Tackle digestive concerns and upsets

Tackle digestive concerns and upsets

By Marsha McCulloch, M.S., R.D., Environmental Nutrition Newsletter

Heartburn, constipation and other digestive tract issues can strike at any age, but some of these problems may become more common in middle age and beyond. Changes in the digestive tract over time, such as increased inflammation and gut permeability (leakiness), along with other factors, such as difficulty chewing or increased use of medications, can impair digestion and elimination as we get older. Here’s a closer look at common digestive tract problems that can occur, along with causes and solutions.


Feeling overly full, upper abdominal pain or discomfort, repeated belching, and/or nausea can be miserable. Sometimes indigestion is triggered by poor habits, such as midnight snacking, eating too quickly, or over-indulging in fatty food and/or spicy food. In such cases, modifying your eating habits may help prevent future digestive upset. In other cases, people may be upset by seemingly healthy foods to which their immune system has developed an inappropriate inflammatory response. “In such cases of indigestion, keeping a food and symptom journal can be a valuable tool to help pinpoint dietary culprits,” says Kathie Madonna Swift, M.S., R.D.N., L.D.N., author of “The Swift Diet: 4 Weeks to Mend the Belly, Lose the Weight, and Get Rid of the Bloat.”


This burning sensation in your chest is caused by stomach acid, but not necessarily because your stomach is releasing too much acid. Heartburn can be due to a hiatal hernia in which the stomach bulges up into your chest cavity, or other factors, such as medications, overeating, obesity, and smoking. Simply eating smaller meals, especially later in the day, and not lying down for three hours after eating may help. Dropping a few pounds, if overweight, also may reduce heartburn, since extra abdominal fat puts pressure on your stomach. Some people also may find heartburn is triggered by certain foods or drinks, such as tomatoes, onions, citrus fruits and peppermint, as well as caffeine and alcohol, which can relax the valve between the stomach and esophagus, allowing acid to back up, and/or stimulate stomach acid production. If you suspect a certain food is the culprit, cut back on it or avoid it for a few weeks to see if your symptoms improve.

Bloating and gas

If you commonly have to loosen your pants after eating a reasonably sized meal, you know the frustration of bloating. “This can be due to a food intolerance, such as to gluten or easily fermentable carbohydrates, such as lactose found in dairy products or fructose found in sweetened beverages and fruit juice,” Swift says. “Bloating also can be caused by small intestinal bacterial overgrowth (SIBO).” In SIBO, bacteria from the large intestine migrate into the small intestine and ferment carbohydrates, producing excess gas and bloating. Seek the advice of a digestive health doctor (gastroenterologist) to determine the cause of bloating; he may prescribe a diet that limits fermentable carbohydrate-rich foods, such as milk, apples and onions, and/or an antibiotic to resolve SIBO.


It’s best to have at least one bowel movement per day. Constipation tends to be more common with aging, but lifestyle factors are often the biggest culprits. “For example, constipation may occur if you’re relying too much on low-fiber convenience foods or if you aren’t getting enough exercise or drinking enough water,” Swift says. “With aging, people are more likely to be taking medications, such as pain pills or antidepressants, and supplements such as calcium carbonate, which may contribute to constipation.” Probiotic supplements and yogurt with live active cultures can be helpful for constipation (and diarrhea), in addition to getting at least 25 grams (for women) to 38 grams (for men) of fiber daily from fruits, vegetables, legumes and whole grains.


“Some of the same factors that provoke bloating, such as food intolerance or SIBO, may trigger diarrhea, too,” Swift says. “Diarrhea also can be caused by medications, such as antibiotics.” In other cases, diarrhea could be due to an infection (which older adults are more vulnerable to as immunity declines), especially if you have traveled overseas or eaten contaminated food at a restaurant. For isolated cases of diarrhea, the traditional “BRAT” diet may help until diarrhea is resolved, which includes bananas to replace lost potassium, and low-fiber rice, applesauce, and toast, to help firm the stool.

Get to the cause. “Getting to the root cause of digestive disorders is key, and that can vary from person to person for a specific digestive issue,” Swift says. Keeping a food/symptom journal and visiting your doctor are good starting points.

(Reprinted with permission from Environmental Nutrition, a monthly publication of Belvoir Media Group, LLC. 800-829-5384. www.EnvironmentalNutrition.com.)