Archive for September, 2013

Irritable Bowel Syndrome – A Common Health Concern

In Canada approximately 5 million people suffer from irritable bowel syndrome (IBS). But what exactly is IBS and why does it occur? To answer these questions, we must first understand the digestive process and the changes that occur in the gut of those who are affected.

Digestion of a meal is a complex process, consisting of many steps to extract nutrients for nourishment. This process begins with the mechanical and chemical breakdown of food in the mouth and stomach before food is passed to the small intestine where it is further broken down and finally absorption of nutrients occurs.

In order to facilitate the passing of food along the digestive tract, muscles found in its walls relax and contract to slowly push food forward. The rate of propulsion of food can be influenced by several factors, including type and amount of food eaten, physical activity, mood, and certain hormones (cortisol, estrogen, etc).

In addition to its role in transport and nourishment, the digestive system also contains a large number of ‘defenses’ to fight off any potentially harmful intruders that are taken in by the mouth. These defenses include the acid found in the stomach and most importantly, immune system cells that line the entire length of the digestive tract. The immune system of the gastrointestinal tract also has the ability to distinguish between healthy bacteria that normally inhabit the tract and potentially harmful bacteria. This distinction is important as it allows us to benefit from the actions of these healthy bacteria, which include the production of certain nutrients (e.g. vitamin K) which aid in the digestion of food (e.g. fermenting fiber), prevention of the growth of harmful bacteria that influence the normal reproduction and growth of intestinal cells and prevention against certain diseases (e.g. Chron’s disease).

Digestive disorders or diseases can be caused by or be the result of an alteration or disruption of normal healthy digestive processes. One such common digestive disorder is IBS, affecting approximately 10-15% of the population. IBS is a disease that can have a great impact on the lives of those affected. It is a disease that is characterized by recurring abdominal discomfort or pain and a change in stool frequency (frequent or delayed bowel movements) and consistency (diarrhea or constipation).

While the exact cause of IBS is not known, the most commonly accepted risk factor is a history of bacterial gastroenteritis (i.e., bacterial infection of the digestive tract) or by an alteration in the normal intestinal bacteria. Specifically, healthy intestinal bacteria can be altered by several factors, including recent antibiotic use, mental/emotional stress, lack of physical activity, and by certain hormones. Other risk factors for developing IBS include food intolerance, mood disorders (anxiety, depression), or genetic predisposition.

The symptoms experienced with IBS are believed to originate from a combination of altered contractions of the muscles in the intestines and from a change in pain sensation in the intestines. With respect to the altered rate of muscular contractions of the intestines, there can be either more frequent and more forceful contractions, causing pain and diarrhea, or slowed non-progressive contractions that lead to constipation. Alterations in the frequency of the contractions may result from ingestion of a fatty meal, mood (stress, anxiety, depression, anger), or the release of certain hormones (estrogen, serotonin, or cholescystokinin, which is a digestive hormone).

People who suffer from IBS are also more likely to have increased pain sensation in their intestines. This altered sensation is triggered by the stretch of the intestinal walls by stool or by gas. This process is often made worse by changes in contraction of the muscles of the smooth intestine, which can cause pain during a contraction or with non-productive contractions which lead to a build up of gas or stool, stretching the walls of the intestine and causing pain. There are several factors that can affect this process, including ingesting certain gas forming foods (beans, cabbage, broccoli, etc.), having an alteration in normal intestinal bacteria (which ferments fiber differently, causing more gas), or mood.

As indicated above psychological factors like anxiety, stress, depression, etc., affect muscular contractions of the small intestines and altered pain sensation. Moreover, these psychological factors can affect the release of secretions that aid with digestion and can alter the function of the immune system. Alterations of immune function then go on to influence the presence of healthy bacteria and can cause an increased release of inflammation producing immune cells.

From a treatment perspective, there are several factors to address in the treatment of IBS. Specifically, one’s diet should be examined, looking to eliminate food sensitivities, and irritants, as well as avoiding gas forming foods. Furthermore, other factors such as mood, sleep, physical activity, intestinal bacteria and any possible damage done to the gut should be considered for their potential contribution to IBS.

If you have questions about IBS, digestive health or how a naturopathic doctor can help you, please call 613-290-6115 or visit Graham Beaton is a Doctor of Naturopathic Medicine in practice at Ottawa Collaborative Care Centres – 102 Lewis Street, Ottawa.

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Nutrition for a Healthy Pregnancy

by Graham Beaton

Consuming a healthy diet is vital to a healthy pregnancy. But what is a healthy diet for someone who is pregnant? Should a pregnant women consider that she is “eating for two?”.

This article will focus on the importance of healthy weight gain during pregnancy and on a few key nutrients that are required to promote healthy fetal development and a healthy pregnancy. It is important to keep in mind that this is not an exhaustive list, and more importantly, the requirement of maternal weight gain and intake of specific nutrients may vary according to the health of the mother both before and while pregnant, and the number of children a woman is carrying (i.e. twins, etc.). Thus it is important to consult with a health care provider to address your specific situation.

Maternal Weight Gain
Weight gain during pregnancy has a significant impact on pregnancy outcome (risk of preterm labour, c-section delivery, etc.), and on the short term and long term health of both the mother (increased risk of preeclampsia, gestational diabetes, retention of weight post delivery, etc.) and child (increased risk of diabetes, etc.). The weight gained during pregnancy takes into account the weight of the baby and the weight that is required to allow a woman to sustain and nourish a child while pregnant and to have reserves available (stored as fat) to facilitate delivery and breast feeding.

The amount of weight a woman should gain during pregnancy varies according to her pre-conception weight. For instance, it is advised that women who are of “normal” weight (according to the Body Mass Index (BMI), (refer to chart) gain approximately 25-35 pounds (approximately 1 pound/week during the second and third trimesters) whereas overweight women should gain approximately 15-25 pounds (0.6 pounds/week during the second and third trimesters) during their pregnancy.

Healthy Weight Gain During Pregnancy by BMI

Folic Acid
Folic acid is a B vitamin that is essential during pregnancy as it is required for the rapid replication and growth of cells of both the fetus and the placenta (organ that connects the uterus of the mother to the developing fetus). In the fetus, folic acid is essential for the formation of the neural tube, which gives rise to the brain and spinal cord. If levels of folic acid are not adequate, the neural tube may be improperly formed (called a neural tube defect), which can lead to anatomical defects in the brain and spinal cord.

In addition to helping with placental development in the mother throughout pregnancy, folic acid is vital during the second and third trimesters for the production of new red blood cells, whose numbers increase in order to carry a greater amount of oxygen to the developing fetus.

Folic acid levels are often low in women, especially if prior to conception, oral contraceptive pills had been used for a long period of time (oral contraceptives lower the dietary absorption of folic acid and increase the rate that it is broken down in the body). Dietary sources of folic acid (green leafy vegetables, legumes, egg yolk, sunflower seeds) are generally insufficient to ensure women have adequate levels of folic acid, thus supplementation is advised.

During pregnancy there is a dramatic increase in the number of red blood cells (red blood cells carry oxygen from the lungs to the tissues of the body) required to meet increased oxygen needs. Due to this change, pregnant women require an increased amount of iron. If iron intake is not increased or is inadequate during pregnancy (resulting in iron deficiency), several negative outcomes to both the mother and child can occur. Like folic acid, it is common for iron deficiencies to occur in women prior to becoming pregnant and in women who are pregnant. As deficiencies are common, it is important for a woman’s iron status to be tested, and depending on results of the test, supplementation with iron may be required (amount of supplementation varies according to test results).

Vitamin A
Vitamin A is readily available in most people’s diets (from the consumption of meats, eggs, dairy products and dark green and yellow/orange vegetables). Vitamin A is involved in the development of all major organs and tissues of the body. Additionally, it is important to the development of the immune system and deficiencies during pregnancy have been linked to the development of night blindness in the child. A note of caution regarding vitamin A – taking supplements with high levels of vitamin A can increase the risk of birth defects if it is taken during the first trimester of pregnancy. Thus, it is best to avoid supplementation as it can be easily obtained from food.

If you are pregnant, or thinking about getting pregnant, it is important to consult a health care professional about what nutritional requirements you require to give birth to a healthy child and to have a healthy pregnancy. As a naturopathic doctor, I work with women who are planning/trying to conceive and with expecting mothers to create a plan to meet their individual nutritional requirements, exercise and physical activity requirements, and to help promote a healthy pregnancy.

Graham Beaton is a Doctor of Naturopathic Medicine in practice at Ottawa Collaborative Care Centres – 102 Lewis Street, Ottawa ON. If you have questions about prenatal nutrition, prenatal health, or how Naturopathic Medicine can help you, please call 613-290-6115.

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