DIGESTIVE problems are one of the most common reasons people seek a pharmacist’s advice. From minor bloating, flatulence, diarrhoea and constipation that perhaps can be alleviated with over-the-counter medications, to persistent or chronic digestive conditions such as lactose intolerance and irritable bowel syndrome, these are essentially killjoys. With few exceptions, the scourge of most digestive illness is directly related to the diet and lifestyle decisions we make on a daily basis.
An efficient digestive system is vital to overall health. Without proper digestion, vitamins, minerals, essential fats, carbohydrates and proteins cannot be absorbed for growth, repair and renewal of cells by the body. As there are more nerve endings located in our digestive system than in our spine, this explains why our emotions such as stress, fear, anxiety, disappointment and excitement influence our digestive health.
For people who are disturbed on a regular basis by their digestive problems, it is important to have a full evaluation by a medical professional to rule out any underlying causes.
This is a condition in which a person cannot digest lactose, the sugar found in milk and milk products due to a lack of the enzyme, lactase. Lactose intolerance is usually suspected when flatulence accompanying diarrhoea, stomach rumbling, abdominal pain and abdominal bloating, occur within several hours after lactose ingestion. It is estimated that more than half the world’s population are lactose-intolerant.
Congenital lactase deficiency or deficiency of lactase existing from birth is a rare disorder that often runs in families. The enzyme lactase is present in the baby’s intestine but the amount of lactase in the intestine begins to drop after weaning. By five to seven years of age, a child’s lactase activity is about 10% of what it was at birth; hence it is not uncommon to find that lactose intolerance usually develops in adolescence or adulthood.
When lactose is not digested, it accumulates in the colon, drawing excessive amounts of water to remain in the stools, leading to watery diarrhoea. Accumulated lactose also becomes a food source for fermenting bacteria that produce bloating, abdominal cramping and flatulence.
Lactose intolerance is usually permanent in adults and symptoms can be completely relieved by eliminating lactose from the diet. Staying away from dairy products that contain lactose may be a short-term solution, as these foods are usually rich in calcium. Calcium deficiency increases the risk of osteoporosis, tooth decay, insomnia, anxiety and susceptibility to infections. In such situations, alternative types of calcium-rich foods such as anchovies, sardines, soya beans, seeds and nuts and calcium supplementation may be the answer.
Irritable bowel syndrome
A local study shows a prevalence rate of 15.8% of irritable bowel syndrome (IBS) in University Malaya medical students with a higher rate in females than males. IBS sufferers have constipation (difficult or infrequent bowel movements); others have diarrhoea (frequent loose stools, often with an urgent need to have bowel movements); and some people experience both.
Although symptoms can disappear for a while, IBS is usually recurrent throughout life. The causes for IBS are linked to stress, food intolerance, especially towards citrus fruits, fizzy drinks, lack of stomach acid, deficiency in digestive enzymes and an upset ecology of resident friendly gut bacteria.
More than 80% of IBS conditions are related to having an excess of the wrong type of bacteria such as Clostridium difficile, parasites and Candida in the gut. It is therefore essential to replace the friendly bacteria with the consumption of probiotics supplements with high bacterial counts of Lactobacilli and Bifidobacteria to help readdress the balance.
Much as IBS causes a great deal of pain, discomfort and distress, it does not usually lead to serious complications. Often stress, anxiety or depression is associated with the syndrome and women may experience a flare-up in their symptoms around their menstrual period.
Probiotics in review
Research indicates that the use of probiotic supplements with Lactobacilli and Bifidobacteria can help those who are lactose-intolerant as well as those with irritable bowel syndrome. Lactobacilli are known to produce lactase, and by introducing large numbers of Lactobacilli to deliver enough bacterial lactase to the intestine and stomach where lactose is digested, lactose-intolerant people are able to enjoy the health benefits of dairy products.
In a study designed to assess the efficacy of probiotics alone or in combination with antibiotics in patients with IBS, researchers found that Lactobacillus acidophilus and Bifidobacteria infantis significantly improved symptoms and quality of life in patients with irritable bowel syndrome and other bowel disorders.
Probiotics are live microbial food supplements that confer health benefits to the body by improving the intestinal flora balance. Research on probiotics therapy demonstrates improvement in gastrointestinal health, enhancement to the immune system, better absorption of nutrients and reduction in the risk of certain cancers.
The composition of the intestinal flora can become unbalanced by ageing, disease, usage of antibiotics, poor health or stress. Regular intake of probiotics helps to maintain healthy levels of beneficial bacteria. The most common bacteria used in probiotic therapy are the lactic acid bacteria, especially Lactobacilli and Bifidobacteria.
1. Kopp-Hoolihan L. Prophylactic and therapeutic uses of probiotics: A review Journal of the American Dietetic Association Feb, 2001
2. Kerr M. Probiotics significantly reduce symptoms of IBS, Ulcerative Colitis Medscape Medical News 2003
3. Local IBS prevalence is significant Medical Tribune 15-30 June 2003
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