It is a rare person who goes through life without experiencing the discomfort of mouth ulcers, heartburn, flatulence, nausea, diarrhoea and constipation. Usually these problems are of short duration and can be treated at home with sensible eating, rest and common sense. Unfortunately, more severe problems do occur, and about one in ten of us will suffer from a serious illness of the gut during some part of our lifetime. Symptoms and treatments vary, but no matter what the complaint or illness, when things go wrong with the gut, food is part of the answer.
Sometimes distinguishing between simple complaints and major illness of the gut can be difficult. A miserable bout of vomiting or heartburn can be self-limiting and cause only temporary distress, or these same conditions may be symptoms of more serious underlying diseases, such as food poisoning or a gastric ulcer. Similarly, feelings of bloating, nausea and bouts of diarrhoea are common complaints, but if these problems persist or reoccur over a period of time they could be signs of irritable bowel syndrome or Crohn’s disease.
This chapter is divided into 20 sections. Each provides basic information about an illness of the digestive system and includes a brief description of symptoms, a list of useful healing foods, a list of foods to be avoided, and some facts about the illness. To help you include more healing foods in your diet, Marguerite Patten’s healthy-gut recipes are recommended throughout.
If you suffer from a gut disorder and are under a doctor’s care, check before changing your diet.
Maintaining a healthy gut obviously depends on eating the right food, but it is also essential to identify what makes you ill. Preventing a problem recurring takes some detective work. A bout of indigestion may have resulted from eating too quickly during a high-pressure lunch meeting with your boss. Or, if you live on a somewhat bland meat and potato diet, and go on holiday to a place where both the sun and food are hot, it would come as no surprise if your digestive system rebelled.
Creating an informal diary of your complaint is a good approach to identifying its cause. When a problem arises (halitosis, vomiting, heartburn, etc.) start your diary by writing down the relevant date, the time and the severity of the condition. Next, write down what you ate over the previous two meals, then briefly make a note of any event that may have triggered your distress. If the cause of your problem is not immediately obvious, keep the diary and add more information when symptoms return. Review your notes from time to time to see if you can identify a pattern. (Halitosis, or bad breath, may be a sign of a sinus or lung infection.)
You may be surprised by what you find. A smell in a particular place can trigger nausea (fish shops and counters are known to affect some people). Or your diary may show that recurring bouts of diarrhoea correspond with periods of unusual exertion during exercise (see ‘Athlete’s Diarrhoea’). As much as you love crabmeat sandwiches, could they be contributing to your stomach cramps (see here for information about food intolerance)? If a specific food seems to be the root of your problem, try an exclusion diet (see here).
Above all else, as you create your diary ask yourself one crucial question: Has anything in my life changed? Spotting a lifestyle change at the root of your new gastric distress can quickly point you in the direction of a prompt cure. Consider all aspects of your life. Are you smoking too much? Have your drinking habits changed? Are the children having problems at school? Are you feeling stressed because you suddenly find yourself caring for an ailing family member? Are you moving house, changing jobs, contemplating a divorce, or is there a new lover in your life?
Ask yourself about other aspects of your health. Has there been a change in your medication or method of birth control? Medication can affect the gut and cause uncomfortable – and sometimes serious – problems. Appendix Two provides basic information that can help you think about the pills you take and whether or not they may be having side-effects on your digestive system.
Seek help from your doctor at once if:
• you show signs of an acute allergic reaction (see here).
• symptoms persist for more than a few days
• you develop a fever
• you experience intense abdominal pain
• there are signs of blood in vomit or stool (see Glossary – ‘false bleeding’).
Coeliac disease reduces the effectiveness of the small intestine, and curtails the normal transfer of nutrients from the gut to the body. Approximately 1 in 300 Europeans suffer from this debilitating condition. It is caused by an intolerance to gluten, a natural protein occurring in wheat, rye and barley, and the incidence of the disease seems to increase with the expanded use of these cereals in processed foods. Although debated, some experts suspect that oats contain a substance similar to gluten, and advise coeliac sufferers to avoid oats as well. There is no cure, but a healthy diet free from all traces of gluten helps rebuild and sustain a healthier gut.
• Rice, polenta (cornmeal), wild rice, millet, quinoa, buckwheat, amaranth
• Potatoes
• Fresh fruit
• Vegetables
• Dairy foods and eggs
• Meat, fish, poultry and cheese made without fillers or sauces containing gluten
• Arrowroot or flour made from rice, corn or potatoes for thickening
• Speciality foods trusted to be ‘gluten-free’
All foods containing wheat, rye and barley, including pasta, cereal, couscous, semolina, barley water, fondants, canned soups and other products thickened with wheat flour. Unless specifically labelled as gluten-free, processed cheeses, stock cubes, gravy granules, mustards and other cooking products are all likely to contain gluten. Unlike 20 years ago, gluten-free alternatives are now widely available and the majority are very good and getting better all the time. If you tried gluten-free products a few years ago and were disappointed, try again.
Remember: oats may affect some coeliac patients.
• Symptoms of coeliac disease include bloating, indigestion, weakness, weight loss and anaemia due to progressive malnutrition. Stools are usually large and may contain fat. Glossitis – an inflammation of that part of the throat associated with the voice box – may also occur.
• Coeliac disease leads to malabsorption syndrome. Malabsorption occurs when the tiny villi in the intestine are damaged, reduced in size or flattened. As the villi are responsible for absorbing and transporting nutrients from within the gut, their inability to function denies the body much-needed proteins, vitamins and minerals. (For more information about malabsorption, see here.)
• The disease develops in all age groups, but is most common in infants and during the third, fifth and sixth decades. If weaned early, infants can develop coeliac disease soon after they are introduced to cereals. This inability to cope with gluten may have few symptoms or may cause considerable upset. As an affected infant grows, the digestive system matures and digesting cereals is soon no longer a concern. There is some evidence that a genetic factor may determine which children experience this problem. This factor would remain for life. It is possible that adults who develop coeliac disease may have carried this genetic weakness into old age, when the body’s functions slow. If this slow-down involves the digestive mechanisms that allow us to cope with gluten, the risk of coeliac disease increases.
Colitis is an inflammation of the colon and rectum causing pain, bloating, diarrhoea and, in severe cases, bleeding. The condition may be acute or chronic, and in severe cases causes ulceration of the lining of the lower gut (see ‘Ulcerative Colitis’). Most sufferers may have few symptoms, while others may be prostrate from the illness and require surgery. Altering the diet can significantly improve symptoms.
• Foods high in soluble fibre (see here)
• Apples and other fruit
• Berries
• Parsley
• Watercress and other green leafy vegetables
• Oily fish
• Liver
• Low-fat dairy products
• Yoghurt (live)
• Foods rich in zinc, such as eggs, Cheddar cheese and beef steak
• Foods high in nutritional value
• All foods high in insoluble fibre (see here)
• Foods to which you know you have an intolerance
• All forms of bran
• Nuts and seeds
• Sweetcorn
• Junk food
• Colitis reduces the body’s ability to absorb nutrients from the gut, so choose foods high in nutritional value such as liver, dark green leafy vegetables and dried fruit, which will provide protein, vitamins A, C, D and B12, and minerals including iron, zinc and calcium. (For more about nutrients, see here.)
• Increasing evidence suggests that colitis results from inflammation caused by an immune response, possibly to certain foods.
• This illness was thought to be psychosomatic in origin, but recent evidence points to a physiological cause.
• Colitis affects about 4–6 people in 100,000; onset is usually between the mid-20s and mid-life.
Constipation is not an illness, but a common sign that the large bowel is having trouble getting rid of waste. It is normal to have one or two bowel motions a day. The normal stool (product of a bowel motion) is large, formed and soft and causes neither straining nor discomfort. Constipation is characterized by passing fewer stools, which are hard and dry (described as ‘rabbit droppings’ or ‘bullets’) and frequently accompanied by straining and discomfort.
Constipation may be a symptom of a more serious condition, such as irritable bowel syndrome.
• Increase your fluid intake. You should drink between seven and eight glasses (2 litres/3½ pints) of water a day. This should be increased if you are losing large amounts of fluid through perspiration or participate in strenuous activities.
• For simple constipation, gradually increase your intake of foods high in fibre, especially wholegrain products, green leafy vegetables, fresh fruit, dried apricots, figs, dates and prunes. Eating yams, parsnips or sweet potatoes once or twice a week can work wonders. All these foods have a high nutritional content. Bran can be added to the diet for bulk, but contains few nutrients and can cause flatulence and discomfort when used in large quantities.
• When constipation is a symptom of a more serious illness, see the advice given under that heading. In general, if the problem is serious, increase the amount of soluble fibre in your diet (see here), and avoid harsh, insoluble fibre like that found in bran, whole grains, nuts and seeds.
• Remember that tea, coffee and cola drinks act as mild diuretics. They should not be included when you estimate your daily fluid intake because they stimulate fluid loss, rather than restore it.
A low-fibre diet is the most common cause of constipation. Avoid a diet dominated by dairy products, meat and highly refined carbohydrates, such as cake and baked goods made with highly processed white flour.
• Experts claim constipation is so common in Western society that it is taken almost for granted. People living on diets based largely on fruits and vegetables, like those in Asia and Africa, are rarely affected. It is also true that they rarely suffer from conditions of the colon now commonly experienced by many eating low-fibre/high-fat foods.
• The elderly and pregnant women tend to suffer more from constipation than others. Gradually increasing the amount of high-fibre foods will resolve the problem.
• Putting off going to the toilet is a common cause of constipation. Avoiding using public toilets while on holiday or out shopping can lead to problems. If you are worried about hygiene, carry toilet seat covers and antibacterial wipes with you.
• Iron tablets can cause constipation. If you think this may be your problem, try increasing the fibre in your diet. If that does not work, ask your chemist to suggest a gentle laxative. Do not stop taking prescribed iron tablets without advice from your doctor.
• Common causes of constipation include: lack of exercise, depression, an underactive thyroid, and certain medications such as diuretics, morphine, codeine, and some antidepressants. Some pain medication contains codeine (Co-codamol and Co-dydramol are examples) and can cause constipation.
• Constipation is no joke. It can set the scene for far more serious conditions such as haemorrhoids and anal fissures (small tears) leading to pain and bleeding when having a bowel motion. Prolonged cases can result in faecal impaction and rectal prolapse. Experts think constipation may contribute to diverticular disease.
• Contrary to many statements in the lay press, constipation does not cause the release of toxins responsible for nausea, furred tongue, fatigue and depression. According to the Royal Society of Medicine Health Encyclopaedia, these symptoms result from an awareness of a full rectum and a belief that constipation is harmful.
Crohn’s disease is an inflammatory disease that can attack any part of the gastrointestinal system, from the mouth to lower bowel. In the intestine it attacks both the superficial and inner layers of the intestinal wall. Common symptoms include nausea, pain, fever, chills, diarrhoea and weakness. It may be caused by an immune reaction.
• Live yoghurt (see ‘Probiotics’)
• Both ginger and mint tea may be soothing (see recipes)
• Keep a food diary and see if you can spot foods that ‘trigger’ symptoms. Many experts advise that all dairy products, meat, eggs, tea, coffee and alcohol should be totally eliminated from the diet. (Lactose intolerance is a common problem; see here.)
• During a flare-up, reduce the fibre in your diet.
• Reduce refined sugar in your diet.
• Oily fish, rich in omega-3 fatty acids, are good for the gut, but may be a negative factor in some Crohn’s disease cases.
Fruit Smoothies made with live yoghurt and berries
• Bacteria may play a role in this disease, so cook food well.
• Crohn’s disease frequently begins during adolescence.
• The cause of this illness remains a mystery, but many experts believe the condition involves an autoimmune response within the gut, possibly precipitated by a food intolerance.
• Although Crohn’s disease usually begins in the gut, complications can occur including arthritis, gallstones, kidney stones, skin swellings, and fusion of the bones of the spinal column (ankylosing spondylitis).
Diarrhoea is not an illness, but a symptom that the gut is not working properly. It is characterized by the passage of watery, loose stools, usually caused by the failure of the large intestine to absorb adequate water from the stool. This failure may result from the effects of infection (food poisoning, dysentery, typhoid, for example), toxins and poisons, medications (including strong or excessive use of laxatives) and underlying conditions, such as irritable bowel syndrome.
• Diarrhoea can cause dehydration, and may have serious consequences for both the young and the elderly. Rehydration products are available at most chemists, but if you need to make your own, see the section on vomiting, below.
• If you have a prolonged bout of diarrhoea, or feel especially unwell, you may not feel like eating. However, consuming small quantities of mashed banana will help restore your mineral balance and provide the carbohydrate energy you need. After a few hours, take good advice from scientists at Harvard University and stay on the BRAT diet for 24–48 hours.
• Camomile tea and foods containing peppermint can help ease the cramps that sometimes accompany diarrhoea.
• Foods that may be contaminated or contain dangerous bacteria.
• Excess caffeine – this can cause diarrhoea in some people.
• Too many high-fibre foods – these can cause loose motions; 30 grams of fibre a day should be adequate.
Toast, plain or topped with banana, ginger syrup or other appetizing spread see here
• Diarrhoea is a common complaint that may indicate a more complex problem.
• Many people are reluctant to discuss diarrhoea, and so suffer without appropriate care. Remember that diarrhoea can lead to the loss of fluids and the nutrients potassium and sodium, resulting in weakness – and even mental confusion – associated with abnormal blood chemistry. Anaemia, weight loss and dehydration can also occur.
• Sometimes the stool is very soft but not watery – this is known as a ‘loose motion’. Loose motions can be caused by eating an unusual amount of fatty or oily foods, or by eating too many high-fibre foods or foods to which you have a mild intolerance, such as cow’s milk and dairy products. These may be embarrassing and uncomfortable, but diarrhoea is more serious.
• Diarrhoea can be acute, lasting one or two days. It can also be chronic and go on for weeks. Chronic diarrhoea can result from a long-standing disease, an infection of the gut by a parasite or fungus, or be a side-effect of medication. If you are on a prescribed drug – especially an antibiotic – for an extended period of time and begin suffering diarrhoea, read the information sheet that came with your medication, or ask your chemist for advice about whether your prescription may be causing the problem (see here for more information about how medication can affect the gut). Food poisoning is a common cause of diarrhoea (see ‘Vomiting’ and pages 73 and 222–5 for more information). A major dietary change, excessive amounts of fatty foods, medications, and both physical and mental stress can all increase the risk of this distressing condition.
• Travellers often suffer from stomach upset when they make rapid dietary changes or encounter foods that may introduce new strains of bacteria into their gut. Given a few days in one place, digestive problems cease when the body adapts to these new conditions.
• A gluten-free or dairy-free diet can be the answer for some people suffering chronic diarrhoea (see here) for more information).
• The overuse of laxatives can cause harmful diarrhoea. Never use laxatives for any purpose other than help with stubborn constipation; never use laxatives as part of a slimming programme.
• Chronic diarrhoea is a symptom of several serious gut conditions, including Crohn’s disease, coeliac disease and irritable bowel syndrome. Read more about these illnesses under the appropriate heading.
• Chronic or blood-streaked diarrhoea should be reported to your GP at once.
Runners and other athletes often find they suffer from a sudden rush from the bowels. During exercise, blood is diverted from the gut to muscle tissue, thus slowing the absorption of nutrients from the intestine. As a consequence, these nutrients then draw water from the body into the gut, causing diarrhoea. Suffering from Crohn’s disease, ulcerative colitis or food intolerances can make matters worse.
Drink water before strenuous exercise, but do so in moderation. When preparing for a race or extended run, cut down on high-fibre foods, fatty foods, dried fruit, caffeine and foods containing high levels of vitamin C.
If you suffer from athlete’s diarrhoea to the point where it interferes with your sport, seek advice from a professional trained in sports medicine.
When pressure builds up within the lower bowel (colon) and expands its width, as happens during constipation, weakened areas of the muscular walls may bulge out into pockets or pouches: these are called diverticula. Inflammation and/or infection in these areas are called diverticulitis. Low-fibre diets are thought to be the main cause of this potentially dangerous condition.
• See the section on Constipation
• Drink plenty of water!
• Apples
• Berries – these are high in natural antibacterial substances
• Cooked green leafy vegetables
• Foods rich in soluble fibre, including oats and brown rice
• Camomile tea
• Live yoghurt
• Forgo foods made with highly refined carbohydrates, specifically table sugar and white flour.
• Skip the fatty meals; it is best to leave the burgers and shakes or deep-fried cod and chips for the occasional meal, and not make them a regular part of your diet.
• About half the population over 50 have diverticular pouches in their gut, but they are asymptomatic and cause no problems. Problems arise only when circumstances cause inflammation of tissue within the pouch.
• You can protect your lower bowel from developing chronic constipation by drinking plenty of water and eating foods high in soluble fibre, such as oat bran.
• Symptoms of acute diverticulitis are sharp pain in the lower left abdomen accompanied by fever and constipation.
• Experts link diverticulitis with the low-fibre Western diet. As more people around the world replace traditional diets, rich in fruits and vegetables, with high-fat foods based on refined carbohydrates, this illness is on the increase.
• Middle-aged people and the elderly are most susceptible to this condition. More women than men are sufferers.
The rumble of sometimes smelly gas released from the colon can be mortifying. Here are some tips on how you can avoid this embarrassment.
• Increase your intake of live yoghurt (see ‘Probiotics’).
• Drink herbal teas, such as peppermint and fennel.
• Add flavour to your cooking by using more caraway, cardamom, fennel and thyme. These seeds add flavour to many dishes – try crushed fennel seeds in warm potato salad, for example.
• Rice is easier to digest than other complex carbohydrates and produces very little gas. If flatulence is a major problem, try substituting rice and rice flour in your cooking.
Reduce your intake of cabbage, peas, lentils and beans. Remember that these foods are rich sources of fibre needed to help elimination from the bowel and avoid constipation. Make sure you replace any ‘culprits’ with other high-fibre foods, including wholegrain bread, fresh fruits and vegetables. Bran added to foods can also help but should be used with caution: too much may encourage other problems.
• Passing air is a normal result of digestion; most of the time you are unaware it happens. The digestive processes in a normal adult produce more than 20 litres of gas per day; happily, most is consumed by bacteria in the lower gut, and only about 5 litres are expelled.
• The habit of swallowing air increases the amount of flatulence.
• Rapid eating and drinking increases air swallowing and the risk of excessive flatulence.
• Stress can increase air swallowing, and thus both belching and flatulence.
Gallstones are lumps of mineral salts, bile pigment or cholesterol that accumulate in the gall bladder. They can be as small as a grain of sand or larger than a marble. Symptoms range from mild upper abdominal discomfort in the upper right-hand quadrant to severe pain with vomiting. Many people have gallstones without experiencing symptoms (silent stones).
• Oats, pasta, rice, wholegrain bread and other foods high in soluble fibre
• Fresh fruit and vegetables
• Artichokes
• Extra virgin olive oil
• Fatty meat
• Full-fat dairy products
• Chocolates
• Ice cream and other fatty desserts
Penne with Stir-fry Vegetables
• Factors associated with gallstones include:
• A diet high in refined carbohydrate
• A diet high in saturated fats
• High oestrogen levels
• Cholesterol-reducing drugs
• Obesity
• Diabetes
• Vegetarians are less prone to gallstones than those who eat large quantities of red meat.
• Stones can pass naturally down the bile duct (a small tube extending from the gall bladder into the gut); this is called ‘biliary colic’ and can cause considerable pain.
• Stones sometimes block the flow of secretions from the pancreas into the gut, causing jaundice and occasionally a dangerous condition called pancreatitis.
• Three times more women are affected than men.
• Age matters. The elderly are those most likely to suffer from gallstones.
(See also ‘Indigestion’.)
Ulcers develop in the upper digestive tract when the mucous lining becomes inflamed and breaks down. Peptic ulcers occur in the main body of the stomach. Ulcers found just beyond the stomach, in the small area where it joins the small intestine, are called duodenal ulcers. Recent medical research indicates that the bacterium Helicobacter pylori and the use of non-steroidal anti-inflammatory drugs (NSAIDs) play a large part in the formation of most ulcers.
• Apricots
• Blackcurrants
• Blueberries
• Strawberries
• Cabbage
• Green leafy vegetables
• Peppers, red and green (if your stomach allows)
• Cheddar cheese
• Whole-grain products
• Eggs
• Seafood, especially oily fish and oysters
• Live yoghurt (see ‘Probiotics’)
• Salted and smoked foods
• Spicy and salty sauces – soya, Worcestershire, HP, etc.
• Pickles
• Caffeinated drinks – coffee, tea, cola
• Chilli peppers
• Black pepper
• Alcoholic beverages
• Foods high in refined sugar, fats or salt
Cheese Soup made with Cheddar cheese
Yoghurt Lemon Syllabub – substitute berries for lemon
• Pain in the centre part of the upper abdomen, just below the ribs, is the characteristic symptom of gastric ulcers. Pain increases with hunger. Nausea may occur.
• Smoking and alcohol are both risk factors for gastric ulcers.
• Helicobacter pylori is the bacterium found in the stomach of many ulcer patients. It causes inflammation that may lead to gastritis and ulcers. Eating more black and blue berries, and other foods known to contain natural antibacterial compounds, is thought to help fight this infection.
• Foods rich in betacarotene, vitamin C and zinc are thought to help heal gastric ulcers. (For more information about specific foods, see here.)
• It may surprise you to learn that modern experts advocate eating smallish meals based on a normal diet; the old days of poached fish, milky bread and low-fibre meals are over.
• Studies suggest that oily fish, rich in the omega-3 fatty acids, aid healing (see here for more information).
This is a common symptom caused by inflammation of the stomach lining. Sufferers experience a burning or ‘grinding’ sensation in the upper abdomen that may move into the chest. Gas and nausea sometimes accompany this pain.
• Drink plenty of water.
• Eat light foods with few spices for a day or two.
• Foods on the BRAT diet.
• Acidic foods, including citrus fruit (orange juice) and pickles
• Milk
• Fatty food
• Alcohol
• Drinks containing caffeine and fizzy drinks
Smoothies made with live yoghurt and fruit
Toast with a topping of your choice
• Risk factors include stress, overeating, too much caffeine, smoking, excess alcohol, bacterial or viral infections and certain medications. (See here for more information about how medication can affect your gut.)
• Milk protein can trigger gastritis in people suffering from lactose intolerance (see here).
Gastroenteritis is an infection of the gut in which dangerous organisms destroy or crowd out the healthy bacteria needed for normal digestion. It is also known as food poisoning, and the primary symptoms are vomiting, diarrhoea and weakness due to fluid loss.
For basic advice on what to eat after an attack, read the preceding section on diarrhoea and follow the BRAT diet for the first 48 hours after symptoms cease. Subsequent to the BRAT diet, make sure you eat live yoghurt at least twice a day to help restore the balance of normal intestinal bacteria. Also enjoy dark berries and red grapes for their antibacterial benefits. Frozen packets of summer fruits are now available in most large supermarkets, and can be a handy source of natural healing even in the depths of winter.
‘Smoothies’ made with live yoghurt and berries are an easy-to-digest way to a healthier gut. If you do not already enjoy these delicious treats, Marguerite Patten has written some smoothie recipes to get you started.
In addition to the suggestions above, try:
Fruit Soup – substitute berries for mango
Accompany food with Roast Garlic or Onion Marmalade, and take advantage of their natural antibacterial content.
Foul-smelling breath can result from smoking, the consumption of alcohol, poor dental hygiene and eating strong-smelling foods such as garlic and onions. If none of these habits apply to you, and you have persistent bad breath, check with your doctor as the cause may be gum disease, tonsillitis, an abscessed tooth, or a lung or sinus infection.
• Mint and parsley both contain high levels of the natural deodorant chlorophyll. Eating the garnish of fresh parsley on your dinner plate will help keep your breath fresh and add to your intake of vitamins and minerals.
• Chewing raw vegetables helps maintain strong gums and teeth.
• If you suffer from a sinus condition, horseradish, mustard and ginger will help decongest the airways.
Garlic, onions, shallots and other alliums are packed with natural antibacterial compounds and are increasingly respected for their healing benefits. To counter their ‘pong’, eat parsley at the same meal.
• Bad breath can be the sign of a serious illness: a fishy or ammonia smell may indicate liver problems; the smell of acetone may indicate a serious diabetic condition.
• Some women experience ‘menstrual breath’ around the time of their period. Regular brushing of teeth, mint tea and eating raw foods with high chlorophyll content (parsley, watercress, spinach) can help eliminate the problem.
• Mouth ulcers may contribute to bad breath, especially during menstruation (see ‘Mouth Ulcers’, below).
• Although both constipation and indigestion are said to cause bad breath, the medical evidence for this is slim.
Heartburn (indigestion) occurs when an excess of acid rises from the stomach into the oesophagus (gullet), causing burning pain. Occasionally, stomach acid reaches the mouth, leaving a repellent bitter taste. Symptoms include pain in the left side of the chest or below the breastbone, upper abdominal discomfort, bloating, nausea, belching and wind (flatulence).
• Mint in all forms, including soothing mint tea. Mint sauce (made with real mint leaves) eaten as part of a fatty meal may help prevent an attack of indigestion.
• Cook with cardamom, caraway, chervil, cumin, dill, fennel and ginger.
• A cup of camomile tea at bedtime helps soothe a delicate stomach.
• If you drink alcohol, do so in moderation.
• Certain raw salad foods – onions, radishes, cucumbers.
• Acidic foods such as pickles, vinegar and lemon juice.
• Fatty foods – skip the fry-ups, milkshakes and the greasy burgers.
• Chilli peppers and hot, spicy foods.
• Some people find chocolate, tea and coffee make gastric acidity worse.
• Do not eat cheese before bedtime.
• Primary causes of indigestion are eating too much, eating the wrong foods, eating too fast and stress.
• Indigestion is one of the most common forms of gastrointestinal distress. It frequently occurs after meals, especially large fatty dinners (a plague during the holiday season).
• Lying down after eating makes matters worse. If you tend to have indigestion, and have just eaten a large meal, take a walk rather than a nap.
• Indigestion occurs in all age groups, including infants.
• Small meals eaten at regular intervals can help control this painful condition.
• If you smoke – stop. Nicotine stimulates the flow of acid gastric juices.
• The pain of heartburn can cause such acute chest pain it may be mistaken by the victim for a heart attack.
• Persistent indigestion and heartburn should be discussed with your doctor. Over a long period, repeated bouts of heartburn can cause erosion or ulceration of the oesophagus, leading to a narrowing of the gut and difficulty in swallowing.
• Pregnancy and obesity can contribute to heartburn by changing the normal placement of the stomach.
• Hiatus hernia (see below) may cause heartburn.
A hiatus hernia develops when a part of the stomach pushes up from the abdomen into the chest cavity through a weakened part of the muscle forming the diaphragm. It can cause considerable pain that may mimic a heart attack.
• Enjoy more and smaller meals during the day. Keep foods light.
• Heavy meals dominated by fatty and highly spiced ingredients.
Circumstances that encourage the formation of a hiatus hernia include:
• obesity
• pregnancy
• tight belts and waistbands
This is a general term used to describe both ulcerative colitis and Crohn’s disease. More information about these diseases is provided under their separate headings.
Many people afflicted by these disorders are lactose intolerant and advised to avoid dairy products. However, special products on the market get around this problem. Lactase, the enzyme needed to digest dairy products, can be purchased as drops and in capsules, and milk treated with lactase is available.
This is one of the most difficult illnesses of the digestive system to manage because it produces pain and other symptoms without having a clinically identifiable organic cause. On examination, the bowel walls show no bleeding or inflammation, unlike inflammatory bowel disease (IBD), with which it is often confused (see above). IBS is widespread and can be very debilitating.
• Live yoghurt (read about probiotics)
• Fresh fruit
• Globe artichokes
• Drink plenty of water (at least 3 litres/5 pints a day)
• Mint, camomile and lemon balm teas
• Ginger
• Coriander seeds ground and added to appropriate dishes
• Any food to which you know you have an intolerance
• Wholegrain foods and pulses
• Bran
• Fatty foods, including cheese, butter, ice cream and red meat
• Foods known to cause flatulence – beans, lentils and cabbage, for example
• Coffee, tea and cola
• AVOID LARGE MEALS: eat small, frequent meals that do not ‘overfill’ your intestine
• IBS is a common complaint and accounts for about half the cases of bowel conditions that lead to seeking medical help. It is estimated that one in three people in the UK suffers bouts of this illness from time to time.
• Symptoms vary and can include one or more of the following: flatulence, alternating diarrhoea and constipation, nausea, a sensation of bloating, feelings of urgency and an inability to empty the bowel. Bleeding can occur. If this happens, seek medical help at once.
• No organic cause has been identified, but an attack often occurs during a period of stress: business or marital problems, bereavement and money worries are examples.
• IBS affects three times more women than men, and usually begins between the ages of 20 and 40. Its symptoms include a feeling of bloating, pain (usually in one corner of the abdomen), alternating diarrhoea and constipation, flatulence, headache, and feelings of anxiety. Eating may bring on pain and urgency to empty the bowels. Both the small and large intestine may be involved. Medical investigations are typically negative, except that muscular activity in the colon is abnormally rapid.
• Some medical experts continue to advise IBS patients to eat high-fibre diets, ‘usually bulked up with bran. Recent scientific evidence has shown, however, that bran and high-fibre diets can make matters worse.
• If you have a food intolerance, adapt your diet accordingly. Keeping a food diary can help you identify which foods may trigger an attack.
• Include more live yoghurt in your diet; the healthy bacteria will help heal inflamed intestines.
• Foods that produce flatulence can irritate this condition (see here for more information).
• Skip drinks that contain caffeine, and substitute herbal teas that soothe the nerves and stomach. Caffeine is a stimulant that heightens the effects of stress.
• Eat regular and small meals.
• IBS is diagnosed by excluding other illnesses. Make sure you seek medical help if symptoms are severe, and always seek medical advice in the case of rectal bleeding.
• Some IBS sufferers find aloe vera soothes inflammation and reduces symptoms. Many people find aloe vera has an unpleasant taste and prefer to take it in capsule form; however, the liquid supplement may have a higher potency. Read the product information and use your personal requirements to determine your choice.
Ulcers occurring inside the mouth are painful and can interfere with normal chewing. Affected areas appear white, grey or yellowish with raised red borders. They can occur anywhere in the mouth: gums, roof, floor, tongue, or inside the cheeks. If located in or near the entrance to the throat, ulcers can cause considerable pain that may mimic earache.
• Foods rich in B-vitamins (wheatgerm, whole grains, nuts)
• Foods rich in zinc (nuts, wheatgerm, eggs, shellfish)
• Foods rich in folic acid (dark-green vegetables, whole grains)
• If you are anaemic, foods rich in iron (apricots, fortified breakfast cereal, liver, dark chocolate)
Mouth ulcers are aggravated by acidic foods, such as vinegar and pickles, salty foods, alcohol and sucking boiled sweets.
Soufflé Omelette with Fruit
• Common causes are nutritional deficiency, stress and food sensitivities, but mouth ulcers may also appear during an attack of Herpes simplex, Crohn’s disease, ulcerative colitis and coeliac disease.
• If you bite your tongue or the inside of your mouth, rinse with a weak solution of antiseptic mouthwash; repeat every four hours until the soreness disappears.
• Check the state of your dental health: broken teeth can cut into the tender tissues lining the mouth.
• Grinding your teeth during sleep can also cause soft-tissue injury.
• High temperatures and immuno-suppressant drugs may cause mouth ulcers.
• Some women suffer from mouth ulcers around the time of their period; these may contribute to bad breath.
• Warning: mouth ulcers can resemble the early stages of oral cancer. If you have an ulcer that persists for more than a month, see your doctor or dentist.
Nausea, or feeling sick, is a common symptom associated with many illnesses and conditions including hormonal changes during the early months of pregnancy, food poisoning, excessive intake of food or drink, side-effects of certain medications, stress, travel motion and Crohn’s disease. This unpleasant sensation usually precedes vomiting.
• Ginger: an ancient plant widely known for its healing properties, ginger is a great aid in controlling nausea. Nibbling a piece of candied ginger, or eating one or two sweet biscuits flavoured with ginger nibs, are good ways to control travel sickness and the nausea that can accompany the first few months of pregnancy. Even the nausea caused by chemotherapy may be treated with this powerful spice.
• Fennel: a herb tasting of aniseed, the seeds and feathery leaves of which are used to aid digestion and control nausea. The taste of fennel marries well with fish. Small slices of fresh fennel add delicious crunch to a salad, or will cook well in a soup or stew.
• Nutmeg: used in small quantities, this powerful spice helps control nausea. Try grating a small amount into a hot cup of ginger and honey tea.
• Camomile tea helps soothe nausea.
• Any food you know triggers nausea.
• Tainted foods, or foods that may have been cooked or stored in less than hygienic conditions (see here for information on food hygiene).
Toast with Ginger Syrup
• The word nausea has its roots in the Greek word naus, meaning a ship.
• When you suffer from nausea, eat small, frequent meals.
• Make sure you are drinking enough water, but sip it rather than gulping it down.
• If you know you feel ill because you ate or drank too much, the answer is obvious!
• One final suggestion: a few deep breaths of fresh air can work wonders.
An inflammatory disease affecting the lining of the colon and rectum, ulcerative colitis
causes pain, diarrhoea and the discharge of mucus and blood from the bowel.
• Ginger
• Turmeric
• Bread and other foods made with refined flour
• ‘Smoothies’ and puréed soups
• Vegetables cooked until soft
• During an acute attack the bowel needs to rest and no food should be taken. Follow medical advice.
• Reduce the residue in your diet. Avoid dried fruit, wholegrain products, brown rice, peas and beans, pulses, nuts and seeds, apples, sweetcorn and salad greens.
• Keep a food diary and look for ‘triggers’: milk, wheat and/or spicy foods, for example. Many sufferers of ulcerative colitis are lactose intolerant (see here).
Pear Soup (see variations under Fruit Soup)
White Toast (topped with honey, crushed preserved ginger, roasted garlic or your favourite topping)
• Ulcerative colitis is a serious disease of Western cultures, and its prevalence is increasing. Estimates run as high as 100,000 sufferers in the UK. Women are more prone to this illness than men. Any age group can be affected, although people under the age of 35 are its most common victims.
• The cause of UC is unknown, although medical research indicates genetics may be a factor.
Vomiting is an involuntary act controlled by a centre in the brain, and has little to do with the stomach itself. It is often preceded by sweating, nausea, pallor and a slowed heartbeat.
• If you have a ‘sensitive stomach’, and frequently experience the unpleasantness of vomiting, try using more herbs and spices in your cooking. Good choices – in modest amounts – include mint, peppermint, garlic, dill, caraway, ginger, fennel, cardamom and cinnamon.
• Follow the BRAT diet during the acute phase of your illness. When you are feeling better, add variety with any of the useful recipes below.
• Food can upset your stomach if it is too fatty, contains too much chilli pepper, or is contaminated with dangerous bacteria. Food poisoning is the major cause of vomiting (see here).
• Too much alcohol.
Summer Berry Smoothie
Stuffed Pears, substituting Yoghurt Dressing for the mayonnaise used in the original recipe
Waldorf Salad, using the variation made with apples and pears, substituting
Yoghurt Dressing for the mayonnaise used in the original recipe
• Vomiting is a symptom of a condition, and not a disorder in its own right. It usually occurs to rid the body of an unwanted substance. Causes include distension of the stomach by excess food or drink, hormonal changes (as in pregnancy), infection of the gut (see ‘Gastroenteritis’), toxins and poisonous substances, certain therapeutic treatments, and illnesses such as diabetes and encephalitis.
• Medications may also cause stomach upset (see here).
• Frequent or prolonged vomiting may indicate a serious underlying medical condition and should be discussed with your GP.
• Repeated vomiting changes your body chemistry. Be aware that when you vomit several times over a period of an hour or so, vital water, salt (sodium) and sugar are lost and need to be replaced. As soon as you feel able, sip a rehydration mixture made in the following way: boil 1 litre (1¾ pints) of water, add 1 teaspoon of table salt and 8 teaspoons of sugar. Stir and cool. (Rehydration mixtures can be purchased at a chemist, but this works just as well.)
• Four or five hours after your last episode of vomiting, try eating a small amount of mashed ripe banana. Bananas are an excellent source of energy, potassium and other minerals needed by your body. After that – and for the next several days – build up your strength on the BRAT diet, which consists of ripe bananas, rice, apples and toast.
• Vomiting is a common symptom of food poisoning caused by poor food hygiene (see here).