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Pamela M. Peeke, MD, MPH

Pew Foundation Scholar in Nutrition and Metabolism
Assistant Clinical Professor of Medicine
University of Maryland
Baltimore, MD

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The Top 2 Ways to Improve Digestion

Whether it's preventing or treating constipation or improving symptoms of IBS, get simple tips for a healthier gut.

Your Health

Whether it's preventing or treating constipation, reducing your risk of diverticulosis or diverticulitis or improving symptoms of IBS, nothing beats fiber. Fiber is basically the indigestible part of the plant. Because fiber absorbs many times its weight in water, it bulks up your stool, helping it move through the colon faster and easier and preventing constipation and straining.

So in the interest of getting more fiber into your diet without feeling like you're trying to digest a cereal box, try the following:

  • Go half and half. If you're fixing pasta or rice, start with half whole-grain and half white. Over time, gradually increase the amount of whole grain and reduce the amount of white until you're only getting the high-fiber stuff. You can do the same with cereal.
  • Stick with real fruits and vegetables. Instead of orange juice, choose oranges. Instead of strawberry jam on your toast, serve your toast alongside a cup of sliced berries. You'll more than meet your daily fiber requirement (about 25 grams) if you get nine servings a day of fruits and vegetables.
  • Be into beans. Toss a cup of canned, rinsed chickpeas into your salad to up the fiber content; spread hummus instead of butter on your bagel; add an extra can of black beans to your chili. All will significantly increase the amount of fiber you're getting.
  • Read labels. You can buy bread with one gram of fiber per slice—or bread with four grams of fiber per slice. Since they taste pretty much the same, which are you going to do?
  • Munch some nuts. A handful of almonds contains about three grams of fiber.

Don't Forget Stress

I consider fiber to be half the equation when it comes to calming your colon and other parts of your gut. The other half is stress. Gastroenterologists and researchers who study the gut know that it contains the equivalent of a "second brain." This is called the "enteric nervous system," and it contains more neurons than the spinal cord (although far fewer than the brain). Just as your brain acts as the conductor for the rest of your body, this enteric nervous system tells your gut how to behave. So how you feel emotionally becomes intimately tied to how you feel physically.

That's why stress is a common trigger for IBS flares, diarrhea or constipation, heartburn, and, some think, even IBD flares. It's also why studies find that mind/body techniques such as stress management, cognitive therapy, relaxation training and hypnosis are so effective for conditions like IBS. And it's why antidepressants are often prescribed for IBS. Believe it or not, you actually have receptors for serotonin and other mood-related chemicals in your gut, which are acted upon by antidepressants, giving more credence to the gut-as-asecond- brain philosophy.

So if you have a condition related to stress, such as IBS, I encourage you to think "outside the box." If your health care professional recommends an antidepressant, don't immediately say no. These medications appear to have beneficial effects on bowel symptoms that are separate from their effects on mood. I also urge you to take a relaxation training class, available at local hospitals, community colleges or recreation centers. While you might not be able to reduce the stress in your life, you can learn how to react so it doesn't set off your GI symptoms.

Finally, learn to think about your gut in a holistic manner. If you're having problems going to the bathroom or suddenly develop diarrhea, bloating or pain, evaluate what else is going on in your life. Are you living on junk food? Spending all your time inside at a computer? Drinking or eating too much? If so, your gut may be crying out for help. It's time to listen.

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