Large Intestine

If you scored high in the ‘Large Intestine’ section of the Health Score Quiz, please read this article as it contains some useful information and resources to help you.

The questions or statements posed in this section relate to the health of the large intestine and imbalances associated with the large intestine.

We are not looking to diagnose anything here, but rather offer some insight and understanding into the large intestine and some of the symptoms associated with imbalances in this area. If you have a number of symptoms in this area, then we recommend seeing your Dr and perhaps gastroenterologist for further assessment and to help rule out any acute issues that may require medical intervention.

On this page we are going to look at:

1. What is the colon and what does it do?
2. Common symptoms and conditions associated to colonic health
3. Testing considerations for colon health
4. Strategies to help cope with those symptoms or imbalances

What is the colon and what does it do?

The large intestine or otherwise known as the colon is very short in comparison to the small intestine at only 3 to 5 feet long, and makes up the final portion of the digestive system.

One of the roles of the large intestine it to help absorb water and remaining nutrients while forming a stool. Therefore, if the food material passes through the bowels too quickly or water is not absorbed effectively this can lead to loose stools and alternatively, if it moves through too slowly and excessive water is absorbed this can lead to constipation.

Not only that, the large intestine is where we house trillions of microbes, the majority of which we live harmoniously with. In fact, these bacteria we have learnt to depend on them and they depend on us, in what is know as a symbiotic relationship. In fact, the microbes that we have in our gut and what we feed them can significantly dictate the health of the gut and our overall health as well. The bugs in our gut help to produce certain nutrients as well, such as vitamin K and certain B vitamins as well as influence areas like hormonal balance, appetite, metabolism and much more.

Helpful bacteria in the colon can help to protect us from illness, they support our ability to digest certain foods, support the movement of faecal matter through the system and help with the production of Short Chain Fatty Acids (SCFAs). These short chain fatty acids are fuel for the colonic cells and help to reduce inflammation in the bowel reducing risk of inflammatory bowel diseases and bowel cancer, particularly in those prone to these diseases. The majority of SCFAs are produced when certain species of bacteria feed off carbohydrates, in particular fibrous foods and resistant starches.

Common symptoms and conditions associated with colon health

Constipation

It is said that around 1 in 10 of us suffer with constipation and that laxatives are one of the most common medications.

There are many potential underlying causes of constipation, ranging from anything as simple as a lack of water and fibre, all the way through to hormonal imbalances like low thyroid, certain medications or iron supplements or even specific medical conditions like Parkinson’s.

Here are some tips that may help with constipation:

1. Increase fibre intake (do this gradually, especially if increasing from veg as this can cause bloating and gas).
2. Increase water intake.
3. Exercise if you are not already. Just light exercise is fine as it helps to massage the intestines and keep the bowel moving.
4. Try psyllium seed husks. These add bulk and water to the stool.
5. Try soaked chia seeds, also add bulk and water to stool (1-2 tbsps. daily is plenty).
6. Improve bowel flora – introduce some cultured and fermented foods and/or take a probiotic supplement. Yoghurt, sauerkraut, miso, are good natural sources of probiotic.
7. Add Magnesium. Magnesium aids muscle relaxation. Stress tends to deplete magnesium levels and thus can lead to constipation 400mg-2000mg per day is a good amount for most people. A high dose in mg can cause diarrhea, especially if using poorly absorbed mg sources. Magnesium citrate or magnesium hydroxide are very good at supporting bowel motility and softening the stool.
8. Perform stress management techniques. Diaphragmatic breathing especially, has a calming effect on the body but can also help aid peristalsis as you use the diaphragm.

If the above does not help then what might be a good idea is to then consider a stool test or look into other systems in the body to see if they are influencing digestive health.

Diarrhea

Diarrhea is a symptom and not a disease, however it is important to understand the underlying cause of the symptom.

Some may experience diarrhea as a result of inflammation in the bowel and conditions like Crohns, colitis or diverticular diseases, whereas others it may be due to a lactose intolerance, a food poisoning incident or excess of bile acids in the stool.

Diarrhea ultimately is the result of a transit time that is too fast where your faecal matter is not in the large intestine long enough for the water to be absorbed. This can be a problem because it means you may not be absorbing adequate water and certain minerals as well.

In acute situations it is more about letting the loose stools pass and ensuring that you maintain a good intake of water and if needed adding salts/electrolytes to the water as well. The acute incidents are typically the body getting rid of something it was not happy with and it is normal to not eat or feel hungry during that time. In fact, a fast with just water and salts if often the best approach with acute diarrhea.

If you are to eat something during acute diarrhea then the BRAT diet is often recommended and this involves mostly bland or binding foods, assuming they are foods that you typically tolerate.

It should be noted that excessive magnesium or vitamin C, particularly the ascorbic acid form can lead to very loose stools as well. As you take these supplements you should also note any changes in bowel habits.

If you suffer with chronic issues with diarrhea, then here are some other considerations:

• Consider food allergies or sensitivities, or perhaps undertake an elimination diet for a short while.
• Try the yeast saccharomyces boulardi. This competitive yeast has been shown to be very useful in combating travellers’ diarrhea.
• Try some probiotic foods or consider the use of an over the counter probiotic.
• Avoid sugar alcohols like xylitol, sorbitol, mannitol etc. These are sometimes used to sweeten foods, or you may find them on sugar free candy or chewing gum.
• Try a period not eating dairy, in particular high lactose dairy like milk, foods containing milk powder, cheeses, yoghurt etc.

Inflammatory Bowel Disease – Crohns and Colitis

Inflammatory Bowel Disease (IBD) often results in very erratic stools and during acute flares often very watery and frequent bowel movements including loss of blood. It is crucial that acute IBD be managed acutely, however when it comes to chronic management of IBD, maintaining remission or preventing IBD in the first place, your nutrition, emotions and lifestyle can play a significant role.

Here is an introductory article reviewing some aspects associated to Crohns along with some recommendations. We are currently working on an article for colitis and diverticulitis which we will link in here once complete.

Haemorrhoids

Haemorrhoids are something that can cause a significant amount of pain when passing a stool or even when sitting down. In some instances, they can cause bleeding.

Haemorrhoids occur when blood vessels in and around the anus swell and stretch under pressure. Often, they occur as a result of excessive straining when going to the toilet, so a large amount of people with haemorrhoids also suffer with bouts of constipation as well. Other risk factors include heavy lifting, sitting for long periods, alcohol consumption and pregnancy, especially childbirth and following childbirth.

Sometimes people will notice bright red blood on the tissue paper when wiping, this is a sign of a fresh bleed in that area.

Understanding your risk factors is the first step in establishing an approach to address them long term. Many of the recommendations to help with constipation also help with haemorrhoids in the long term, so review some of those recommendations.

Other recommendations to help with this include:

1. Not spending too long on the toilet
2. Take a bath, especially an Epsom salt bath
3. Use a salve to apply to the effected and inflamed area. A salve containing witch hazel can be good for soothing tissue in that area.

Testing for Colon Health

Your first step is to always speak with your Doctor and Potentially gastroenterologist about your symptoms. If you manage to rule out red flags but are still no closer to resolving your issues then there are certain tests that are worth exploring, in particular a comprehensive stool test.

These types of tests are easily accessible through any Functional trained health practitioner and help to explore the following areas:

• The diversity and abundance of certain types of bacteria, yeasts, fungi, parasites etc
• Rule out chronic infections
• Understand how the immune system is functioning in the gut
• Establish inflammation levels in the bowel
• Assess the ability to digest foods
• Assessment of SCFA levels or the bacteria that produce SCFAs

With this information you can then create a plan of action to bring better balance to the large intestine and see how this impacts your symptoms.

It is also worth noting that in many instances, the health of the large bowel or symptoms in that area are affected by other systems and hormones in the body, especially thyroid hormones, stress hormones, sex hormones and more. If you scored high in other areas then we recommend also looking to improve those areas as well, with an initial focus on just optimising and elevated nutrition and lifestyle scores on your health questionnaire.

Additional Resources

Books

• Digestive Wellness – Elizabeth Lipski PhD
• Breaking the vicious cycle – Elaine Gotschall
• 10% Human – Alanna Collen
• Gut – Giulia Enders
• The Mind-Gut Connection – Emeran Mayer MD

Articles

• 5R approach to restoring gut health
• Foods that support a healthy digestive system
• Understanding Fibre
• What are phytonutrients