Does Easter typically leave you with an unsettled gut?

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 to help manage gut problems and discomfort. Having digestive complaints may make life truly miserable and there are many factors that could 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 such as 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 digestive complaints include:

• Abdominal discomfort
• Bloating
• Wind
• Urgent need for a bowel movement 
• Irregular bowel movements
• Diarrhoea
• Constipation

The reason why some people develop digestive issues is not always clearly understood and unfortunately it may often be 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 from one person to another. 

Possible triggers may include: 

• Oxidative stress due to inadequate defence nutrients which may set the scene for chronic low-grade inflammation within the cells that line the digestive tract.
• Extra sensitive nerve endings around the bowel which may account for increase levels of pain experienced for some people with digestive issues.
• Imbalances, disruption or sensitivities in the way the brain and gut communicate, which may affect the digestive system.
• Slower or faster than normal food transit time creating changes in bowel movements.
• Food intolerances may be present which may trigger digestive complaints.
• Imbalance within the gut microbiome which may in part be influenced by a high sugar or high fat diet.
• Unusual response to gut infections 
• Stressful life events

4-Step support for healthy digestion

1. Remove trigger foods as well as fermentable starches and foods high in insoluble fibre, 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 help protect cells from oxidative stress.
4. Replenish healthy gut friendly bacteria

Step 1 - Foods to avoid 

Different foods influence bowel function, bowel movements and gut sensitivity in different ways, 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 are potentially harmful to intestinal cells.

Additionally, highly fermentable carbohydrates known as FODMAPS (Fermentable Oligo-, Di-, Mono-saccharides and Polyols) tend to be poorly absorbed in the small intestine by some IBS patients and may contribute to 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) which may lead to cellular oxidative stress and many of the symptoms commonly associated with IBS. Scientists have found that eradicating SIBO may lead to a significant improvement in the management of IBS symptoms.
• According to some small studies, broad-spectrum antibiotics may impact some of the risk factors associated with the development of IBS and this is likely due to alterations in the gut microbiome. 

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 could promote cellular inflammation and oxidative stress within the gut. Glutathione is a powerful defence nutrient produced by the body to help neutralise free radicals and help protect against the harmful effects of reactive oxygen species. Poor status of cellular defence nutrients may therefore contribute to damage to cells within the gut. 

Eating good quality protein foods such as chicken, fish and beans provides the amino acids required for the body to produce 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.