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Back to Gut Basics with Dr Chris George

We asked NHS GP Dr Chris George to take us back to gut basics, sharing the science behind common digestive symptoms and his GP-approved ways to tackle them.

Digestive symptoms such as bloating, tummy cramps, constipation, and gas are extremely common amongst Brits and account for more than 10% of GP consultations. In fact, this number may be an underestimate of digestive issues as even more people chose not to see a healthcare professional out of fear and stigma. A recent YouGov poll found that most people do not think about their digestive symptoms as part of their overall health and wellbeing. This back-to-basic gut guide will take you through digestive symptoms, common triggers and plenty of self-help advice to keep you healthy and happy.

Bloating
Bloating is a full or uncomfortable feeling affecting the tummy. It is a very common symptom and there are several things you can do to help relieve bloating.

Symptoms of bloating include:
  • Your tummy feeling full or bigger than usual
  • Tummy pain or discomfort
  • Your tummy rumbling or making noises
  • Passing gas more than usual

Things you can do to help
  1. Regular exercise and increasing your daily water intake can help digestion and reduce bloating.
  2. Peppermint oil or capsules can help to reduce bloating symptoms and is used quite often for people with irritable bowel syndrome (IBS). Peppermint helps to relax the muscles in the intestinal wall which allows gas to move along more effectively.
  3. Increase the amount of fibre in your diet slowly to achieve the recommended 30g per day of fibre which helps prevent constipation and bloating.
  4. Massaging your tummy from right to left can also provide some relief from bloating.
  5. Avoid fizzy drinks containing additional gas, gas producing foods such as cabbage, beans or lentils, eating late at night and slouching whilst eating meals.

 

Tummy cramps
Tummy cramps can occur after eating and can feel like a dull or a sharp pain across the abdomen and is sometimes associated with other symptoms such as diarrhoea. These symptoms are usually short lived and not due to a serious underlying issue. Severe pain is however a cause for concern, and you should see your doctor. There is a whole range of causes of tummy cramps with the most common being:

Symptoms of tummy cramps include:

  • Bloating and passing gas = possible cause, trapped wind.
  • Feeling full after eating, bloating and sickness = possible cause, indigestion.
  • Unable to pass stool = possible cause, constipation.
  • Watery stool, nausea and vomiting = possible cause, gastroenteritis which can be due to things like food poisoning and viral illnesses.


Things you can do to help

  1. Stomach cramps with bloating is often caused by trapped gas. You can see your pharmacist and try over the counter treatments such as Mebeverine and Buscopan.
  2. Indigestion symptoms can be improved by chewing food carefully before swallowing, drinking water with meals, and avoiding highly processed foods and alcohol which can worsen symptoms.
  3. Constipation tummy pains can often be alleviated by using an over-the-counter laxative, ensuring good hydration and increasing dietary fibre.
  4. Stomach cramps due to gastroenteritis usually get better after a few days without treatment. It’s worth having a very plain diet and avoiding foods high in protein and fat as this can often cause worsening tummy cramps followed by urgency to open your bowels.


Excess gas
Flatulence is passing excess gas out of the back passage from the digestive tract and commonly referred to as ‘passing wind’. Although it is very common it is often associated with embarrassment especially in social settings.

Excess gas can be caused by swallowing more air than usual or eating foods that produce excess gas leading to symptoms of burping and flatulence. In most cases excess wind is of no concern but in a small number of people it can be a sign of an underlying digestive disorder.

When swallowing food, drinks or even saliva you swallow small amounts of air which can accumulate in the digestive tract leading to symptoms of burping and flatulence. In most cases people are unaware of passing wind as it is odourless. Symptoms can be more troublesome when they are associated with noise and bad smells which often contain gases such as sulphur which have an odour.

Things you can do to help

  1. Avoid foods that produce gas which are commonly cruciferous vegetables, such as broccoli, brussels sprouts, cabbage etc.
  2. Eating smaller amounts of food more frequently.
  3. Ensuring that all food is well chewed with your mouth closed to avoid ingesting excess gas.
  4. Regular exercise may also help expel gas that can cause bloating and tummy pains.


When to see your GP?

The bottom line is if you notice any changes in your digestive symptoms or have concerns then you should speak to your GP. In clinic I often hear patients say that their symptoms are trivial and that they don’t want to waste resources, but this really shouldn’t be the case. If you’re worried or embarrassed, then writing things down or bringing a friend can sometimes help.

The emergency symptoms that require an urgent appointment include:

  1. Blood in the stool or on the paper
  2. Persistent change in bowel habit
  3. A pain or lump in the tummy
  4. Unexplained weight loss
  5. Extreme tiredness for no reason


Whilst in most cases these symptoms are nothing to worry about it is important to get checked up.

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