– January 2010

Q) I have been told by my doctor that I have got IBS my main symptom is bloating as opposed to cramps. I do not know a whole lot about this syndrome and I was wondering could you give me some facts. I have been on antibiotics but they do not seem to be working, would seeing a dietician be worthwhile? Are there any other tests that can be done to show how severe it is or so on?

 A) Recent evidence suggests that bloating occurs when spasm of the gut holds up the content of the bowel and that content is fermented releasing gas.  Antibiotics are unlikely to help.  Think food and mood.  A diet that contains a lot of fruit and vegetables and cereal fibre tends to be a gassy diet because it contains a lot of carbohydrate that would be fermented.  And tension, anxiety, frustration, depression, working too hard, nervous exhaustion can disrupt the way the bowel contracts wither causing spasm and hold up or moving food through too quickly so that less is absorbed and more gets fermented.  A dietician may advise on the sorts of food that generate less gas.  There are no specific tests for bloating so I don’t think further testing will help.        

Q) My son, aged 5 and a half, has just been in hospital with suspected appendicitis, but turns out it was a gastro-intestinal infection.  For a couple of weeks prior to this, each time he’s been to the bathroom (usually twice a day) his poo has been quite soft and ’squirty’. I’m not sure if the two things are related - no-one at the hospital seem bothered by the ’squirtyness’.  Is this something I should worry about?

 A) Has he been treated for the infection?  Has the squirtiness improved?  Has he changed his diet recently? Often when you get loose motions or when you take antibiotics, the numbers of healthy bacteria in the gut are reduced and this compromises the colons ability to salvage complex starches and sugars.  I doubt it’s anything serious to worry about, but you might try giving him a supplement of probiotic, such as Yakult, daily for a time to restore bacterial populations.   

Q) I have looked at the symptoms for Crohn’s disease and other digestive infections, and I seem to have quite a few. I have been travelling for 3 months so lost a bit of weight then but now I got back and I have been constantly bloated and constipated for 4 days now since I got back,.
And when I was passing stools there was mucus and sometimes black!
Does this sound like I should go to my GP as I don’t like wasting their time?

 A) Yes, I would go and see your doctor.  You don’t say where you have been travelling, but I would wonder whether you might have picked up a parasitic infestation, such as giardiasis or amoebiasis or even roundworms.  Sometimes when you have picked up an infection abroad the symptoms continue (even though the infection has disappeared - the memory of it lingers on in the gut.  This is more likely if you are anxious or depressed or have been stressed. The black motions might indicate bleeding from the gut.  Another good reason to check this out with your doctor. 

Q) I suffer from continual flatulence which makes things in life extremely difficult. I find this especially a problem when travelling, out for the evening etc. I do eat a lot, mainly a healthy diet, firstly because I have a healthy appetite & secondly because I have been slim all my life & find it impossible to put on weight. I am over 60. It is embarrassing, & I have seen my GP without any success. Do you have any suggestions?

 A) This sounds like the cause of your symptoms may be a combination of a healthy diet and an active gut.  You probably eat a lot of fruit and vegetables and cereal fibre, all of which would be fermented in the colon releasing large amounts of gas.  You may also have a rapid transit through your gut, reducing the time for absorption in the small intestine and dumping more fermentable semi- digested food into the colon.  Alternatively you may have a specific cause of malabsorption such as coeliac disease, which would produce the same symptoms.  This can be checked by your GP with a simple blood test.  Try reducing the amount of fibre in your diet, lead a balanced life allowing plenty of off time to relax.  Think food and mood.    

Q) I have battled Candida for many years and spent a considerable amount of money trying to eradicate it. It has penetrated the gut wall. How do I kill off this fungus?

 A) How do you know it’s penetrated the gut wall?  Candida is a common commensal organism; it is present in the gut of most, if not all of us, and it usually does no harm unless your immune system is run down.  Unfortunately the treatments to eradicate candida tend to have a lot of side effects - and it will soon come back anyway.  I would advise you check this diagnosis out with your GP or specialist.

Ask the Doctor

Answers to the above questions have been provided by Professor Nick Read, consultant gastroenterologist and psychotherapist, expert on Irritable Bowel Syndrome and medical adviser to The Gut Trust.

For anything you might wish to know about the way the gut works and what happens in Irritable Bowel Syndrome and other causes of gastrointestinal disturbance, the role of diet, emotions, infection, and the various ways of managing your symptoms, do become a member of The Gut Trust and consult its comprehensive self management programme, available on the  website (www.theguttrust.org/) .  Membership of The Gut Trust also enables people to access the  telephone helpline free, obtain free medical advice,receive regular copies of the magazine, Gut Reaction, get a can’t wait card and a travel card to gain access to toilets at home and abroad,  get monthly newsletters, find out if there is a self help group in your area and much more.