Managing digestive distress is a lifelong effort

Irritable bowel syndrome, heartburn, constipation, diarrhea, gas, bloating — almost every intestinal problem that seems to occur as we age was covered at The Greens at Cannondale’s most recent Community Health Series. Dr. Mae Tighe, gastroenterologist with Western Connecticut Medical Group, trained at Yale, Cornell and a graduate of Johns Hopkins Medical Center, was the presenter.

One of the outstanding features of a Greens Community Health session is the fact that speakers are chosen who know the most recent information about the topic. This often reverses commonly held notions. Everyone’s digestive tract is different. People have different food sensitivities, different digestive histories. Tighe’s goal was to provide information that would help in the personal management of common problems.    

“It almost goes without saying that diet and lifestyle are two of the most important factors to consider. But after that, come specifics,” she said. “Medications can cause constipation. Instead of helping, certain laxatives can add bulk and decrease intestinal mobility.”

Dr.Tighe recommends old-fashioned milk of magnesia. A stool softener like Colace can be helpful. Better still, is the action of probiotics, which are microorganisms that put healthy intestinal bacteria (called flora) into the gut. She recommended two products: Activia yogurt, and a probiotic called Align.

“Probiotics only work while you’re using them, so they should be taken daily. Though there are currently no FDA regulations for probiotics, they have proven extremely successful in treating gassiness, bloating, as well as constipation and diarrhea,” she said.

“We have millions of organisms in our gut. Gas is produced by the fermentation of undigested carbohydrates and sugar alcohols. These are in many healthy foods we eat.  We know them as fructose, lactose, caffeine. There are many medications that can ease the symptoms of irritable bowel disease, gas and bloating, each one little different, so it’s best to consult your doctor. For longstanding symptoms, a good physical exam is indicated, plus bloodwork and further testing with an endoscopy or colonoscopy.”

Tighe introduced a new word: FODMAP, an acronym for Fermentable Oligo-, Di- and Mono-saccharides, and Polyols. These are carbohydrates and sugar alcohols in foods that cause fermentation problems. Though they are present in healthy foods, they can cause problems when eaten excessively. Fructose and lactose are major culprits.

“Most of the world’s population is lactose intolerant, which varies in severity. The product Lactaid still has some lactose in it. Almond milk is truly lactose-free. ”

Tighe admitted that achieving a “perfect diet” is difficult, if not impossible. The list of indigestible FODMAPs is huge. But making small changes and eliminating certain foods can reduce intestinal upset.

“Irritable bowel syndrome is a phrase for a multitude of conditions,” she said. “It is associated with changes in stool form and frequency. Usually triggered by diet, it has been linked to stress, depression and anxiety. Dietary distress can affect sleep and poor sleep can add to dietary distress. The idea that wine at bedtime might be a good choice is all wrong. Wine wrecks good sleep.”

Certain “take home messages” for intestinal health summed up the presentation.

1) Consider adding a probiotic capsule or daily probiotic yogurt.

2) Ask your doctor about some of the newer medications for constipation and IBS.

3) Look over your diet for FODMAPs that could be causing gas or loose stools.

4) Review with your doctor your use of PPI’s (Proton Pump Inhibitors). These are medications to reduce gastric acid, like Nexium.

5) Don’t eliminate seeds and nuts if you have diverticulosis. They are good sources of protein and fiber.

6) Make sure you take advantage of the abdominal imagery techniques to detect and prevent serious digestive disease.