gassy bloated? ?

bloated?
gassy?
Want to be rid of stomach aches for good?
Don’t eat. Don’t stress. Don’t drink. And hope no one in your
family has a history of tummy trouble. Fortunately, you don’t
need to go to such extremes to feel better. The first step:
Make an appointment with your doctor. Sounds obvious, but
“some women don’t bring up their stomach problems during
office visits because, frankly, they find them quite
embarrassing,” says Dayna Early, a gastroenterologist at the
Washington University School of Medicine in St. Louis, USA. Next,
examine your lifestyle. And if lifestyle changes don’t help,
medication often does. “There’s no need for women to suffer,”
Early says. Here, leading gastroenterologists tell you what can
be done to soothe that ailing tummy. ➤
By Hallie Levine Photography by Justin Loh
52 | live healthy | SHAPE August 2006
ART DIRECTION LINDA TOM STYLING CARRIE TAN HAIR & MAKEUP DENNIS EE (HP 9856-8293) MODEL CAROL, MANNEQUIN OUTFIT FLASH & SPLASH
8 reasons your stomach hurts
and how to feel better fast.
Even if you’re
lactose intolerant,
you may still be
able to indulge in
yogurt and hard
cheese which are
easily broken
down by the body.
SHAPE August 2006 | live healthy | 73
1
● you’re popping
over-the-counter
remedies, instead
of watching what
you eat. Everyone takes
the occasional Tums, but if
you’re downing over-the-counter
acid blockers morning, noon and
night, you may have
gastroesophageal reflux disease
(GERD), a chronic condition
caused by stomach acid that
moves from the belly to the
oesophagus. This is usually a
result of weakness in the
muscular valve that separates
the stomach and the esophagus.
The first step towards getting
healthy involves making lifestyle
changes such as watching what
you eat. Specific foods — namely
citrus fruits, tomatoes and
tomato sauces, chocolate, wine
and caffeinated beverages — can
trigger GERD.
Your doctor may also have
you keep a food diary for two
weeks so you can pinpoint the
foods that are giving you
problems, adds Roshini
Rajapaksa, a gastroenterologist
at the New York University
School of Medicine. One tip: Fill
up on fibre-rich foods like fruits,
veggies and whole grains and
limit saturated fat. A Baylor
College of Medicine study found
that those who ate high-fibre
diets (at least 20 grams a day)
were 20 per cent less likely to
suffer from GERD. As well, those
with a diet low in saturated fat
also cut their odds.
2
● you’re stressed
beyond belief.
Making lifestyle
changes like eating a
high-fibre diet can
help keep stomach
problems at bay.
People who eat
high-fibre diets are
20 per cent less
likely to suffer from
chronic heartburn.
3
Ever wonder why you have to make frequent runs to the bathroom when you
have a tight deadline at work or when you’ve just had a fight with your
husband? When you’re frazzled, elevated levels of stress hormones activate
the normal contractions in your stomach and colon, causing them to go into
spasms, says Patricia Raymond, a GI doctor at Eastern Virginia Medical School
in Norfolk, Virginia. Stress hormones can also contribute to the overproduction
of stomach acid, making you more susceptible to GERD. On top of that, stress
often leads us to make poor food choices which can cause constipation and
even more bloating.
When you know you’re going to have a tough day, plan to eat small meals
regularly so you’re not too hungry or full, and avoid overindulging in caffeine,
54 | live healthy | SHAPE August 2006
all of which can trigger an upset
stomach. And get moving: An aerobics
workout (aim for at least 30 minutes)
will not only help you destress, it’ll also
combat constipation by speeding up
the movement of food through your
digestive tract, says Raymond.
● you’ve got a bowel
that’s easily irritated.
If you’ve had intestinal pain for more
than three months, you may have
what’s known as irritable bowel
syndrome (IBS). The problem affects
about one in five women and is
characterised by bloating, gas and
alternating bouts of diarrhoea and
constipation that are brought on
by anything from dietary changes
to stress.
Ask your doctor about the IgG
antibody test, a blood test that helps
A British study found that IBS symptoms improved by
26 per cent when trigger foods were eliminated.
pinpoint particular food sensitivities, suggests Mark Hyman, author of
Ultrametabolism (Scribner, 2006). A British study found that eliminating
foods from your diet improved symptoms by 26 per cent. “Other studies
show that peppermint-oil capsules, available at health food stores, relieve
IBS symptoms by relaxing the colon,” adds Michael Cox, a gastroenterologist
at Mercy Medical Center in Baltimore. Look for “enteric coated” pills which
break down in the colon, not in the stomach where they can cause irritation.
Moderate symptoms should see an improvement with these two
strategies. For more severe cases, your doctor may prescribe Zelnorm, a
medication that regulates the movement of stool through
your bowels, and suggest dietary changes and relaxation
techniques like yoga.
● you’re lactose-intolerant.
FOOD PHOTOGRAPHY ALVINN LIM & DARREN CHANG STYLING JUDY WANG
6
About one in
four women have trouble digesting lactose, a sugar found
naturally in dairy products like milk, ice cream and soft
cheese. If you suspect that your gas or bloating is a result of
lactose intolerance, cut out dairy products for a few weeks to
see if symptoms improve, suggests John Chobanian, a
gastroenterologist at Mount Auburn Hospital in Cambridge,
Massachusetts. Still uncertain? Ask your doctor about the
hydrogen breath test, where you blow into a bag after
downing a lactose laced drink. High levels of hydrogen
indicate you’re intolerant.
Even so, there’s no need to give up dairy products. Yogurt and hard
cheese are the easiest for your body to break down. Yogurt contains
enzymes that help you process the lactose while hard cheese doesn’t contain
very much lactose. You may also be able to retrain your digestive system to
break down lactose by consuming smaller servings of milk several times a
day for three or four weeks, according to Purdue University researchers.
Some women also find that drinking milk with meals minimises symptoms.
“I recommend starting with half a cup of milk with a meal, and if this is
tolerated, after a few days, slowly increasing the amount so
you’re sipping 2–3 cups a day,” says the author of the
study, Dennis Savaiano, Dean of Purdue University’s
School of Consumer and Family Sciences in West
Lafayette, Indiana. Or try drinking lactose-free
milk and/or taking tablets that protect against
lactose intolerant symptoms (see the sidebar
Ban The Bloat on the next page).
4
5
● you’re eating too much fruit.
A University of Kansas Medical Center study found
that almost half of all patients who complained of
unexplained gas and bloating after taking 25 grams of
fructose (the simple sugar found in fruit) were
actually fructose-intolerant, meaning their bodies
can’t digest fructose properly. Like lactose
intolerance, this condition can be diagnosed with
a breath test.
If you’re fructose-intolerant, the first thing to
do is to steer clear of products that contain
fructose as its primary sugar, such as apple juice,
says author of the study, Peter Beyer, a professor
of dietetics and nutrition at the
University of Kansas. While you won’t
need to totally swear off fruit, you may
need to avoid certain types. “You
should limit your consumption of fruits
that are high in fructose, such as apples
and bananas,” Beyer explains. One
medium apple has about 8 grams of
fructose, one medium banana almost 6,
a cup of cubed cantaloupe has 3 and
apricots have less than a gram apiece.
Another strategy: Spread out your daily
fruit servings so you don’t eat them all
in one sitting.
● you’re chewing gum
to keep from snacking.
Believe it or not, chomping on gum is
one of the main causes of stomach
problems. “You often swallow lots of air,
which can create gas and bloating,”
explains Christine Frissora, a
gastroenterologist at New York
Presbyterian Hospital in New York City.
In addition, some sugarless gums
contain the sweetener sorbitol, small
amounts of which can contribute to
swelling in your belly.
“Sorbitol pulls water into your large
intestine which can cause bloating and
even diarrhoea, in high doses,” Cox
explains. A study in the journal
Gastroenterology found that just 10
grams of sorbitol (the equivalent
of a few sugar-free candies)
was enough to produce
symptoms, while 20 grams
caused cramps and
diarrhoea. Other sugar
substitutes to monitor:
maltitol, mannitol and xylitol,
found in some sugar-free gum
and low-carb products.
(Sometimes listed as
“sugar alcohols” on labels.)
7
● you’re
sensitive to wheat.
In people with celiac disease –
also known as gluten intolerance
– gluten (found in wheat, rye, barley
and many packaged products) sets off
an autoimmune response that causes
SHAPE August 2006 | live healthy | 55
their bodies to produce antibodies that attack
the villi, those tiny hairlike projections in the
small intestine that absorb vitamins, minerals
and water, Cox explains.
Over time, the villi is damaged, causing
abdominal cramping and bloating, and prevents
you from absorbing nutrients. This makes you
more susceptible to vitamin and mineral
deficiencies and conditions like anaemia and
osteoporosis. The bad news: Celiac disease has
a strong genetic link. It occurs in 5 to 15 per cent
of the children and siblings of people who
have it.
Although the diagnosis can be made via a
simple antibody blood test, Celiac disease is
easy to miss as the symptoms closely mimic
that of other conditions like lactose intolerance
and IBS. “I’ve diagnosed women with this
condition who’ve suffered for years and have
been misdiagnosed or told by doctors that their
symptoms were all in the head or stressrelated,” Frissora says.
To manage the condition, eliminate grains
such as wheat, rye and barley from your diet.
“Following a gluten-free diet is incredibly tricky.
You may have to visit the nutritionist to sort out
what you can and can’t eat,” Early
acknowledges. “But once you modify your diet,
the symptoms will disappear.” Gluten-free
products are available at natural-food markets
and health food stores.
8
● you’re overweight.
Carrying
extra weight can leave you more susceptible to
developing gallstones, the solid deposits of
cholesterol or calcium salts that can cause
severe pain in your upper right abdomen,
Raymond says. Women between the ages of 20
and 60 are three times more likely to develop
them than men. Excess weight also increases
your risk of GERD. A study published last August
by the Baylor College of Medicine found that
overweight people were 50 per cent more likely
to have GERD than those of a healthy weight.
“Extra weight puts pressure on your
stomach, which in turn puts pressure on the
valve between the stomach and the esophagus,
making it easier for acid to back up,” Early
explains. Losing 4.5 to 7 kilogrammes may be
enough to eliminate the problem.
56 | live healthy | SHAPE August 2006
BAN THE BLOAT
Is lactose intolerance leaving you sick to
the stomach? If so, opt for these tummy
friendly choices. By Camilla Chiam
• Vitagen ($2.65 for a six-pack, at supermarkets)
This cultured milk drink is lactose-free and contains
less sugar than other probiotic drinks on
the market.
• Marigold HL Low Fat Milk
($2.50 per litre, at supermarkets)
Suitable for lactose
intolerance sufferers as
the milk sugar is
broken down and more
easily digested. Low in
lactose and high in calcium, protein and
vitamins A, B1, B6, C and D3.
• Wyeth Enercal Plus ($11.65/400g,
$21.65/900g from pharmacies and leading
supermarkets) A lactose-free,
vanilla flavoured shake
packed with 26 nutrients like
calcium, iron and zinc. It’s also
low in cholesterol and sodium and
contains no vegetable fat.
• Dairy Care Digestive
Supplement ($28.35 for 30
capsules, at Guardian, Unity and
Watsons stores) Take these supplements
which contain “active’’ lactobacillus
acidophilus. Each dose gives you a day’s
protection against lactose intolerant
symptoms like nausea and cramping.
• Marigold Fresh Soya Milk
($1.60 per litre, at supermarkets)
Soya bean milk is ideal for those who
are lactose intolerant. This contains five
types of vitamin B and a Bone plus formula
with vitamins K and D. It’s also cholesterolfree, preservative-free and low in saturated
fat. Choose from four versions – Hi Calcium
Fresh Soya Milk, Reduced Sugar Fresh Soya
Milk, Sugar Almond Fresh Soya Milk and
Reduced Sugar Wheatgrass.
PRODUCT PHOTOGRAPHY DARREN CHANG
STYLING JUDY WANG
Stop chewing gum if you
have stomach problems as
it creates gas and bloating.