Is your gut unsettled over Easter?

If you are one of the many people around the world that suffer from digestive troubles, you probably have a lot of unanswered questions about how you can manage gut problems and discomfort. Having digestive complaints can make life truly miserable and there are many factors that can exacerbate this, including celebratory occasions such as Easter. Even though it’s only one long bank holiday weekend of indulgence, a high intake of chocolate and sugar rich Easter eggs may be enough to kick start a bout of digestive discomfort. However, although there’s no quick fix, some nutrients like glutathione and vitamin D could potentially offer some support for the digestive system.

Signs that the digestive system may not be functioning smoothly vary greatly between individuals and for women they may often be worse during menstruation. Common complaints include:

• Abdominal discomfort
• Bloating
• Wind
• Urgent need for a bowel movement with little control
• Diarrhoea
• Constipation

The reason why some people develop digestive issues is not always clearly understood and unfortunately it is often difficult to define exactly what causes the variety of gastrointestinal complaints. However, more recent research has led to a better understanding of the mechanisms that may promote the functional gastrointestinal changes. Evidence suggests there may be numerous factors that contribute to digestive conditions, which may depend on the individual. Symptoms can therefore manifest differently in different people.

Possible causes identified include:

• Oxidative stress due to inadequate antioxidant defences which may set the scene for chronic low-grade inflammation
• Sufferers may have particularly sensitive nerve endings around the bowel which may account for pain experienced
• Problems with the way the brain and gut communicate, which may affect the digestive system
• Food transit time may be too slow or too fast creating changes in bowel movements
• Food intolerances may be present which may trigger digestive complaints.
• High sugar and high fat diets may promote growth of unhealthy gut bacteria.
• Unusual response to gut infections
• Imbalance in gut microbiome.
• Stressful life events

4-Step Support for healthy digestion

1. Remove trigger foods as well as fermentable starches and fibres, to help reduce the impact of bacterial fermentation in the gut.
2. Supplement with natural antimicrobials to support gut microbiome.
3. Include nutrients that help neutralise free radicals and reduce oxidative stress.
4. Replenish healthy gut friendly bacteria

Step 1 - Foods to avoid

Foods can influence bowel movements and gut sensitivity, which is why some people identify certain foods as trigger foods. The gut microbiome is a delicate balance between opportunistic gut pathogens and healthy gut friendly bacteria. Eating too much sugar or sugary foods can tip the balance encouraging the proliferation of microbes that produce gas and substances that may promote inflammation.

Additionally, highly fermentable carbohydrates known as FODMAPS (Fermentable Oligo-, Di-, Mono-saccharides and Polyols) are not well absorbed in the small intestine and by some IBS patients and may trigger common symptoms. Short-term avoidance FODMAPS (fructose, fructans, lactose, sorbitol, mannitol, xylitol and maltitol) is thought to help settle down stomach distention and digestive discomfort.

Step 2 - Gut microbiota

Several trillion microbes naturally reside in the intestine and play a central role in the balance of the digestive system. An overgrowth of unhealthy bacteria in the gut is associated with digestive disturbance.

• As many as 60% of all patients with IBS may suffer from small intestinal bacterial overgrowths (SIBO). This digestive condition may lead to inflammation and to many of the symptoms commonly associated with IBS. Scientists have found that eradicating SIBO results, may lead to a significant improvement in IBS
• According to some small studies, broad-spectrum antibiotics may increase the risk of developing IBS and this is likely due to alterations in the gut microbiota

Step 3 – Glutathione, vitamin D and oxidative stress

IBS patients tend to have increased levels of key substances that are involved in the way the immune system responds to gut bacteria. This abnormality promotes cellular inflammation and oxidative damage within the gut. Glutathione is a powerful antioxidant, produced by the body to help counter damage to the cells caused by reactive oxygen species, such as heavy metals and free radicals. Poor antioxidant defences may therefore result in damage to cells in the gut.

Eating good quality protein foods such as chicken, fish and beans provides the amino acids your body needs to synthesise glutathione and may help to support the health of cells that line the intestinal wall.  

Check your vitamin D levels

Sheffield University recently conducted a review of a large body of research related to IBS and found that there is a high prevalence of vitamin D deficiency amongst patients with IBS. The researchers also assessed the potential benefits of vitamin D supplementation on IBS symptoms. Their findings highlighted the importance of adequate vitamin D levels for supporting good gut health.

Step 4 – Replenish good gut bacteria

Supplementing with probiotics may be recommended after a course of antibiotics or natural antimicrobials, as these may affect the delicate balance of friendly bacteria within the intestine.

By Jacqueline Newson BSc (Hons) Nutritional Therapy

REFERENCES

1. Ahmad OF and  Akbar A. Microbiome, antibiotics and irritable bowel syndrome, British Medical Bulletin, 2016; 120, 1: 91–99.
2. Al-Daihan et al. High-fat diet stimulates the gut pathogenic microbiota and maintains hepatic injury in antibiotic-treated rats. Cell Mol Biol . 2018; 64(1):103-106.
3. Brenner DM and Stern EK. Gut Microbiota-Based Therapies for Irritable Bowel Syndrome. Clinical and Translational Gastroenterology 2018; 9: 134. 
4. Derrien M et al. Fecal chromogranins and secretogranins are linked to the fecal and mucosal intestinal bacterial composition of IBS patients and healthy subjects. Scientific Reports 2018; 8 :16821.
5. Ding WX, Ong CN and Shen HM. Intracellular glutathione is a cofactor in methylseleninic acid-induced apoptotic cell death of human hepatoma HEPG(2) cells. Free Radic Biol Med. 2002 ; 33(4):552-61.
6. Gibson P R and Shepherd S J Personal view: food for thought – western lifestyle and susceptibility to Crohn’s disease. The FODMAP  hypothesis. Alimetn Pharmacol Ther. 2005; 21: 1399-1409.
7. Harper A, Garcha D, Naghibi MM. The Role of Bacteria, Probiotics and Diet in Irritable Bowel Syndrome.  Foods. 2018;7(2):13.
8. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/symptoms-causes. [Accessed 25.2.19.]
9.  https://www.sheffield.ac.uk/news/nr/vitamin-d-supplements-ibs-1.759023 [Accessed 28.2.19.]
10. Ledochowski M, Sperner-Unterweger B, Widner M et al. Carbohydrate malabsorpton syndromes and early signs of mental depression in females. Dig Dis Sci. (2000) 45: 1255-9.  
11. Siebecker A. Takeaways from the 2017 Integrative SIBO Conference
12. Practice update from the speakers. Natural Medicine Journal 2017; 9,6.
13. Wang et al. Opposing Effects of Fasting Metabolism on Tissue Tolerance in Bacterial and Viral Inflammation. Cell 2016; 166, 1512–1525.