Health Link

Tame Your Digestive Track

Story by Sue Robbins

Cranky tummy? You’re not alone. Learn how fibre, a balanced diet and gentle exercise can help.

Sarah Carver is an accomplished author and journalist who teaches at the local university and lives with her husband and son.  She’s also been living with ulcerative colitis for 14 years.

COLITIS HAS GIVEN SARAH RECTAL BLEEDING, cramping, bloating and diarrhea.  She’s tried a myriad of medical treatments and, along with her doctor, she has discovered a drug that helps alleviate her symptoms.

She emphasizes, however, the importance of nutrition and physical activity in the management of her disease.  “My philosophy is to try to eat a balanced, healthy diet.  For years I tried to control the illness by banishing “bad” foods, and I found that this doesn’t work.”

Sarah is one of the estimated 100,000 Canadians who have a condition known as Inflammatory Bowel Disease (IBD).  Carolle Anderson, the Regional Director of the Alberta/ NWT/Nunavut division of the Crohn’s and Colitis Foundation of Canada, says that this is a conservative estimate.  Unfortunately, there has been little research to determine the extent of Crohn’s and ulcerative colitis, but it is acknowledged that these diseases have high rates in North America and northern Europe.

According to the Canadian Medical Association, Crohn’s Disease and colitis are two closely related conditions that cause persistent or recurring inflammation of one or more parts of the intestine.  Crohn’s includes any part of the gastrointestinal system (mouth to anus) and ulcerative colitis is contained only in the colon.  There is no cure for either disease, short of a colostomy, which is the removal of the large intestine.

Intestinal problems aren’t exactly a hot topic around the water cooler, but many of us have had bouts of abdominal pain, gas, bloating, constipation or diarrhea.  These symptoms can be related to more common digestive disorders known collectively as Irritable Bowel Syndrome (IBS).  Taking simple steps such as including fibre in our meals and introducing gentle exercise to our lives can help alleviate symptoms and help manage digestive tract disorders.

Fibre has Been Given a Bad Rap

Food containing fibre has been given a bad rap, conjuring up images of dry, bulky, tasteless food.  Beans and bran cereal are not the only sources of fibre; peanuts, pears and broccoli all contain fibre.

There is evidence that a high-fibre diet can help prevent such diseases as diabetes, colon cancer and heart disease.  Plus, high fibre foods fill us up and can make us feel full for longer than food that is quickly digested.  This is a plus for those hoping to cut down on calories.  However, the processing of our modern-day food removes much of our rough fibre from our diets.  An over refined diet is a low-fibre diet.  The Canada Food Guide suggests a daily fibre intake of 30 grams.  Most adults consume less than half of that amount of fibre a day.  As a first step, stock up on whole grains and cut down on fast foods.

What is Fibre?

The Calgary Regional Health Authority defines fibre as, “the part of grains, fruits, vegetables and legumes that our bodies cannot digest.”  Fibre is contained only in plant products, thereby eliminating meat or dairy dishes from fibre contention.  There are two types of dietary fibre:

• Insoluble fibre absorbs water and promotes regular bowel movements; examples of insoluble fibre are wheat, rye, brown rice.
• Soluble fibre may help to control blood cholesterol and blood-sugar levels. It may have little or no effect on bowel movements; examples of soluble fibre are lentils, kidney beans, apples, strawberries, yams, potatoes, whole grain bread and pasta.

The best sources of both soluble and insoluble fibres are unrefined cereal grains (oats, brown rice and whole wheat), peas, beans and squash.  From the fruit family; apples and berries provide the most fibre per serving.  Alberta is rich in fibre foods – barley, peas, beans and wheat are all grown right here in the province.

Shatter These Fibre Myths

Myth #1:  It was once thought that all fibre was taboo for those having intestinal problems like diarrhea.  No longer.  The key to healthy nutrition is variety which includes fibre.  Sarah says she used to avoid fibre but found that “fibre is good, especially because fibre decreases the risk of colon cancer.”  The College of Family Physicians of Canada agrees, “Fibre can be helpful because it improves how the intestines work, whether you have diarrhea, constipation or both.  Fibre also may reduce bloating and abdominal pain. It does this by bulking the stools and making them softer.”

Kelly Anne Erdman is a Registered Dietician with the University of Calgary’s Sport Medicine Clinic.  She’s worked with clients who have intestinal problems, including Crohn’s and colitis.  She concurs that some clients respond well with soluble fibre during episodes of diarrhea but that insoluble fibre (such as fruits) may contribute to the diarrhea because of their sugar content.  The key is to experiment with different foods to find out which are best for you.

Myth #2:  You can never have too much fibre.  However, as with all food, fibrous foods are best consumed in moderation.  Most fibrous foods are low-calorie, so consuming a very high-fibre diet can lead to an inadequate consumption of calories.  Insoluble fibre can bind to some nutrients, but it also can result in decreased absorption of necessary vitamins and minerals such as iron.  Canada Food Guide’s rule of 30 grams of fibre a day is the best rule of thumb to follow.

Gentle Physical Activity Helps

Nancy Campbell, a Calgary-based Certified Fitness Consultant, works with clients who have chronic diseases.  She believes that bowel health can improve with the right nutrition and physical activity.  Nancy emphasizes that one should check with one’s physician before embarking on new physical activity, but that even those with chronic disorders can benefit from even 10 minutes of walking a day, three times a week.  A gradual introduction of a variety of physical activity can lend itself to increased energy, gastrointestinal motility and can help the body get rid of toxins.  Coupled with healthy nutrition, those affected by digestive disorders can see benefits of gentle physical activity within 2-3 weeks.

Sarah concurs.  To manage her colitis, she says, “Exercise is excellent and does help.  When I am feeling sick, I try to exercise, even if I don’t have the energy to do my usual workout. I find it helps both as a preventative measure and as a way of getting back to normal faster.”

New Research is Improving Intestinal Health

The University of Alberta is dedicated to researching links between nutrition and the prevention of chronic digestive diseases.

Dr. Catherine Field, Associate Professor of Nutrition and Metabolism at the University of Alberta, is working with beta-glucans, which are a type of fibre found in oats and barley.  The U of A is looking at the ability of beta-glucans to affect the small intestinal immune system and to help reduce the risk of infection and improve intestinal health.

But until a cure is found for these diseases, thousands of Canadians have to find ways to manage their symptoms.  Those with the less serious Irritable Bowel Syndrome may also benefit from eating whole foods, getting more fibre and engaging in gentle exercise to alleviate their symptoms.

Lessons Learned

A cure for colitis might not be discovered in Sarah’s lifetime, but her colitis has taught her to lead a healthier lifestyle – to be aware of what she eats and to emphasize physical activity.

She’s also learned “not to live life in the crazy lane. I am a much calmer person than I used to be and better at letting go of things I can’t control. I am actually grateful to the illness for teaching me this.”  Words of wisdom from someone with a chronic disease – words we can all live by.