Do You Have a Bowel Problem?
What it could be: Natural sugars (such as fructose), sugar alcohols (such as sorbitol, xylitol or erythritol) and artificial sweeteners (such as sucralose, i.e. Splenda) "can have almost a laxative effect" for some people, says Robin Rothstein, M.D., medical director of the Inflammatory Bowel Disease Program at Temple University. Those sweets are just one category of "fermentable carbohydrates," foods that can wreak havoc on some people's guts (another common irritating class is lactose), causing diarrhea, gas and/or bloating.
What to do: "[If you're] munching on sugar-free gummy bears and then running off to the bathroom," Rothstein says, start keeping an eye on food labels. Avoid foods with ingredients ending in –ose (as in fructose) and –ol (such as xylitol).
What it could be: "Increasing your fluids will not help bowel functions," says Spencer Dorn, M.D., vice chief of gastroenterology at the University of North Carolina School of Medicine, calling that common piece of advice a myth.
What to do: Only if your urine is an intense yellow or you have diarrhea should you really worry about hydrating more. Make sure you're getting dietary fiber. Fruits and veggies have the added benefit of providing water in our diet, says Rothstein. "We underestimate how much fluid we get from food."
What it could be: Yes, doctors routinely recommend dietary fiber for people with a healthy gut, but those prone to diarrhea should proceed with caution, Dorn says. And fiber cannot always combat chronic constipation. For those who have an inflammatory bowel disease such as Crohn's, in which some of the intestine narrows, these foods can make things much worse, says Darwin Conwell, M.D., director of gastroenterology, hepatology and nutrition at the Ohio State University.
What to do: If fiber seems to be bothering you, try steaming or baking vegetables instead of eating them raw, and skip high-fiber fruits such as apples. Some surprising plant products that can also give people gut grief include corn and popcorn.
What it could be: A bout with gastroenteritis can actually give you irritable bowel syndrome (IBS)—especially if the infection was caused by particular bacteria, such as Salmonella or Campylobacter. These microbes can proliferate in the gut, throwing off a once-healthy bacterial balance, triggering IBS—a constellation of symptoms such as abdominal pain, gas, bloating, diarrhea and/or constipation, with no other detectable abnormalities—in some 4 percent to 32 percent of people who had the stomach bug.
What to do: There isn't a specific cure for this or other types of IBS—a condition that affects some 10 percent of the population and is more common in women. But most people eventually get better on their own. The other good news is that IBS isn't likely to cause lasting damage to the colon. More chronic conditions, such as the inflammatory bowel diseases (IBD) Crohn's disease and ulcerative colitis, can have similar symptoms but can be diagnosed based on physical changes in the body.
What it could be: Many drugs affect our guts in unexpected ways, says Dorn. Some antidepressants cause constipation while others trigger diarrhea, and even over-the-counter meds, such as ibuprofen and naproxen can cause abdominal upset.
What to do: Collaborate with your doctor to determine if your intestinal issues are linked to your medicine, Dorn recommends. In some cases, dietary changes can help; probiotics can often prevent or relieve diarrhea caused by antibiotics. Or discuss trying a different medication.
What it could be: A healthy balance of microbes in the gut is linked to happy bowels. But what is less clear is how to get that blend of good bacteria to flourish in your gut. Research suggests that just tossing back lots of probiotics (whether from yogurt or other fortified foods)—without doing more to change your gut's environment—might not be a cure-all for everyone, including some people with IBS.
What to do: "Don't keep taking more and more and more," says Conwell. If a little isn't working, more isn't likely to fix the problem. Instead, that might be a sign to check with your doctor to make sure probiotics make sense for you (in many cases, such as for those with a stress or food trigger for their symptoms or for those with a more serious bowel disorder, they might not).
What it could be: "There is a lot of variability in bowel function—in how people use the bathroom," Dorn says. "Having an upset stomach or constipation is part of being a normal human being." A large survey found that less than half of adults had the quintessential once-daily bowel movement, with a third of women going less than once a day and 4 percent going twice or more daily. Only about half of stools themselves qualified as "normal"—not too hard or too soft.
What do to: Don't fret too much about your personal frequency: "What certain people consider constipation might be completely normal for someone else," Dorn says. What you should watch out for are changes to your normal. Abdominal pain, unexplained weight loss or bloody stool could have a simple explanation (bad food, good luck, hemorrhoids). But, Rothstein says, they could also be the sign of something more serious, such as IBS or an inflammatory bowel disease.