What’s up with your gut? Find the answers to bloating and diarrhoea in my new book

Gut problems are incredibly common and plague millions of people on a daily basis.Sadly, many people never find a satisfactory explanation or diagnosis for their painful and embarrassing symptoms.

Whether you bloat after eating bread or pasta, suffer cramping pains in your abdomen or experience bouts of watery diarrhoea or suffer  unexplained constipation despite eating lots of fibre – it can be a battle to get to the bottom of  what’s really up with your gut.

With coeliac disease for instance, where the body’s immune system mistakes gluten, a protein found in wheat, barley or rye for a pathogen and mounts an inflammatory response, it can take an average of 13 years to get a diagnosis and in the UK it’s been estimated that 75 per cent of cases go undiagnosed.

It’s the same with a whole host of other gut conditions -including bile acid diarrhoea and non coeliac gluten sensitivity to name just a few.With this in mind, I’ve co-authored a new book with gastroenterologist Professor Julian Walters from  Imperial  Healthcare in London called ‘What’s Up with Your Gut?’ (Hammersmith Press £14.99 on Amazon).

The book discusses possible causes for gut problems and helps you spot key symptoms for different diseases.  These include familiar ones you will heard of including IBS ,coeliac disease and Crohn’s disease but also some lesser known but surprisingly common conditions you might not have come across before, including bile acid diarrhoea, non coeliac gluten sensitivity, small intestinal bacterial overgrowth (SIBO) and microscopic colitis. There are also useful sections on spotting the signs of cancer, indigestion  GORD, globus sensation and pretty much every other gut complaint you can think of!

There’s also lots of information about FODMAPs (short chain carbohydrates or sugars) and the foods you should try and cut down on; tips on how to get tested  for lactose intolerance and other food intolerances.

Seven mystery gut problems you probably haven’t heard of

Here’s a taster of seven mystery gut complaints that you can read all about in the book.

  • Bile acid diarrhoea: Up to one million people in the UK could have bile acid diarrhoea (BAD) also known as bile acid malabsorption – according to some estimates. It’s a particularly nasty type of diarrhoea which can produce up to 10 watery bowel movements a day. The good news is that there’s a test and a treatment available for it.
  • Non coeliac gluten sensitivity (NCGS): It’s estimated between four and seven million people could have NCGS in the UK. Despite NCGS producing symptoms similar to coeliac disease including bloating, diarrhoea, and weight loss and it responding to a gluten-free diet – blood tests and biopsies are negative for coeliac disease.
  • SIBO (small intestinal bacterial overgrowth):SIBO is another common cause of watery diarrhoea. It’s caused by too much bacteria growing in the small intestine  and results in fatty stools, weight loss, bloating or even anaemia. Some experts have proposed it is a possible cause of Irritable Bowel syndrome.
  • Microscopic colitis: This can be a cause of severe, watery,persistent diarrhoea, bloating and pain and is caused by inflammation of the colon and estimated to affect one in 1,000 people. The inflammation is only visible under a microscope and can be missed in standard  biopsies.
  • Globus sensation: This is the medical name for feeling that you have a lump in your throat (when no physical lump exists) and accounts for one in 20 referrals to ENT specialists.
  • Pelvic Radiation Disease: PRD can cause 21 different bowel symptoms including bloating and diarrhoea with loose and fatty stools and is caused by radiation treatment for cancer in the pelvic area. Symptoms can develop long after treatment so patients may not realise they are connected to their radiotherapy.
  • Slow transit constipation: Between 15 and 30 per cent of patients with chronic constipation have slow transit where their gut doesn’t move food and waste at the normal rate. Eating more fibre will make it worse – leading to years of discomfort unless the right diagnosis is made.

I’ll be blogging about some of these conditions in more depth shortly but just thought I’d give you the heads up that the book is now available to buy (there’s a Kindle  version too). I really hope the book  helps you find out what is up with your gut – the inspiration for  it came from the very encouraging feedback I’ve had on the blog so thanks to everyone who has commented and read WUWYH. Big thanks go to Professor Julian Walters for his help and guidance with the research  and writing of the book too.

Here’s a link  to an article in the Daily Mail about the book which will tell you more (the fact that it has been shared online 1.5K times means there are clearly a lot of people out there affected by these issues). http://www.dailymail.co.uk/health/article-3820080/The-7-mystery-gut-problems-doctor-not-spot-Millions-patients-left-undiagnosed.html

Continue reading What’s up with your gut? Find the answers to bloating and diarrhoea in my new book

You’ve been told you have IBS but could you have BAD ?

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CAPTION: Always on the loo?

Until a few weeks ago I’d never heard of bile acid diarrhoea (let’s call it BAD). Despite writing about all manner of tummy upsets for quite a while now – including Irritable Bowel Syndrome (IBS), Crohn’s disease and ulcerative colitis to name but a few – I’d never come across this particular gut nasty.
But then I spoke to Professor Julian Walters, professor of gastroenterology at Imperial College, London, and learned that up to 500,000 people in the UK who have been diagnosed with Irritable Bowel Syndrome – may actually have BAD instead.
Why does it matter? Well, according to Professor Walters, BAD is comparatively easy to treat and there’s a diagnostic test and effective medicine you can take for it – where as the diagnosis and treatment for IBS is far more complicated and seems (to a layman like me at least) to be a more let’s suck-it-and-see-if-it-works approach.

Why don’t more people know about BAD?

I can’t be the only one who is wondering why BAD is not on the radar of more doctors(and patients). By contrast, coeliac disease has become fairly well-known now as has Crohn’s disease. But BAD affects potentially far more people, so why is there is no information about it?
‘Most patients – and doctors – are unaware that bile acid diarrhoea even exists and that there is a diagnostic test and effective drug treatment available,’ explains Professor Walters.
‘IBS is estimated to affect four million adults in the UK; of those 1.3 million have diarrhoea as the predominant symptom. However, its cause is often difficult to diagnose and patients may undergo several investigations, including those for inflammatory bowel disease, colonic cancer, coeliac disease and chronic infections, without a definitive cause being identified or effective treatment.’

Freedom after 48 years

Judith Fulton who I interviewed for the Daily Mail Good Health section http://www.dailymail.co.uk/health/article-2255492/Bile-acid-diarrhoea-For-40-years-doctors-said-I-IBS-In-fact-hormone-problem-cured-simple-pill.html suffered from unexplained daily bouts of watery diarrhoea for over 40 years. She had countless tests including the invasive kind most of us would rather avoid if it isn’t absolutely necessary – doctors just said it was IBS though -and they offered her no treatment.
When Judith read about Professor Walters’ research though it was a light bulb moment and she tracked down his email on the internet and asked him for a consultation. She was later diagnosed with BAD and after treatment with the drug cholestyramine (Questran) her symptoms disappeared within a few weeks. After forty-eight years of suffering she is now free to leave the house without researching where the nearest toilet is. That’s what I call a result and partly why Judith was willing to be interviewed about such an embarrassing health problem – she wants more of us to know about it.
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CAPTION: FREEDOM TO GO OUT WITHOUT RESEARCHING THE NEAREST LOO

A bit about bile acid (before we go on)

I won’t bore you with a full blown biology lesson, but in a nutshell: bile acids are essential for digestion and absorption of fats and fat-soluble vitamins in the small intestine. The liver produces large amounts of bile acids which flow into the intestine every day, but only relatively small quantities are lost from the body. This is because approximately 95 per cent of the bile acids are recycled back to the liver from the ileum (part of the small intestine). But in bile acid diarrhoea – bile acid is overproduced and the excess bile passes into the colon causing watery diarrhoea.
Bile acid diarrhoea is also associated with Crohn’s disease, a chronic severe condition characterised by inflammation, ulcers and bleeding that may affect any part of the gastrointestinal tract, including the terminal ileum (the end of the small intestine). This is because Crohn’s causes inflammation and reduces absorption of bile in the intestine and this sometimes necessitates removal of the ileum. This is referred to as bile acid malabsorption as bile is not as absorbed as well in the intestine.
‘In idiopathic bile acid diarrhoea though – patients don’t have a problem with absorbing the normal amounts of bile produced, explains Professor Walters.’Their diarrhoea is triggered by a hormone disorder which causes overproduction of bile and it is this excess bile which causes the diarrhoea – this is an important distinction,’ explains Professor Walters.

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CAPTION: Bile acid is produced in the liver

Hormone deficiency is the cause

Professor Walters conducted research which found that the trigger for idiopathic BAD (from an unknown cause not related to Crohn’s disease) is a deficiency in a hormone called FGF19, which normally switches off bile acid production when bile acid is reabsorbed.
‘At the moment we don’t know why this happens – it doesn’t appear to be genetic although some patients report their symptoms started after a gastrointestinal infection.’

Symptoms
Unfortunately the symptoms of BAD can be hard to distinguish from diarrhoea caused by IBS.These include up to ten watery bowel movements every day, usually with an urgent need to go and frequently resulting in accidents or faecal incontinence. There is also some bloating and abdominal discomfort.

Diagnosis and treatment

Unlike IBS though, there is a diagnostic test available for BAD. It’s called the SeHCAT test(which stands for selenium-labelled synthetic bile salt) and involves two full body scans seven days apart. In a person with normal bile acid production more than 15 per cent of bile is detectable in the body after seven days, but in people with BAD this figure can be as low as one to five per cent.
Once diagnosed with BAD patients can be prescribed cholestyramine and around two-thirds of patients are reported to respond – although this admittedly may take some time until the correct dosage to control symptoms is found.
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CAPTION: What’s really causing your upset tummy?

Hang on a minute though…..
As with many things in medicine though, not everyone agrees. The National Institute for Clinical Excellence, for instance, recently decided although it was’promising’ there was insufficient evidence to recommend the SeHCAT test. Professor Carole Longson, NICE health technology director, said there was also little evidence of the clinical effectiveness of the drugs used to treat the condition and also whether bile acid diarrhoea is a primary or secondary condition.

Professor Nick Read,a gastroenterologist and adviser to the IBS Network is somewhere in between the two camps. He doesn’t believe BAD is a medical condition in its own right – just a symptom of IBS diarrhoea, but on the other hand he says he prescribes cholestyramine frequently to people with IBS where diarrhoea is their predominant symptom and it works really well. He told me:’I find that cholestyramine is an effective drug which mops up bile acid in the intestine. I’ve seen patients who have had diarrhoea for years dramatically improve using this treatment.’

Whatever the mechanism – the upshot is if you’ve had diarrhoea for years and been given an IBS diagnosis and told to live with it, you might want to ask about getting a SeHCAT test. Just like Judith the test (and the treatment) might give you your life back.

Watch Professor Walters here: http://www.youtube.com/watch?v=-O3uR0iDObw

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Here’s some more of my articles about gut health you may want to read.
http://www.dailymail.co.uk/health/article-2194464/My-doctors-orders-Crisps-doughnuts-strictly-veg.html
http://www.dailymail.co.uk/health/article-1350238/Feel-bloated-Cramps-The-problem-BRAIN.html
http://www.dailymail.co.uk/health/article-1313821/For-TEN-YEARS-Lucy-told-worry-stomach-cramps-In-fact-chronic-disease-eating-away-gut.html

Are you allergic to your chicken tikka?

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Britain is a nation of takeaway lovers, and chicken tikka masala is now apparently more popular than roast beef. Until now spice allergies have been comparatively rare – accounting for just  two per cent of food allergies. But now US experts are predicting they could rise as more of us become exposed to spices – in foods, household products and fragrances.

Yorkshire nurse Christine  Caudwell experienced spice allergy at first hand when –  out of the blue – she developed itching and hives after eating her favourite takeaway chicken tikka dopiaza. This was a dish she’d eaten at least once a week for 20 years or more and yet, suddenly in her forties it became a problem . Her allergic reactions became progressively worse until she eventually suffered a life threatening anaphylactic reaction and needed a shot of adrenaline. She was later later diagnosed with allergies to 26 different spices including chilli, turmeric and paprika.You can read more about Christine’s story in my article for the Daily Mail Good Health section http://www.dailymail.co.uk/health/article-2242522/Did-eating-chicken-tikka-deadly-allergy.html

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Avoiding spices

Christine says she now has to follow a restricted diet because spices are added to so many processed foods including sausages, cheesy puffs and even Easter eggs – and often the label does not specify which spices are ingredients.

But if Christine finds it a nightmare to avoid spices though it’s even more difficult for mother of four Nasiba Mansor, a care worker, 42, who is Asian and lives with her husband Ayub, 45, also a care worker in Leeds. Her son Musa, 11, has been having allergic reactions to spices since the age of six and has to avoid the spices she uses daily in family meals.

‘Musa will sometimes beg me for a samosa but if eats one his mouth will instantly start tingling and he will come out  in red hot welts all over this body.  Sometimes his blood pressure drops too. He’s ended up in hospital many times and has to carry an EpiPen because of the risks he faces.

‘He has to eat plain food with no spices – I can’t use anything with spices or artificial flavourings in his meals – and understandably he feels left out. He wants to be like the rest of the family – but if we go to an extended family get together he has to eat his own packed lunch. I make him non spicy versions of Indian dishes – chicken flavoured with lemon juice and coriander rather spices, cheese, roti bread, plain rice and samosas without the spices.

It took Nasiba a year to work out what was triggering Musa’s severe allergic reactions – he had an EpiPen of adrenaline prescribed – but doctors didn’t know what food was responsible for the reactions.

‘Musa’s lips started to swell and tingle one day after we’d just finished a family meal. Then he came out in small red weals which were red hot to the touch.

‘The food did contain spices but nothing we hadn’t eaten before. I couldn’t work out what was wrong – we have no family history of allergies in our family and had no experience of anything like it.

Nasiba took Musa to hospital and he was given anti-histamines and his symptoms died down – but she still worried because she didn’t know what had provoked the reaction.

‘I carried on giving Musa spicy food – it just didn’t occur to me that spices could be causing the reactions. Spice allergy is unheard of in the Asian community so it didn’t enter my head.’

Although skin prick tests didn’t prove positive for an Ig E reaction – Musa’s specialist believes anything that causes his body to heat up triggers his reactions – including spices. He also reacts if he gets hot from exercising or has too many bedclothes on at night.

‘We think its mainly garam masala spice and chilli which trigger his reactions – but as garam masala is a blend of six spices  and each blend is slightly different it’s  almost impossible to isolate which one is responsible.

‘Better food labelling would definitely help me identify which foods are safe for my son to eat. He’s eleven now and wants to be independent and eat out with friends – it is getting so difficult for him.’

Lindsey McManus, deputy chief executive of the charity Allergy UK, says specific spices don’t have to be listed on ingredient lists on food products in the UK.

‘Spices are also used in a wide range of  non food products – for instance cinnmaldehyde the chemical which gives cinnamon its flavour is used in some toothpastes and can cause skin rashes – they  are increasingly very difficult to avoid.

‘As a charity we are constantly campaigning for clearer and more detailed food labelling.’

Why are more of us becoming allergic as adults?

Allergy consultant Dr Pierre Dugue, from the London Bridge Hospital, says adults developing allergies  was unheard of when he left medical school in the 1970s and yet now it is becoming increasingly common. Why? The truth is nobody really knows, although Dr Dugue says it’s probably something to do with the modern Western lifestyle. One theory is that there’s a window in the development of an infant’s immune system when exposure to good old fashioned dirt can help protect against allergies in later life. He says although spice allergy is rare at the moment it is likely that is  under diagnosed because not many people are aware that spices can trigger allergies, and it can be hard to pinpoint which spice exactly is triggering the response.

Christine Caudwell told me she was dying for a curry – but knows that nothing is worth putting her life at risk.  But  thanks to the vagaries of our food labelling regulations – avoiding spices just isn’t that easy.

Now sag aloo and lamb pasanda are as commonplace  as fish and chips and hot dogs in the UK,  it’s something that food manufacturers  might have to  consider a lot more when they  review how specific  ingredients are listed on packaging.

For more information on allergies call Allergy Uk on 01322 619 898 or visit allergyuk.org

How old are YOUR bones?

How old are your bones?

When Conservative MP Sarah Newton, 51, was diagnosed with the fragile bone disease osteoporosis  after falling outside the House of Commons she was stunned.

Mrs Newton had broken her hip in a simple fall and told newspapers how shocked she was to have an “old women’s disease”.

Osteoporosis is a fragile bone disease which can cause the bone structure to become weak and porous, making bone prone to fractures.

Like most people with osteoporosis, Mrs  Newton was only diagnosed after suffering a fall and breaking a bone. It’s a common scenario; most women (and men) diagnosed with osteoporosis in the UK  are over 50, there are three million people with the disease in the UK. Between them they suffer around 230,000 painful fractures every year. There’s no routine screening for osteoporosis in your 50s and beyond  as there is for breast cancer – even though osteoporosis affects such huge numbers.

                       Not just an “old women’s disease”

Fractures mainly happen in the over 65s but  did you know the damage that causes bones to weaken can start years before – even as far back as your teens? And that women in their 20s, 30s, and 40s, can actually have the bone ages of  much older women?

Although the main risk factors for developing osteoporosis are age (one in two women over 50 have the disease), and losing the protection of the bone strengthening hormone oestrogen after the menopause , there are other risk factors too. These include having a mother with a history of hip fracture, suffering fractures yourself from minor falls/incidents, early menopause or hysterectomy, lack of calcium in your diet, vitamin D deficiency, eating disorders , rheumatoid arthritis, side effects of steroid drugs, over training (to the extent that your periods stop), thyroid problems  and  lack of weight-bearing exercise , as well as coeliac  disease.

                                                                                                How old are YOUR bones?

I’ve been writing about the risks  of  developing osteoporosis in  younger women in a feature in today’s Daily Mail Good Health section  http://www.dailymail.co.uk/health/article-2235473/Brittle-bones-Are-bones-older-Brittle-bones-arent-just-problem-old-age-As-women-discovered-damage-start-DECADES-earlier.html We  sent six women in their thirties and forties for a DXA bone scan to test their bone density – and in some cases  got some very surprising results. Three of the women actually turned out  to have  osteopenia – a low bone density condition that can lead to osteoporosis – something they were completely unaware of. All of them said they were  grateful they’d found out now before it was too late to do something about it.

I’m not suggesting  for a minute that  all  healthy younger women start storming  their GP practices demanding bone scans; but greater awareness of the risk factors so you can take  positive steps to strengthen your bones before it’s too late,  is surely a sensible punt.   Consultant rheumatoloigst Dr Alex Brand  from the  NHS Chelsea and Westminster Hospital and  private Lister Hospital , Chelsea, says it’s just like realising you have high cholesterol or high blood pressure in your 40s and  then taking steps to bring both down to prevent heart disease in later life.

How can you strengthen your bones?

Although pre-menopausal women can’t be prescribed bone strengthening drugs – what they can do is take more  weight-bearing exercise (that’s any exercise which supports the weight of your own body and includes brisk  walking, jogging, tennis, aerobics, dancing and lifting weights), to help strengthen their bones.

Younger women can also eat a calcium-rich diet;  calcium is found in milk, yoghurt, cheese, leafy greens, bony fish and dried fruit), stop smoking (which has a toxic effect on bone), moderate their alcohol consumption to within safe limits and make sure they get exposure to the sun to ensure their body makes enough vitamin D ( vital for calcium absorption). They may even consider taking a calcium and vitamin D supplement. If they’ve had a premature menopause or early hysterectomy they can take Hormone Replacement Therapy to strengthen their bone density.

If you’re under 50 and  are worried you have some of the risk factors for osteoporosis though – it’s probably worth checking out this quiz on the National Osteoporosis Society website http://www.nos.org.uk/page.aspx?pid=1157&srcid=263.

If you’re scoring high for risk factors  have a chat with your GP – they now have a computerised  screening tool  called FRAX (http://www.shef.ac.uk/FRAX) developed by the World Health Organisation  and the University of Sheffield ,which calculates your risk of having a fracture within the next 10 years. If your risk score for  a fracture is high you may need a DXA bone density scan.

Bones  get porous as you age … so start taking care of them now.

Click here to read another article I’ve written about osteoporosis http://www.dailymail.co.uk/femail/article-2053545/Fatal-toll-fragile-bones–women-suffer-osteoporosis.html

Are you taking too many pills?

New figures published this week reveal more than half of over65s in the UK are now taking five pills a days – so this article about my mum and dad and their rucksack full of pills is still as relevant as it was four years ago.Sadly though, my lovely mum Elizabeth passed away in August.

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CAPTION: My seventy-something parents – were they taking too many pills?

I’ve been writing about the growing problem of polypharmacy – put simply that means taking multiple daily prescription pills for long-term chronic conditions. You can read the full article here in the Daily Mail’s Good Health section http://www.dailymail.co.uk/health/article-2280761/Pills-The-patients-prescribed-25-different-drugs-day-devastating-results.html.

I got the idea for the story after my lovely parents (pictured above) who are both in their mid seventies, came to stay with me with a rucksack jam-packed full of their prescription medication. I was shocked when I saw how many tablets they had been instructed to take. Admittedly, they do both have long-term chronic health conditions including diabetes, heart disease and arthritis – but what I was surprised at was how many additional pills they were taking to counter side effects of other tablets. Also some of the drugs they had been on for years and no-one had ever…

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Great review for ‘What’s Up With Your Gut?’

If you’ve read my post on  Why you bloat after eating bread and pasta (and lots of people seem to be reading it as it’s getting thousands of views per week), you may want to read more about similar gut complaints in my book ‘ What’s Up  With your Gut?‘  Why you bloat after eating bread and pasta and other gut problems co-written with Professor Julian Waters  and  published by Hammersmith Press.

Here is a recent review http://www.independentliving.co.uk/advice/whats-up-with-your-gut /

It’s available to buy here on Amazon https://www.amazon.co.uk/Whats-Up-Your-Gut-Problems/dp/1781610673

Do you bloat after you eat bread or pasta? You may want to read this…..

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CAPTION: Pasta contains gluten which can cause bloating

When I first published this blog on non coeliac gluten sensitivity  three years ago I had no idea that it would cause such a stir and still be getting thousands of views  a week from  all over the world several years later.

As the hits grew and grew it got me thinking – if there’s this much interest  – how about a book?  My  experience as a health journalist interviewing  dozens of people with gut problems  for magazines and newspapers over 20 years had taught me that  most people with gut complaints wait an awful long time to  get to the bottom of what’s wrong with them.Some of them just give up and put up with it – letting their gut problems dictate their life and in some cases ruin it. What about if I could put all the information about gut problems in one place and help them along the way?

Luckily, I managed to enlist help and advice from Professor Julian Walters a consultant gastroenterologist at Imperial College in London and together we landed a book deal  with Hammersmith Press. Our book:’What’s Up With Your Gut? is scheduled to be published in  June 2016  and is available to pre-order at Waterstones  now https://www.waterstones.com/book/whats-up-with-your-gut/jo-waters/professor-julian-walters/9781781610671 . An e-book will be published in June too –  if you subscribe to the blog I’ll keep you updated.We hope you’ll find the book a really useful guide to all those  gut conditions that can make you feel  so uncomfortable – causing gas,bloating, diarrhoea, wind, burping and constipation. Some of the conditions the book  describes are quite easy to test for, others are diet-related or related to gut bacteria and infections or even in rare cases cancer. We’ve written the book for the millions of people worldwide like you who have troublesome guts – to help you find out what’s wrong and get your symptoms under control at long last.It’s not a replacement for seeing a doctor but it will  hopefully give you some useful pointers – in plain English too.

Now back to non coeliac gluten sensitivity……

It’s a mystery that has puzzled gastroenterologists for years. Why do they see so many patients who complain of bloating ,diarrhoea and stomach pain after eating foods  such as bread and pasta, but who test negative for coeliac disease? And more importantly why do many appear to get better when they switch to a gluten-free diet?

Yes, a minority  will test positive for coeliac disease , an auto immune condition where the body produces antibodies to gluten ,a protein found in wheat and other grains including barley and rye. The antibodies cause damage to the villi that line the small intestine (their job is to  absorb food). Eventually, the villi shrink and food and nutrients begin to pass through the  body without being absorbed leading to vitamin and mineral deficiencies.

Doctors can diagnose coeliac disease with a blood test for antibodies and a biopsy to test for damage to the lining of the gut. If patients test  positive they must avoid gluten for the rest of their lives and their symptoms will largely disappear unless they accidentally eat gluten hidden in restaurant meals  for instance.

‘Most were told they didn’t have coeliac disease and just told to get on with  it’, admits Dr Kamran  Rostami , consultant gastroenterologist at the Luton and Dunstable Hospital, Bedfordshire.’ I’ve  seen so many patients  like this, but  many of them told me they got better if they stopped eating foods containing gluten.’

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CAPTION: Is gluten causing your unexplained bloating?

Many gastroenterologists  like Dr Rostami now believe that these patients do actually have a medical condition:it’s called Non Coeliac Gluten Sensitivity  (NCGS)  and has similar symptoms to coeliac disease, but  does not appear to involve the immune system or damage the lining of the gut. Crucially though, the symptoms go away if the patients avoid foods containing gluten.

By no means all doctors believe NCGS exists – mainly because no one understands what causes it and there is no diagnostic test for it – but it is now  gaining wider acceptance , mainly due to a flurry of new research in the last three years – and doctors say this has been driven by patients.

Last November Dr Rostami wrote an article in the British Medical Journal  describing a patient who had been troubled by abdominal pain, diarrhoea ,bloating,joint pain,fatigue and many other symptoms. He tested negative for coeliac disease but his health improved dramatically after he switched to a gluten-free diet. After the article was published Dr Rostami received scores of  emails from doctors and patients wanting to know more about NCGS  and he is still receiving them.

Dr Rostami says : ‘It is now becoming clear that, besides those with coeliac disease or wheat allergy, there are patients with gluten sensitivity in whom neither allergic nor autoimmune mechanisms can be identified.

‘It has been estimated that, for every person with coeliac disease, there should be at least six or seven people with non-coeliac gluten sensitivity. Gluten sensitivity may therefore affect 6 to 10 per cent of the general population. This means approximately 4 to 7 million people in the United Kingdom have this condition, and the vast majority are unaware of their sensitivity to gluten.’

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CAPTION: Is  the bread  basket to blame?

 What should you do if you think you have  NCGS?

Perversely, the advice is to carry on  eating foods containing gluten  at least until you can get tested for coeliac disease. ‘ It’s very important coeliac disease is eliminated first ‘, advises Professor David Sanders , a consultant gastroenterologist at the Royal Hallamshire Hospital , Sheffield, and chair of the charity Coeliac UK’s Medical Advisory Board.’ If this been eliminated then it might be worth a patient being put on a trial of a gluten-free diet – in my experience it does help in many cases.’

Today, I’ve written about the experiences of  50-year-old Sue Clark from Luton in the Daily Mail Good Health section http://www.dailymail.co.uk/health/article-2439660/How-wheat-intolerant–know-If-youre-feeling-bloated-tired-victim-hidden-epidemic.html Sue was recently diagnosed with NCGS , after suffering from bloating, fatigue  and diarrhoea since the age of eight. Sue had been told she had “grumbling appendix” as a child  when she suffered tummy cramps. Later she was told it was Irritable Bowel Syndrome that was to blame and  told to eat a high fibre diet which made her symptoms worse. In her thirties her GP just dismissed her symptoms as signs of stress.

But after seeing Dr Rostami earlier this year and testing negative for coeliac disease,Sue was eventually diagnosed with NCGS and switched to a gluten-free diet. Now her symptoms have disappeared. She’s got her energy back , has lost two stone and has no more stomach pain or diarrhoea. She just wishes she’d been diagnosed years ago .

The worrying thing is that there could potentially be millions of people just like Sue in the UK .If you know someone this article could help – please tell them  about  the site as this is exactly the reason I write this blog – to help people find out what’s up with their health.

In case you’re interested here are some other links to other articles I’ve written about gut problems;

http://www.dailymail.co.uk/health/article-2255492/Bile-acid-diarrhoea-For-40-years-doctors-said-I-IBS-In-fact-hormone-problem-cured-simple-pill.html

http://www.dailymail.co.uk/health/article-1350238/Feel-bloated-Cramps-The-problem-BRAIN.html

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5 reasons why we should all be LOVING prunes

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Prunes:  yes they’re wrinkly  BUT delicious and good for you too

Prunes have always had a bit of an image problem – often teamed up with the words “wrinkly”, “old” or even “laxative” – they’ve had a bit of a bad press of late.

Classic 1970s school dinners didn’t help much either –  lots of us remember prunes in their own juices (with the stones still in) and being made to eat  up every last one before we left the table.Yuk!

Fact is though, prunes (dried plums with water extracted  if you want to be technical), are just as healthy and delicious as some of their most glamorous superfood cousins such as blueberries and pomegranates – the “It Girls” of soft fruits . I’ve got some prunes on my desk as I write and they make great  healthy snacks, but like most people I wouldn’t  have a clue how to cook with them.

I should really  say ” wouldn’t have had a clue” though, because that all changed when I got an invite to join celebrity chef Rosemary Shrager for a day in the kitchen at her fabulous new Rosemary Shrager’s Cookery School in Tunbridge Wells down in Kent. Turns out none of us really know what to do with prunes. Rosemary, the new brand ambassador for the California Prune Board no less, was on a mission to convince a dozen of us  food and health writers that prunes are the new pomegranates and that we should all  get over our unfair prejudices against them.I’m a great one for the underdog so I decided to  give it a go.

Rosemary Shrager  : Celebrity chef Rosemary Shrager at her new cookery school

Rosemary showed us just how versatile prunes are to cook with, gave us the recipes and ingredients and let us get on with it. An hour or so later we sat down to  a three course prune-themed lunch we’d  cooked ourselves – starting with  wheaten prune bread, followed by a main course of chicken breast stuffed with prunes,  chicken livers and rosemary, wrapped in strips of  pancetta, on a bed of red Camargue rice(with prunes) and then prune and white chocolate Panna cotta for pud. You’re already smirking aren’t you?  But no the food wasn’t horrible (it was absolutely delicious) and there was no queue for the loo afterwards either or any other digestive events later on to report. We health and food writers were collectively impressed . Who knew the humble prune was quite so versatile?

  CAPTION: Below: Chicken breast with prunes, liver and rosemary served on a bed of Carmargue rice  – with  more prunes

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Prune pannacotta< CAPTION> Prune and White Chocolate Panna cotta

Some health benefits of prunes

Just three prunes count as one of your 5-a-day fruit and veg – but they have other health benefits too.

  •  They keep you (ahem) “regular”: Indeed, last year the EU allowed the California Prune Board to make a health claim stating that eating 100g a day of prunes (that’s around 8-12 prunes) contributes to “normal bowel function” as a part of a healthy, balanced diet and lifestyle. I think that’s the polite way of saying they help you avoid constipation and keep you regular. A study published in 2011 in the medical journal Alimentary Pharmacology and Therapeutics found that  prunes were a more effective treatment than psyllium (high fibre plant husks used to treat constipation – they work by drawing out water from the gut and making stools softer). The researchers concluded plums were “safe, palatable and more effective than psyllium for the treatment of mild to moderate constipation”.  Obviously don’t overdo it though…. prunes can REALLY get things moving in the bowel if you eat too many of them because as well as fibre they contain sorbitol which also stimulates bowel movements. Start off  gently with a few  prunes a day and  see what effect they have and gradually increase your intake if needed. If you have  a long-term problem with constipation though its best to see your GP for advice.
  • They may help with weight control: Surely not you’re thinking? Most diet sheets tell you to steer clear of dried fruits because of their high sugar content (30g of prunes contains 11.4g of sugar and 69 calories), but new research published by the University of Liverpool found dieters who ate prunes as a snack lost more weight than another group of dieters just given advice about healthy snacks. The more successful dieters said the prunes helped them feel fuller and less hungry. Whilst there’s no magic ingredient in prunes that helps you lose weight, the researchers concluded they certainly didn’t undermine dieting and their fibre content seems to help with satiety. Prunes also taste sweeter when they are cooked so can also be used  as a puree in recipes which are traditionally high in sugar so that the overall sugar content can be reduced.
  • They may be good for bone health: Prunes are a rich source of vitamin K as well as the mineral manganese and both contribute to the maintenance of normal bone health. A study at Florida State University published in 2011 found that post menopausal women who ate prunes had improved bone mass density compared to those who ate dried apple. The researchers thought this could be in part due to the fact that they suppressed the rate of bone turnover.
  • They may be beneficial for blood pressure: This is due to their potassium content which can help maintain normal blood pressure.
  • They may help you feel less tired: Prunes contain vitamin B6 which is important for energy release – so a great snack for between meals.

Need I go on? Anyway, I for one won’t be wrinkling my nose up at prunes anymore… I’ve banished those  school dinner nightmares from memory and I’m actually looking forward  to using them more in  my home cooking – although I probably wouldn’t have them in every  course just because they are incredibly filling and sweet.

Oh, and if you have any healthy or indulgent recipes using prunes  you’ve devised  yourself  you could win a bread making masterclass for two with Rosemary Shrager on 10 May 2015 (including travel and overnight accommodation), plus a chance to have them published in an e-recipe book.Upload your recipes in either category at www.californiaprunerecipes.co.uk or visit the California Prunes Facebook page for details. Ten runners-up will each win a £100 supermarket voucher to spend in a store of their choice.

WWW.ROSEMARYSHRAGER.COM

£35 heart screening test is ‘feasible and cost effective’ says new study

It’s cCrdiac Risk in the Young Awareness Week so I’m reblogging this post about lovely Arabella Campbell and how screening can prevent more deaths like hers

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Holly and ArabellaCAPTION: Arabella  (pictured bottom) and Holly playing volleyball just weeks before Arabella’s death in May 2013

A year ago next week my 16-year-old daughter Holly’s beautiful, funny, clever,kind, best friend Arabella died. Her mum Clare found her in her bedroom with her GCSE revision books around her. She’d had a normal quiet Sunday with her cousins and grandmother and gone upstairs to study for the following day’s exams and her heart had simply stopped

Arabella was bright, exuberant, hilarious, athletic and the picture of a good health with boundless energy and had not been ill. She had suffered a sudden cardiac death – completely out of the blue and without any warning.

To say she has left a massive hole in all our lives is an understatement – it is a vast gaping chasm and we mourn her every day and the wonderful fun-packed life she should be still living…

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£35 heart screening test is ‘feasible and cost effective’ says new study

Holly and Arabella CAPTION: Arabella  (pictured bottom) and Holly playing volleyball just weeks before Arabella’s death in May 2013

A year ago next week my 16-year-old daughter Holly’s beautiful, funny, clever,kind, best friend Arabella died. Her mum Clare found her in her bedroom with her GCSE revision books around her. She’d had a normal quiet Sunday with her cousins and grandmother and gone upstairs to study for the following day’s exams and her heart had simply stopped

Arabella was bright, exuberant, hilarious, athletic and the picture of a good health with boundless energy and had not been ill. She had suffered a sudden cardiac death – completely out of the blue and without any warning.

To say she has left a massive hole in all our lives is an understatement – it is a vast gaping chasm and we mourn her every day and the wonderful fun-packed life she should be still living now. Arabella loved horse riding , tennis, Duke of Edinburgh hikes and keeping ducks in her back garden and amongst other achievements had learned all the words to the South African National Anthem (by watching YouTube videos), a song that was played at her unspeakably sad funeral. She loved Barack Obama, Prince William and Kate, the Arctic Monkeys, the Lion King, hugging, Twitter, ‘Toddlers and Tiaras’ and lying in bed (a lot). She could have been anything she wanted when she grew up, the world was at her feet.

Arabella was a member of a large extended loving family but there is always an empty place at their table now.My daughter misses walking to school with her and texting her lines from ‘Friends’ and receiving the next line back in seconds – they were word-perfect on all the scripts. But so many other people miss her too for so many different reasons.

 

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CAPTION: 12 young people a week die a sudden cardiac death in the UK

Could screening save lives?

Arabella is one of 12 young people who die from a previously undetected heart condition every week in the UK (yes it really is that many). I was vaguely aware of the charity Cardiac Risk in the Young’s (CRY) work before Arabella’s death, but have since learned more about their fantastic work in screening young people for potential heart problems, funding research into the causes of sudden cardiac deaths and their work with bereaved families and young people who are diagnosed with a heart condition as a result of screening. They do an amazing job.Open the pages of CRY’s quarterly fundraising newsletter though and I promise you you’ll struggle to hold back the tears – there are pages and pages of photographs of all the other young people who have died – young sportsmen on the football pitch, teenagers off on their gap years, fresh-faced graduates,  beautiful new brides,fathers in their 20s, mums who will never see their toddlers grow up – it is heartbreaking. Every death is as tragic as Arabella’s.

I’ve since had two of my daughters screened (the other one will be screened when she turns 14), at one of the mobile screening sessions CRY organise around the country and no problems were detected. I did it because Arabella’s mum Clare said had she known about screening then she would have paid for a test every year of Arabella’s life. Many of the screening sessions are funded by relatives of young people who have died They all feel passionately as Clare does that they don’t want the same tragedy to be repeated in another family. The test takes about 15 minutes . CRY wants all young people to be screened – so do I .

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Is screening cost-effective?
Until now health economists have argued these deaths are too rare for it to be cost-effective to screen for cardiac conditions, but now research based on work funded by CRY at St George’s Hospital , London, presented today at the EuroPPrevent 2014 Congress has proved that it is both “feasible and cost effective”.

In the study more than 12,000 people aged between 14 and 35 were screened at a cost of £35 (40 euro) each; rates of subsequent referral for further investigation were low and considered of “a relative low additional cost” to health services. Dr Rajay Narain, Clinical Research Fellow from the Department of Cardiovascular Sciences, St George’s University of London (and CRY) explained that the most publicised cases of sudden cardiac death ( SCD) in young people occur in elite sports players and athletes. Yet the majority of cases occur as a result of inherited cardiac conditions (such as hypertrophic cardiomyopathy), and a large proportion of these, he adds, can be detected during life. SCD in a young person is likely to have resulted from an arrhythmia caused by a mutation in one of the cardiac ion channels or from other inherited conditions affecting the muscles of the heart.
‘To prevent such tragedies,’  said  Dr Narain.’Sporting and scientific bodies recommend pre-participation screening in young athletes. However, this approach is controversial because of cost – and most SCDs in the young are likely to occur in non-competitive athletes. It was thus our aim to see if population screening was feasible in this age group.’
The study involved the screening of 12,000 young people irrespective of their athletic ability. Only 13% were considered elite athletes. Screening was performed at a cost of £35 per individual and comprised a health questionnaire, 12-lead ECG and consultation with a cardiologist. Those with abnormalities had an echocardiogram on the day or were referred for further evaluation.
Results showed that almost one-in-ten of the population (9.4%) were sent for echocardiography on the day, and 2.7% (323 individuals) were referred for further assessment. Of these who responded to the questionnaire and completed their follow-up investigations (189), a cardiac pathology (or findings necessitating regular follow-up) were identified in 31 (16%). The most common were heart block (10), irregular heart rhythm (9) and valvular heart disease (6). Different cardiomyopathies were evident in 11 cases.
By applying such a screening programme as the one investigated here, Dr Nairn said that many of the sudden deaths from these conditions, which number around 12- 15 per week in the UK, can be prevented.

Population screening to prevent SCD in young people is “possible and achievable” said Dr Narain, who added: “Most developed countries have the potential for creating an infrastructure in high schools similar to established immunisation programmes. There is evidence that teachers, coaches and even volunteering parents could be trained in ECGs. The incentive is prudent – 25–30% of the population in the Western world is now aged 18 or under.”

 

Park life                                                        CAPTION : Arabella (behind) was full of life

Write to your MP
Practically every MP  will have had young people like Arabella die a SCD in their constituencies so maybe it’s worth a letter to yours asking when  a national screening programme in schools is going to be introduced?  Arabella’s constituency MP Colonel Bob Stewart  ( whose daughter was a classmate of Arabella’s) has already done his bit by mentioning Arabella’s death in a parliamentary debate asking :’Can Arabella’s death and the death of hundreds of others of children and young adults be used as a spur to reinvigorate the NHS campaign to identify young people who may suffer a heart attack as a result of a problem that has not been detected, difficult as that maybe?

Jeremy Hunt said at the time ( last June), that he was waiting from advice from the national immunisation and screening committee ‘on the right way forward in this respect’ Let’s hope someone puts this research paper right under their noses today.

We can’t bring Arabella back and screening may or may not have detected a heart abnormality in her case – but we may be able to stop more young people dying in the same way.

In the mean time contact CRY to get your child screened  – here’s the link http://www.c-r-y.org.uk/ecg.htm

 

 

Do you bloat after you eat bread or pasta? You may want to read this…..

This article now regularly gets about 500 views a week from all over the worlds so I’m shamelessly reblogging it as there is obviously a lot of interest in this subject. Anyone want to give me a book deal?

whatsupwithyourhealth.wordpress.com

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CAPTION: Pasta contains gluten which can cause bloating

It’s a mystery that has puzzled gastroenterologists for years. Why do they see so many patients who complain of bloating ,diarrhoea and stomach pain after eating foods  such as bread and pasta, but who test negative for coeliac disease? And more importantly why do many appear to get better when they switch to a gluten-free diet?

Yes, a minority  will test positive for coeliac disease , an auto immune condition where the body produces antibodies to gluten ,a protein found in wheat and other grains including barley and rye. The antibodies cause damage to the villi that line the small intestine (their job is to  absorb food). Eventually, the villi shrink and food and nutrients begin to pass through the  body without being absorbed leading to vitamin and mineral deficiencies.

Doctors can diagnose coeliac disease with a blood test for antibodies…

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Why you don’t have to be a sun worshipper to get skin cancer

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CAPTION: WATCH THAT MOLE

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I tan easily, rarely burn and prefer a “healthy” glow to a deathly white pallor.Like all health journalists I wear sun cream. And a hat.And I sit in the shade and reapply cream regularly, but I  have to admit I do love a bit of sunshine.

I don’t have freckles or red hair or have a penchant for tanning booths.With an indoor “office” job and limited time to soak up the sun’s rays, a darkish skin tone, brown hair (underneath my highlights) and not many moles, I didn’t think I’d be at high risk of skin cancer. I think I was guilty of thinking It Won’t Happen To Me.But now I’m thinking differently.

That’s because I’ve spent a couple of hours interviewing Dr  Bav Shergill, a consultant dermatologist at the Queen Victoria Hospital, East Grinstead, this week and I’ve finally realised that you don’t have to be a sun worshipper to be at risk of developing skin cancer. Dr Shergill  was acting as a spokesman for a fundraising campaign from the British Skin Foundation charity called It Takes Seven highlighting the fact that seven people a DAY in the UK now die from malignant melanomas, the most serious type of skin cancer.

 

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CAPTION: Bob Marley the reggae singer had malignant melanoma < IMAGE SHUTTERSTOCK>

The It Takes Seven campaign is aiming to raise money for more research into the cause of malignant melanoma as there is currently no cure once the disease has spread. More than 13,000 people are now diagnosed with malignant melanoma every year in the UK and there are 2,000 deaths. Malignant melanoma cases have risen by a fifth since the mid 1970s and the cancer is now the second most common in the 15 to 34 age group .Of course we all travel more now and the population is aging and some people still love tanning salons – but not all skin cancer patients have engaged in high risk activities, have freckles, red hair or are older. One girl I interviewed this week was just 19 when she developed malignant melanoma. The reggae singer Bob Marley died from  malignant melanoma – highlighting the fact that all races can get it.

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I’ve interviewed six people this week for the Daily Mail Good Health section about their experiences of  skin cancer. Like me – none of them thought they were at high risk and there wasn’t a sun worshipper amongst them. None of them were beach bums  or went to tanning salons.One man had dark hair and brown eyes and thought he tanned easily, a primary school teacher got skin cancer from sitting in her conservatory and another lady just forgot to wear her hat when she was gardening and developed skin cancer on her scalp.  It really is that easy.  Hardly any of them took holidays abroad much, or if they did it was just a fortnight in the Med once a year. One girl can remember burning at the beach …. but it was at Bognor Regis. These people just spent a little time outdoors every day – jogging ,walking their dogs or pottering in their gardens – but maybe they just didn’t apply enough sun cream or didn’t reapply it often enough.

Dr Shergill explained to me that although the sun’s  UVB rays ( responsible for most cases of sun burn), reflect off glass, UVA rays can penetrate through and cause people to develop skin cancer in some cases.To prove it he emailed me an alarming  photograph of an American office worker who’d sat in the same corner office seat for 15 years next to the window. She had developed skin cancer and more visible signs of aging on one side of her face only -the one facing the window.The same thing happens to truck drivers too, as rays can penetrate  windscreens  and driver cab windows as well.

As Dr Shergill was telling me all this I started to think hmm just like me. I walk my  dog every day and don’t put cream on unless it’s practically a heat wave and only really bother if it’s a hot day at the beach or if  I’m on holiday abroad.You can read the full article here in today’s Daily Mail http://www.dailymail.co.uk/health/article-2615283/Think-sun-worshippers-skin-cancer-Wrong-As-rates-malignant-melanoma-soar-six-sufferers-share-stories-proving-ANYONE-fall-victim-deadly-disease.html 

Dr Shergill said so much is still unknown about malignant melanoma – no-one knows for instance why some people get malignant melanomas in parts of the body never exposed to the sun. He says scientists desperately need to do more  research to find out more about the causes and develop new treatments – so this  is why it’s so important to support the It Takes Seven campaign.

This summer I’ll still be having a tan – but this time it will be a fake one out of a bottle and I’ll be spending much more time in the shade.With a bigger hat. And I’ll be applying  factor 50 sun cream  – you need two tablespoons to cover  your whole body each time you apply, according to Cancer Research UK – so it’s going to be expensive for my family of five – but worth it for peace of mind. Also, I won’t be getting a conservatory anytime soon or aiming to land a top job in a corner office.

You can read more about Imogen Cheese’s personal experience of  having malignant melanoma at her brilliant blog  www.melanomarollercoaster.co.uk – if you have just been diagnosed with skin cancer this is essential reading.