an advantage. Studies have shown that they can positively influence the intestinal environment by balancing the gut microflora (reducing the number of pathogens), influencing digestion and having a wider effect on the immune system.




References:

  1. World Gastroenterology Organisation. 2007. ‘WGO Practice guidelines on Constipation'. [Online]. [Accessed: November 2011]. Available from: http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/05_constipation.pdf.
  2. World Gastroenterology Organisation. 2009. ‘WGO Global Guideline Irritable Bowel Syndrome: a global perspective.' [Online]. [Accessed November 2011]. Available from: http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/20_irritable_bowel_syndrome.pdf.
  3. Ringel Y and Ringel-Kulka T. 2011. The rationale and clinical effectiveness of probiotics in irritable bowel syndrome. J Clinical Gastroenterology. Nov; 45 Suppl: S145-8.
  4. World Gastroenterology Organisation. 2007. ‘WGO Practice Guidelines on Diverticular disease.' [Online]. [Accessed: November 2011]. Available from: http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/07_diverticular_disease.pdf.