Q. In an effort to improve my dietary habits and cholesterol levels, I recently started eating oatmeal instead of rice or pasta for lunch and dinner.
The upside is that I feel less sluggish and bloated after meals. However, from time to time, when I eat food such as rice or curry, my tummy will get bloated quickly and I will feel flatulent. Within the hour, I will have to move my bowels.
Is this normal? Has my body become so accustomed to "bland" food that it can no longer handle "heavy" food? How can I manage this situation better, either naturally or with medication?
A. Our intestines contain an ecosystem of more than 1,000 species of bacteria, and these organisms normally participate in digestive processes by converting complex nutrients, such as mucins (the main constituent of mucous), into simple sugars and short-chain fatty acids for absorption by the body.
They are also responsible for the production of vitamins K and B12 as well as bile reabsorption.
Rather than viewing gut bacteria as "toxins" to be flushed out of our system, they should be seen as an additional "organ" that, through a complex interplay of human processes and bacterial activities, is crucial to our normal functioning.
Sudden changes to one's diet can, sometimes, result in changes to the environment within the gut, leading to an imbalance of certain species of bacteria.
For instance, there may be an overgrowth of certain bacteria that causes fermentation of ingested dietary fibre, causing more gas to be produced and bloating. So, the key to better gut health is to avoid sudden drastic changes to your diet.
In this case, taking some probiotics may help to restore balance to the bacterial flora in your gut and reduce some of your symptoms. Probiotics are considered to be "good" strains of bacteria which are useful in helping to modulate the digestive processes in our gut.
A patient with irritable bowel syndrome may experience increased flatulence and a quicker urge to move his bowels after meals, as you have described. The underlying problem of this syndrome is hypersensitivity of the digestive system.
While medication can help to alleviate some of these symptoms, it may not be entirely possible to get rid of them permanently.
Apart from medication, one should also avoid certain types of food that can increase the amount of gas being formed in the gut.
These include certain vegetables, such as cabbage, cauliflower and broccoli, as well as nuts, beans and onions, which are more likely to form gas when they are acted upon by gut bacteria.
Taking certain strains of probiotics can help to reduce gas-forming strains of bacteria and have produced positive results in clinical studies.
Importantly, if these symptoms are new and persistent, a thorough evaluation by a physician is necessary to ensure that other causes of flatulence and frequent bowel movements are not missed.
A change in bowel pattern is one of the symptoms of colorectal cancer. While stress and changes to one's diet can, sometimes, lead to a change in bowel patterns, you should consider a more thorough evaluation, such as a colonoscopy test, especially if your change in bowel pattern has persisted for a couple of months.
DR KOH POH KOON,
Senior consultant colorectal surgeon at Fortis Surgical Hospital