Q: I often have embarrassing and painful digestive distress. One doctor told me to take an antacid, but that only seemed to make things worse. I want to feel better, but I’m not sure where to start. Can you help?
A: Digestive distress can have many causes. The food you eat travels through a complex 30-foot long winding tube. Enzymes are secreted, and small muscles move things along mostly without needing your cooperation. However, there are many simple ways that you can improve your digestive process, which is what turns food and drink into the agents of tissue repair and the ongoing energy for work and play that you enjoy every day.
First Things First: Slow Down
First, never eat in a hurry. If you don’t have time to sit, chew your food properly, and relax while eating, please wait until you can make time. This is a big request, admittedly. However if there’s one take-home message in this column, this is it.
Digestion is a parasympathetic function. That’s the opposite of sympathetic (also known as “fight or flight”). There is no way you can digest properly if you’re having an adrenaline rush. For the enzymes in the mouth, stomach, and small intestine to do their jobs, and for the muscular colon to move waste for elimination, you must be at least be somewhat relaxed. To put it plainly, if you want to feel better, you must make time for slow, peaceful eating.
As we age, we need less food. This is why I favor intermittent fasting as a way to both spend less time eating and greatly improve the quality of the eating experience. Two meals a day for folks over 55 is largely sufficient. I like to have one meal around 11:00–11:30 a.m. and another around 6:00–6:30 p.m.. Digestion can be enormously energy-consuming, which is why eating more than you need can age you quickly.
Drugs Aren’t the Long-Term Fix for Digestive Distress
Conventional doctors like to give names to bodily functions that don’t work optimally. In the digestive arena there’s Irritable Bowel Syndrome C (constipation), D (diarrhea), or M (mixed)—each with a list of recommended drugs. Then there are gastric ulcers, peptic ulcers, leaky gut, SIBO, Crohn’s disease, ulcerative colitis, gastroparesis, and other labels, each with an insurance-reimbursable code and corresponding prescription medicine. These interventions may improve symptoms, but they won’t fix your problem. The only way to do that is to restore your body’s natural digestive process.
If you have a family history of celiac disease, and notice that gluten-containing grains (particularly wheat) cause diarrhea and abdominal pain, you should get tested for celiac. The cure is avoiding gluten. For most other digestive complaints, you may need some medicine in the short term (e.g., a senna-based laxative for constipation), but improving your eating habits will usually cure what ails you. Here are the steps to take:
- Chew your food well. All food should be reduced to a soupy consistency before swallowing. Really pay attention to this instruction.
- Do not drink liquids while eating. Little sips are okay, but you don’t want to dilute your digestive enzymes with excessive liquid.
- Take digestive enzymes with meals for several months if your digestive distress is longstanding (more than 6–12 months). I like to start patients with a digestive “multi” containing protease (protein-digesting enzyme), amylase (for starch), lipase (for fat), and cellulase (for fiber). If after a few weeks, you trend constipated, you may need to take supplemental hydrochloric acid capsules to kick-start your own optimal acid production. Start with 500–750 mg per meal, once a day, and increase each day until you feel a mild warmth in your stomach, then reduce the dose.
Too Little Acid Is Often the Issue
Too often, people take antacids because they were told their problem is “too much acid.” But this is rarely the issue. Acid is only a problem when it comes up into your throat. This is the case in heartburn and GERD (gastro- esophageal reflux disease), which is caused by a malfunctioning sphincter between the base of your esophagus and the top of the stomach. This problem is called a hiatal hernia, and is almost always the cause of GERD.
Your stomach makes stomach acid (if it has enough chloride ion, largely acquired from salt in the diet) for good reasons: to sterilize food and other items coming down the pike before they hit the bloodstream; to help break down proteins into amino acids so you can absorb these micro-units of all tissue repair; and to stimulate downstream digestive juices (pancreatic enzymes, bile) and colonic contractions (called peristalsis). All of this requires stomach acid.
Supplements That Help Digestive Distress
If you experience irregular bowel habits, bloating after meals, or the urge to go to the bathroom without results, there is likely something you can to do improve your natural capacity to digest and assimilate nutrients from food.
- Fiber is important to feed the “good bugs” in your guts, but all fiber isn’t equally helpful. Soluble fiber (something that softens up in water such as oats, celery, psyllium husks, or ground flax seeds) is helpful; insoluble fiber (beans, nuts, whole wheat) isn’t.
- Magnesium (250–500 mg at bedtime) is a useful laxative, especially for women who also suffer from menstrual cramps. Peppermint tea is antispasmodic that can help relieve intestinal cramps. A heating pad on the abdomen at night is lovely to relax spastic (less-effective) peristalsis. Applying castor oil first, then a heating pad for 20–40 minutes, is even more effective.
Also consider taking the following digestive herbs:
- Artichoke leaf and milk thistle seed (100–200 mg) promote the flow of bile and are particularly helpful for fat digestion.
- Ginger root (20–30 mg) has been shown in human and animal studies to increase gastric motility (so food won’t hang around in the stomach too long and start to ferment).
- Fennel seeds (often available at Indian restaurants at the check-out counter) or 25 mg of fennel seed oil, are well known for reducing gas production by inhibiting the activity of a methane-producing bacterial enzyme. Fennel seeds, tea, and seed oil also promote gastrointestinal stimulation and thus improve motility of food through the tube. Ideally, you want your food to go from mouth to waste in 18–24 hours. Less time in transit means suboptimal nutrient absorption. More time in transit means that food starts to putrefy, which causes gas, cramping, pain, and embarrassment.
- Turmeric remains a favorite anti-inflammatory and should be included in food every day (ideally ¼–½ tsp. daily depending on your level of inflammation). Inflammation is at the root of many common disruptions to good health. Given that the gut is at the center of our health and well-being, it should be no surprise that it’s highly connected to our brain and emotions. This is why stress-relieving, self-awareness-building techniques like meditation, yoga, deep breathing, walking in the woods, acupuncture, biofeedback, hypnotherapy, and cognitive behavioral therapy all have a role in improving digestive function. Take time to make real food, not too much, and enjoy every bite.
Bad and Good Foods
Foods that may cause digestive distress:
- Apples, applesauce, avocados, blackberries, dried fruits, fruit juice, pears, persimmons, apricots, cherries, mangoes, nectarines, peaches, plums, prunes, watermelon
- Asparagus, beets, broccoli, Brussels sprouts, cabbage, cauliflower, garlic, green bell peppers, leeks, mushrooms, okra, onions, shallots, sweet corn, tomato paste
- Cottage cheese, ice cream, milk, ricotta, yogurt
- Barley, rye, wheat
- Beans, cashews, chickpeas, hummus, lentils, most soy products, pistachios
- Apple cider, apple juice and other fruit juices, chamomile tea, instant coffee,
soft drinks with HFCS or crystalline fructose
- Agave, HFCS, honey, molasses, sorbitol, xylitol, mannitol, maltitol
Foods that are generally safe:
- Bananas, blueberries, melons (eaten alone), grapefruit, grapes, kiwi, lemons, limes, oranges, papaya, pineapple, raspberries, rhubarb, strawberries, tangerines
- Bamboo shoots, bok choy, carrots, celery, chives, cucumber, eggplant, green beans, kale, lettuce, parsnips, pumpkin, radishes, red bell peppers, spinach, squash, sweet potatoes, turnips, white potatoes, zucchini
- Butter, cream, cream cheese, hard or aged cheeses, kefir, lactose-free milk, goat’s milk, or yogurt
- Gluten-free products, millet, quinoa, rice, organic cornmeal
- Pumpkin seeds, sesame seeds, sunflower seeds, firm tofu
- Black tea, espresso, filtered coffee, green tea, peppermint tea
- Brown rice syrup, cane juice, no-calorie sweeteners such as stevia, pure maple syrup.
- What Can I Eat to Improve Digestion?
- Top 10 Digestive Enzymes
- What Are Probiotics and Which Ones Should You Take?
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