LOOK AFTER YOUR BOWEL
S
One part of the body that most people are pretty clear about is the digestive system, the tube that runs from the mouth to the anus with a few organs like the liver and the pancreas feeding into it. One reason for this is that British people are relatively obsessed by their bowels, in the way the French are by their liver and the Germans by their circulation.
What are the effects of ageing?
Ageing by itself, as is often the case, does not appear to cause many problems until the late nineties. The problems, as always, are primarily due to loss of fitness and disease.
How can you minimise the effects of ageing and living longer?
Perhaps the single most important thing is to recognise that our bowels were not made for the modern diet. In the book called “The Story of the Human Body: Evolution, Health and Disease” Daniel Lieberman the distinguished Professor of Biology at Harvard says that we have Palaeolithic bodies in a post-Palaeolithic world. That is to say that we evolved for many generations in a life not much different from the life of cave men although the introduction of agriculture and the cultivation of grains was a major change in relatively recent history, that is a couple of thousand years ago. The cultivation of grain led to a change in the diet which had previously consisted largely of fruit and meat or fish, eaten raw before fire was invented. With the growth of agriculture people ate more calories and less fibre but at least this was offset by the need to be very active, until about two generations ago. The problem that we now faces that the bowels that we have inherited genetically have to cope with a world in which calories are plentiful and in which most of us spend our time sitting. The consequence is obesity, often compounded by constipation . Furthermore we have moved to a world in which white flour is everywhere and our bowels evolved genetically to cope with food was full of fibre and if you do not have fibre the bowels become weak because the bowel is just a tube of muscle that needs exercise, the exercise that comes from hammering fibre and extracting nutrition from it. When the bowels become weak the consequence is constipation, sometimes complicated by irritable bowel syndrome, often with diverticular disease, and haemorrhoids!
What can you do to reduce the risk of disease?
There are three common diseases of the digestive tract. One is called diverticular disease and it consists of little pouches in which the wall of the bowel gets weak and a pouch of the tissue lining the bowel bulges out. The cause of this is inadequate fibre with the bowel struggling not because there is too much fibre but because there is too little, the pressure builds up as the bowel tries to move on without enough pressure to grip on and little diverticulae pop out and cause what is sometimes called Irritable Bowel Disorder. Sometimes these little pouches become inflamed and this is called diverticulitis
The second type of bowel disorder is Inflammatory Bowel Disease, confusingly sometimes also called IBD. In the small intestine this is sometimes called Crohn’s disease and in the large intestine ulcerative colitis, but these are two similar conditions. The person affected, usually but not always in adult life, has severe diarrhoea and malabsorption of essential elements. The diarrhoea may also have bleeding. There are now powerful drugs to treat this disorder.
The third type of disorder is cancer and the best means of reducing the risk of cancer of the bowel is to have a high fibre diet and physical activity is, perhaps surprisingly, also associated with a lower risk of cancer. In addition people over sixty are invited to participate in the Bowel Cancer Screening Programme. A kit is sent to the person’s house and they have to smear some fecal matter onto three patches of specially treated paper. This can detect what is called occult or hidden blood, namely blood that is not red but has started to change colour because it has been out of the blood vessels for a few hours and is therefore hidden from the naked eye but can be detected by a chemical test.
How can you maintain and increase bowel fitness?
Who can help?
The GP is the best person to give initial advice, but the Practice Nurse is also very well equipped to speak about dietary changes to increase fibre and prevent obesity. When bowel disease occurs the GP may refer to a gastroenterology clinic for advice from the specialist gastroenterologist and dietitian
HOW COULD YOU USE THIS KNOWLEDGE TO ACHIEVE YOUR OWN OBJECTIVES ?
HOW COULD YOU USE THIS KNOWLEDGE IF YOU ARE SUPPORTING SOMEONE ELSE ?
LOOK AFTER YOUR BOWEL
S
One part of the body that most people are pretty clear about is the digestive system, the tube that runs from the mouth to the anus with a few organs like the liver and the pancreas feeding into it. One reason for this is that British people are relatively obsessed by their bowels, in the way the French are by their liver and the Germans by their circulation.
What are the effects of ageing?
Ageing by itself, as is often the case, does not appear to cause many problems until the late nineties. The problems, as always, are primarily due to loss of fitness and disease.
How can you minimise the effects of ageing and living longer?
Perhaps the single most important thing is to recognise that our bowels were not made for the modern diet. In the book called “The Story of the Human Body: Evolution, Health and Disease” Daniel Lieberman the distinguished Professor of Biology at Harvard says that we have Palaeolithic bodies in a post-Palaeolithic world. That is to say that we evolved for many generations in a life not much different from the life of cave men although the introduction of agriculture and the cultivation of grains was a major change in relatively recent history, that is a couple of thousand years ago. The cultivation of grain led to a change in the diet which had previously consisted largely of fruit and meat or fish, eaten raw before fire was invented. With the growth of agriculture people ate more calories and less fibre but at least this was offset by the need to be very active, until about two generations ago. The problem that we now faces that the bowels that we have inherited genetically have to cope with a world in which calories are plentiful and in which most of us spend our time sitting. The consequence is obesity, often compounded by constipation . Furthermore we have moved to a world in which white flour is everywhere and our bowels evolved genetically to cope with food was full of fibre and if you do not have fibre the bowels become weak because the bowel is just a tube of muscle that needs exercise, the exercise that comes from hammering fibre and extracting nutrition from it. When the bowels become weak the consequence is constipation, sometimes complicated by irritable bowel syndrome, often with diverticular disease, and haemorrhoids!
What can you do to reduce the risk of disease?
There are three common diseases of the digestive tract. One is called diverticular disease and it consists of little pouches in which the wall of the bowel gets weak and a pouch of the tissue lining the bowel bulges out. The cause of this is inadequate fibre with the bowel struggling not because there is too much fibre but because there is too little, the pressure builds up as the bowel tries to move on without enough pressure to grip on and little diverticulae pop out and cause what is sometimes called Irritable Bowel Disorder. Sometimes these little pouches become inflamed and this is called diverticulitis
The second type of bowel disorder is Inflammatory Bowel Disease, confusingly sometimes also called IBD. In the small intestine this is sometimes called Crohn’s disease and in the large intestine ulcerative colitis, but these are two similar conditions. The person affected, usually but not always in adult life, has severe diarrhoea and malabsorption of essential elements. The diarrhoea may also have bleeding. There are now powerful drugs to treat this disorder.
The third type of disorder is cancer and the best means of reducing the risk of cancer of the bowel is to have a high fibre diet and physical activity is, perhaps surprisingly, also associated with a lower risk of cancer. In addition people over sixty are invited to participate in the Bowel Cancer Screening Programme. A kit is sent to the person’s house and they have to smear some fecal matter onto three patches of specially treated paper. This can detect what is called occult or hidden blood, namely blood that is not red but has started to change colour because it has been out of the blood vessels for a few hours and is therefore hidden from the naked eye but can be detected by a chemical test.
How can you maintain and increase bowel fitness?
- Eat more fibre and here are some suggestions below from the British Nutrition Foundation
- Wholegrain breakfast cereals, wholewheat pasta, wholegrain bread and oats, barley and rye
- Fruit such as berries, pears, melon and oranges
- Vegetables such as broccoli, carrots and sweetcorn
- Peas, beans and pulses
- Nuts and seeds
- Potatoes with skin
Who can help?
The GP is the best person to give initial advice, but the Practice Nurse is also very well equipped to speak about dietary changes to increase fibre and prevent obesity. When bowel disease occurs the GP may refer to a gastroenterology clinic for advice from the specialist gastroenterologist and dietitian
HOW COULD YOU USE THIS KNOWLEDGE TO ACHIEVE YOUR OWN OBJECTIVES ?
- Learn about and move to a Mediterranean Diet - look at the NHS Choices website
- Have a lookout the book Sod It! Eat Well
HOW COULD YOU USE THIS KNOWLEDGE IF YOU ARE SUPPORTING SOMEONE ELSE ?
- Support the person in a move to a Mediterranean Diet - look at the NHS Choices website
- In particular encourage increased fibre intake - NHS Choices gives clear information