The Good Gut Guide: Help for IBS, Ulcerative Colitis, Crohn's Disease, Diverticulitis, Food Allergies and Other Gut Problems. Stephanie Zinser

The Good Gut Guide: Help for IBS, Ulcerative Colitis, Crohn's Disease, Diverticulitis, Food Allergies and Other Gut Problems

href="#fb3_img_img_d4e129e0-5ba0-5260-886b-b7a7889c112c.jpg" alt=""/> Homeopathy: There are several homeopathic remedies for various types of occasional constipation. These include lycopodeum, nux vomica, sepia, silicea, bryonia and alumina.

Further Information: National Digestive Diseases Information Clearinghouse, www.niddk.nih.gov/health/digest/pubs/const/const.htm and www.niddk.nih.gov/health/digest/pubs/whyconst/whyconst.htm For constipation in children, see Digestive Disorders Foundation, www.digestivedisorders.org.uk/Leaflets/adconsNEW.html

Laxatives – What Are They?

Laxatives are substances that encourage the bowels to open. They are extraordinarily popular – nearly $1 billion is spent on laxatives each year in the US. There are several types:

Bulking agents are concentrated fibre preparations that include bran, ispaghula husk, methylcellulose and sterculia. Brand names to look for include Fybogel and Isogel (UK), Metamucil and Citrucel (US). All bulking agents should be taken with plenty of water, as this helps them to swell and form their bulk, which in turn helps move waste effectively through the large intestine.

Stimulant laxatives encourage bowel movements by stimulating the nerve endings in the bowel walls to make the muscles contract. This speeding up of bowel muscles encourages waste to pass through more quickly. In doing so, less water is reabsorbed back through the bowel walls into the body, the stools retain more moisture, are less dense and compacted, and therefore easier to pass. Stimulant laxatives can cause diarrhoea if taken too often or in overdose and dependency can develop with overuse. They should not be used for longer than a week at a time and never given to children without a doctor’s specific advice. Brands include Dulco-Lax and Senokot (both UK and US).

Lubricants and stool softeners such as liquid paraffin, mineral oil and glycerine suppositories can be given to help soften hard, impacted faeces. They are most often used when haemorrhoids or anal fissures cause severe pain on straining.

Osmotic laxatives such as Epsom salts are used to attract more water into the bowel, which then softens hard stools. They can cause chemical imbalances in the blood and aren’t generally recommended for long-term use. Lactulose and sorbitol sugars also act as osmotic agents and are often used as an alternative to bulking agents in the long-term treatment of chronic constipation. Lactulose should never be used by anyone with lactose intolerance or milk allergy.

Diarrhoea

‘Everyone knows it – first, you get a gripey feeling deep in your belly, then you know you’ve got just a few seconds or less to get yourself into the nearest loo. It’s something that babies in nappies wouldn’t care about, but as an adult it becomes a real social problem. If it’s an acute case of food poisoning or holiday tummy it’s bad enough, but to have it constantly is a different ball-game altogether. It changes your life completely. You can’t go anywhere or do anything without military planning and knowing where every toilet is located. You become really good at inventing excuses and avoiding intimate situations. I’ve even had to resort to carrying spare underwear and wet wipes because of the odd disaster.’

Graham, 22, who suffers from severe, urgent diarrhoea caused by ulcerative colitis

Diarrhoea is defined as ‘frequent passing of abnormally loose or watery faeces’, and most of us easily know when we’re suffering from it! The urge to get to the bathroom quickly is normally a main feature and occasionally the first time we know we’ve got diarrhoea is when we’re ‘caught short’ or break ‘wet’ wind. Faecal incontinence (the medical term for being caught short) is more common than you might think, affecting one in 20 of us at some time or another.

Diarrhoea is often, though not always, accompanied by stomach cramps and, if it is caused by food poisoning, food intolerance or a flu-like illness, you may feel sick and throw up as well. Diarrhoea can be acute, starting suddenly and lasting only for a short period of time, or chronic and linger for weeks, months or years.

What Causes Diarrhoea?

The guts are very susceptible to developing diarrhoea – excess caffeine, vigorous exercise, excess fibre, excess alcohol, stress, antibiotics and even medicines and supplements (like iron, for example) can all cause it. Food intolerance and coeliac disease can also induce diarrhoea and in children it may be associated with a condition called encopresis. An overactive thyroid can cause diarrhoea, but so can viral gastroenteritis, parasitic infections, food poisoning, malabsorption, IBS, polyps and proctitis. While diarrhoea is far more likely to be caused by a minor problem, it can occasionally indicate more serious problems like ulcerative colitis, Crohn’s disease, diverticulitis, appendicitis, TSS, typhoid or paratyphoid, cholera and bowel cancer.

How Should I Treat Diarrhoea?

The first and most important thing is not to become dehydrated. This is especially important for babies, young children and the elderly, who dehydrate far more quickly than adults. Dehydration has all sorts of serious knock-on effects as it upsets the finely tuned balance of body salts and essential nutrients; in serious cases it can even lead to brain damage and death. An infant or child with diarrhoea is soon at significant risk of dehydration, so always take action quickly and seek medical help if it persists for more than 6 hours. Babies cannot tell you how they feel, but in infants under 18 months old, the fontanelle (the space between the growing skull bones that can be felt on the top of a baby’s head) may look sunken. In both babies and adults the urine will be a dark yellow colour and hardly any will be produced at all. Other symptoms include having a dry mouth and lips, and lethargy.

When to Seek Help

An attack of diarrhoea can pass very quickly, but if it is severe, prolonged or accompanied by bleeding seek medical advice urgently. In children and the elderly, diarrhoea can rapidly become very serious, if not life threatening, and help should be sought quickly.

Self-Help for Diarrhoea

Fluids: If you have diarrhoea and vomiting, it may not be a good idea to drink much for a while, until your stomach can handle a few sips of water. Otherwise, if you’re unaffected by sickness, drink plenty of fluids – bottled water and soft drinks. If you’re abroad and think you may have ‘traveller’s diarrhoea’, avoid all tap water and any drinks containing ice cubes, as these may have been made from tap water.

Balance your electrolytes: Rehydration salts like Dioralyte and Rehidrat are widely available at pharmacies and most supermarkets or grocery stores. These are important as they help restore vital salts like sodium (common salt) and potassium, which are easily lost with diarrhoea. In emergencies, you can easily make your own using basic kitchen ingredients – put a generous pinch of salt and one teaspoon of sugar into 250ml (8fl oz) of cooled boiled water, bottled water or fruit juice.

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