HOW DO I KNOW IF I HAVE A “GUT ISSUE”?

By Dr Pennie Taylor CSIRO Research Scientist and Practising Dietitian

There are many factors that influence our gut health or the perception one is experiencing gut health issues.  To help get to the bottom of it, a Consumer Experience Gut Health Survey was run by CSIRO. The respondents are parents of young children who rated the following factors as very or extremely influential in their poor gut health experiences: 

• Gut microbiome imbalance (77%),  
• Lifestyle factors (79%),  
• Emotional health (73%) and   
• Food intolerances or sensitivities (68%).   

The perceived cause of gut health issues as indicated by the respondents include dietary restrictions of problematic foods and consumption of probiotics. Furthermore, it was revealed that this population experience high levels of stress as well as the lack of sleep quality, which are contributing factors.  

“Gut issues” are very common, but when symptoms are persistent, they interfere with your quality of life, or cause you concern, it’s important to seek medical advice. Changes in bowel habit or abdominal discomfort can be the first signs of serious disease and if so the earlier investigated and diagnosed the better.   

One of the most common group of gut problems are the “functional gastrointestinal disorders”. These conditions are caused by abnormal functioning of the gut rather than structural, such as cancer or biochemical disorders. Routine diagnostic tests such as endoscopic examinations, blood tests and scans usually do not detect any problems. This has led to the development of a symptom-based system called the “Rome criteria”, which is used by doctors for diagnosing functional gastrointestinal disorders. Before diagnosing a functional gastrointestinal disorder, doctors will examine their patients to ensure they do not have any symptoms such as unintentional weight loss, recent change in bowel habit, symptoms or family history of colon cancer, as these that could indicate more serious disease.   

Functional gastrointestinal disorders can affect any part of the gastrointestinal tract. The most common disorder is irritable bowel syndrome (IBS), which is associated with recurrent pain when passing bowel motions and a change in stool frequency or form. Bloating is also common. Other functional gastrointestinal disorders include dyspepsia, vomiting, abdominal pain and constipation and diarrhoea. If you are experiencing any of these symptoms, please see your health care professional for personalised medical support. 

Image Credit: iStock.com

These functional gastrointestinal disorders have been associated with gut motility (or peristalsis), gut sensation and brain-gut dysfunction problems.  Abnormalities with gut motility can result in spasm and pain, or slow or disorganised muscular contractions along the gut. Sensation problems can mean the nerves in the gut become very sensitive so even normal intestinal contractions may cause pain. Brain-gut dysfunction means communication between the gut and the brain is disrupted.  

IBS has been traditionally considered a brain-gut disorder. The development of the condition was thought to occur when psychological stress such as anxiety and depression, in combination with a gut infection or inflammation caused changes in the gut bacteria and the intestinal wall, which may become “leaky”.  This leakiness allows bacteria or their products to cause local swelling and inflammation, changes in muscle and nerve function and IBS symptoms. This could be worse in people genetically predisposed to gut problems.  

We now know that up to half of IBS patients develop their gastrointestinal symptoms first – gut-brain rather than brain-gut – in response to factors like infection, medication, certain foods and inflammation. Changes in mood – anxiety, depression – follow later and worsen their IBS symptoms. The gut-brain message may be caused by local inflammatory factors that affect gut muscle and nerve function, which send signals to the brain.  IBS symptoms persist in between 10-20% of patients after acute gastroenteritis, suggesting either low level inflammation or changes in the gut bacteria may be involved in these patients. 

We know emotions and stressors can affect gastrointestinal secretions, motility and sensation, and vice versa – that gut activity can affect pain perception, behaviour and mood. People in hospital with IBS have been found to have more psychological difficulties than other patients, whereas the psychological health of people with IBS who have not sought medical advice is no different to people without IBS. This shows that although psychological factors can make symptoms worse, IBS is not a psychiatric illness. Like any chronic illness, functional gastrointestinal disorders negatively affect a person’s health-related quality of life and work productivity.   

The treatment of functional gastrointestinal disorders depends on the symptoms a person is experiencing. Medications to treat abdominal pain and bloating, and abnormal motility or hypersensitivity, are available in Australia on prescription. The latter may be more effective when taken before eating to reduce intestinal spasm. Both over-the-counter and prescription anti-diarrheal and laxative medications are available for mild and more severe symptoms. Antidepressants are also often prescribed for their beneficial effects reducing the intensity of chronic gastrointestinal pain and for normalising motility. Probiotics are available to treat abdominal pain but there is limited evidence they work, and it’s unclear which bacterial species or strains are of benefit. 

*We advise that the information contained does not negate personal responsibility on the part of the reader for their own health and safety. It is recommended that individually tailored advice is sought from your health care professional.  The publisher and their respective employees and authors are not liable for injuries or damage occasioned to any persona as a result of reading or following the information contained.