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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mum and dad

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

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

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

ALL IMAGES : SHUTTERSTOCK

5 reasons why we should all be LOVING prunes

prunes

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

chicken  and prunes

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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