if you think you may be lactase deficient. The enzyme lactase is necessary to digest lactose (milk sugar) properly and some people – mostly those of Mediterranean, African, Asian and Native American heritage – don’t always produce enough lactase, with the result that undigested milk sugars ferment within the gut, producing wind. Lactase supplements can help in these situations.
Starches – with the exception of rice and rice flour – produce gas when broken down in the intestine. Use rice instead of potato or wheat-based carbohydrates.
Avoid chewing gum and sucking hard sweets as they make you swallow more often (as does smoking).
Avoid sorbitol-based sweeteners and products containing sorbitol – they can be found in sugar-free products like mints, for instance.
See your dentist: Badly fitting dentures encourage air to be swallowed, so get your dentures checked if they feel loose.
‘Anti-gas’ preparations: Remedies containing simethicone – for example, Rennie Deflatine, Setlers Wind-eze®, Maalox (various types) and Mylanta II (US) – help by combining small wind bubbles in the stomach that are then more easily burped up. (Note that some of these products, for instance, Remegel Wind Relief, also contain sorbitol – see above.) Activated charcoal tablets can help reduce colon wind, and Beano® (available in the US) may help digest the sugars found in beans and many vegetables, thereby reducing gas.
Herbal help: Celery seeds can help reduce wind, as can fresh dill tea (simply brew some fresh dill in boiling water for a few minutes, strain and drink). Peppermint oil also helps prevent wind.
Homeopathy: Lycopodium, arsenicum and argentum nitricum are all recommended for relief of wind and bloating.
If all else fails: It may sound like a joke but it isn’t – you can buy special airtight underwear (Under-Ease) from the US that contains a replaceable charcoal filter designed to remove the unsociable smells associated with troublesome and persistent wind – visit www.under-tec.com or call (1) 888 433 5913 for details (from outside the US call (1) 719 584 7782).
‘I was in the bar, having a drink, and I suddenly sensed an ominous feeling. I knew I had a matter of seconds to make it to the loo, and a whole crowded bar to get through. Barging past people was bad enough, but as I burst through the door to the Ladies’ Room, I saw a row of girls staring at me, arms folded, waiting their turn. I didn’t have time to queue up, but I couldn’t think what to say either. As soon as I saw a door to a cubicle open, I pushed forward, apologizing, and slammed the cubicle door shut behind me. I was already a bit too late and my embarrassment at having been caught short was only made ten times worse when I heard all the gossiping and tut-tutting going on outside.’
Andrea, 23, who suffers from ulcerative colitis (feelings of urgency are a common feature of this disorder)
‘Urgency’ means that desperate rush to the bathroom that often happens when we have an attack of holiday diarrhoea. Most of us, most of the time, manage to make it to the loo, but sometimes we don’t and the resulting embarrassment and feeling of shame can be dreadful – even when nobody else knows what’s happened. Bowel control is something that, because it’s learned when we are toddlers, seems to remain firmly embedded in our minds as an essential ingredient of being ‘grown up’. Anyone who can’t control their bowels is immediately open to ridicule – how can anyone fail to control something so basic, something even toddlers can do?
‘Frequency’ refers to the need to empty our bowels more often than normal – another symptom often associated with irritated intestines. Increased frequency is often accompanied by feelings that the bowel has not been emptied properly – what doctors refer to as ‘incomplete evacuation’. Most people open their bowels a maximum of 2–3 times a day, but if you have severe frequency and urgency you can find yourself going to the loo 10, 15 or even 20 times a day.
What Causes These Problems?
The number of conditions that may cause these symptoms is relatively small. The most common cause is haemorrhoids. Proctitis and IBS are two other common causes of feelings of urgency, frequency and incomplete evacuation. Less commonly, such symptoms may be caused by ulcerative colitis, Crohn’s disease and (even more rarely) bowel and anal cancer.
Self-Help for Urgency, Frequency and Incomplete Evacuation
‘Can’t Wait’ cards: These credit-card-sized cards are available from associations like National Association for Colitis and Crohn’s Disease (NACC) and are designed for people who often need to find a toilet fast. They state that the holder of the card is suffering from a non-contagious condition that causes them to need the toilet urgently. Can’t Wait cards can spare you the embarrassment of having to ask and explain, and give your request more credibility. Use them in shops and offices, aircraft or public places.
Go prepared: If urgency is a persistent feature of your daily life, then be prepared. Carry a spare change of underwear, or wear a discreet incontinence pad (even a feminine pad) in your underpants in case of emergencies.
Don’t rely on public toilets: You might be lucky enough to get to a public toilet, only to discover with horror that it has no toilet paper. Always carry a handy pack of tissues with you, just in case, and a small packet of wet wipes.
Identify your triggers: Some people find certain things act as triggers – try to identify what yours are. Stress often acts as a laxative and specific foods like coffee (caffeine), chocolate and alcohol can too. It could be that certain times of day are worse than others – morning is often a bad time for many people. Learn what your triggers are and then work around them.
Avoid smoking: Ask any smoker what gets them to the bathroom to open their bowels and invariably they’ll tell you it’s the first cigarette of the day. Nicotine exerts immensely powerful effects on the body, one of these being a laxative one. If you were ever going to quit smoking, now is the time.
Strengthen your pelvic floor: The muscles of the pelvic floor are structured somewhat like a figure ‘8’, running from back to front – from the anus to the vagina (in
