Are you starting to notice new or increased digestive issues in your 40s?
Indigestion, reflux or heartburn, gas, bloating, loose or urgent stools, constipation or a confusing mix of both?
These symptoms might be common but they are NOT NORMAL!
They are your body’s way of letting you know something is awry with your digestion and gut health – and they mustn’t be ignored. Pesky gut symptoms aside, the health of your gut and your ability to digest your food is CRUCIAL for your overall health and wellbeing including immunity, hormone balance, metabolism, brain health and disease prevention. As Hippocrates once said; “All disease begins in the gut”.
The good news is that in most cases some simple changes make a BIG difference. In other cases, there might be some deeper work to do to find resolution, but it CAN be done!
In a previous blog, I explained the link between your gut and your ability to break down and clear out used oestrogen for optimal hormone balance. In this blog I’ll explain how the digestive process works, what can go wrong and some top tips for improving and optimising your gut health straight away.
The digestive process 101
The digestive process is basically a series of actions that break down your food into smaller, simpler molecules so that the nutrients can be absorbed and used by the body.
Digestion starts before your meal even begins!
The smell, sight and preparation of food stimulates your saliva glands to start producing saliva, which triggers your digestive organs to start preparing for the breakdown of food and absorption of nutrients. Your saliva actually contains some initial enzymes that start the process of food breakdown.
Once you start to chew, your teeth and saliva work together to break the food down into smaller pieces, forming it into a liquid, known as a bolus or soft, moist mass of chewed food which is then swallowed. The bolus of food then travels down the oesophagus and enters the stomach where it’s further broken down and mixed with stomach acid.
Stomach acid, also known as gastric acid, is produced by the cells in the lining of the stomach and its job is to neutralise any harmful bacteria or other microorganisms that may be present in the food plus help with the breakdown of proteins and absorption of some key nutrients, such as vitamin B12 and iron.
The stomach then slowly releases the resulting liquid mixture, known as chyme, into the small intestine where the majority of nutrient absorption takes place. This triggers the release of Cholecystokinin (CCK), a hormone released from the small intestine in response to fat and protein. CCK stimulates the release of pancreatic digestive enzymes into the upper part of your small intestine (the duodenum), as well as the contraction of the gallbladder to release bile to help break down fats.
Digestive enzymes and bile liberate nutrients from your food for absorption through the gut lining into the bloodstream for use by the different systems, organs and cells in the body.
Then the digestive process moves into the large intestine, which is the final part of the digestive tract and also known as the colon. The large intestine is primarily responsible for;
- absorbing water and electrolytes (from the chyme), which helps to form solid faecal matter in preparation for a healthy, fully formed bowel movement and,
- even though most nutrients have already been absorbed in the small intestine, some other key nutrients are produced by gut bacteria in the large intestine for absorption into the bloodstream, such as vitamin K and biotin.
The trillions of bacteria in the large intestine play important roles in many different functions in the body including regulating the immune system, metabolism and weight, energy production, neurotransmitter production and hormone metabolism. Your gut bacteria, which comprises bacteria, viruses, fungi, and other microbes, also form a protective barrier in the gastrointestinal tract, preventing harmful bacteria from colonising and causing trouble, such as fermentation of undigested food, IBS symptoms and infections.
Gut bacteria can stimulate the immune system to produce antimicrobial compounds and other immune chemicals that can help to protect the gut lining from harmful bacteria and pathogens. This helps to maintain the integrity of the gut lining and prevent a situation known as ‘leaky gut’ or ‘intestinal permeability’ which would allow the entry of harmful substances and bacteria into the bloodstream.
The entire digestive process is controlled by the nervous system and specific hormones that regulate the timing and amount of stomach acid and digestive enzymes produced, as well as the movement of food through the digestive tract (also known as gut motility).
As your nervous system plays such a crucial role in the digestive process and gut motility, it’s crucial to consider the impact of stress on the digestive process. Chronic stress, eating when stressed or on the go and rushing your meals will negatively (and significantly) impact your ability to breakdown and digest your food and therefore your absorption of nutrients from your food.
Your ability to digest food is CRUCIAL for your overall health and wellbeing – physically, cognitively and emotionally.
What can change in your 40s?
Changes in gut motility
The hormonal shifts and changes of perimenopause can impact digestion and gut health in various ways. One of the most common digestive symptoms during perimenopause is bloating. Erratic fluctuations of oestrogen and declining levels of progesterone can cause gut motility (contraction and relaxation of the muscles throughout the digestive tract) to slow down, resulting in constipation, gas, bloating and gastric reflux (heartburn). Changes in gut motility can also cause stools to be looser or more urgent due to inefficient digestion of food and it can often be a confusing and frustrating mix of the two.
You may have noticed that you experience heartburn just before your period, which is likely because oestrogen is at its lowest in the few days leading up to your period, and low oestrogen can impact gut motility and cause gastric reflux.
Changes in gut bacteria
Oestrogen levels have been shown to impact the diversity and amount of healthy, protective gut bacteria, leading to a situation known as ‘gut dysbiosis’ or bacterial imbalance in favour of unfriendly strains. The crashes of oestrogen in the rollercoaster and then the subsequent decline in oestrogen later in your 40s and eventual loss of it at menopause can significantly impact your gut microbiome
Gut dysbiosis can lead to a variety of digestive and non-digestive symptoms including bloating, gas, diarrhoea, constipation abdominal pain, food intolerances, energy issues and fatigue, underactive thyroid, blood sugar imbalances, weight gain and changes in body composition, low immunity, skin issues such as acne or eczema, mood issues and sleep issues.
Where things can go wrong in the digestive process
1) Maldigestion + malabsorption
This starts to occur when food isn’t properly broken down and absorbed in the digestive system due to a deficiency or absence of chewing, stomach acid, digestive enzyme and bile secretion, leading to incomplete digestion and poor nutrient absorption. The healthiest diet in the world is no good to anyone if it is not being broken down properly so that all of the big and small nutrients are absorbed into the bloodstream/body.
Main causes of maldigestion + malabsorption include:
- Lack of sight, smell and thought of food before starting eat
- Lack of chewing
- Stress, nervous system dysregulation
- Lack of stomach acid
- Eating on the go or too fast
- Low digestive enzyme secretion
- Low bile secretion
- Dysbiosis (gut bacterial imbalances), including infections, parasites, yeast overgrowth, pathogenic bacteria
- Poor diet e.g. high refined carbs, trans fats and ultra processed foods
- A defective gut lining (‘leaky gut’) that allows harmful bacteria, microbes and other toxins to ‘leak’ out of the gut and into the bod
- Small intestinal bacterial overgrowth (SIBO)
- Overuse or chronic use of antacid and proton pump inhibitor medication, anti-inflammatory medications and antibiotics
Symptoms of maldigestion malabsorption include:
- Gas and or bloating after meals
- Bloating a couple of hours after eating a meal
- Loose stools, urgent stools
- Low energy or fatigue
- Nutrient deficiencies, which may present in a variety of ways
2) Immune system activation and chronic inflammation
If point 1 above is the case for you, then there’s likely to be some inflammation in the gut too and some immune system activation.
Did you know that 80% of your immune system is located in and around the gut lining?!
Within the lining, there is a complex network of cells and tissues that work to defend the body against harmful pathogens and foreign substances. The gut-associated lymphoid tissue (GALT) is a major component of the immune system in the gut and is made up of various types of immune cells.
So, when gut lining becomes inflamed, which maldigestion can cause, it can create a situation of low-grade but chronic systemic inflammation where immune system chemicals are released at a low grade level, causing low-grade flu-like symptoms such as fatigue, headache, foggy brain, low mood and muscle and joint aches but also underlie the development and or progression of autoimmune diseases such as Rheumatoid Arthritis and Hashimoto’s Disease.
Over time, gut bacterial imbalances and/or chronic stress can cause the gut lining to become permeable (also known as ‘leaky gut’) which allows gut toxins, undigested food particles and bacteria to ‘leak’ through the gut lining and enter the bloodstream and elicit an immune response, which results in systemic inflammation.
Inflammation messes with your hormone production and their communication plus all of the symptoms I’ve already mentioned here as well as weight gain and trouble losing it.
3) Gut bacterial imbalances (dysbiosis)
Dysbiosis is a term used to describe an imbalance or disturbance in the gut microbiota, which is the collection of trillions of microorganisms that live in the gut. Dysbiosis occurs when the normal (healthy) balance is disrupted in favour of higher levels of potentially harmful, disease-causing strains of bacteria, yeasts, viruses and parasites.
Gut bacterial imbalance can be caused by a variety of factors such as overuse of antibiotics, a diet high in ultra processed foods and sugar, stress, chronic inflammation and environmental toxins. It can lead to a range of health issues including a collection of gut-related symptoms and those associated with an irritable bowel, autoimmune disorders, allergies and cognitive and mental wellbeing challenges.
Restoring the balance of microorganisms in your gut is essential if you want to address and restore health whether digestively and or generally. It’s important to have a diverse range of different species living in your gut that all work synergistically together.
8 steps to better digestion and a healthy gut
- TAKE SLOW DEEP BREATHS BEFORE EATING
Taking deep breaths before eating can help to calm your nervous system and turn off the “fight or flight” stress response. When the stress response is activated digestion is shut down.
- CHEW, CHEW + CHEW!
This is absolutely CRUCIAL! Chew every mouthful REALLY well (almost to liquid) before swallowing.
- EAT A DIVERSE VARIETY OF COLOURFUL PLANTS EVERYDAY
The fibre from colourful plants helps to feed the beneficial bacteria and allow it to thrive plus the various compounds found in these plants support the health of the gut lining and reduce inflammation. ‘Colourful plants’ means vegetables, berries, herbs, spices, nuts, seeds and whole grains. In your weekly shopping, aim to include vegetables and berries from all of the colour categories: green, orange, yellow, red, purple, brown and white/beige. Go for plenty of dark green leafy veggies as your base and add in plenty of colour on top, the more variety the better. Aim to eat between 20 and 30 different plants each day which is actually easier than you might think. For example, eat a salad made with a base of 3-4 different green leaves, 2-3 herbs such as coriander, basil and parsley, grated beetroot, grated carrot, red chilli, red onion, tomato, cucumber and avocado; that’s 14 already! Have a stir fry for dinner with garlic, ginger, broccoli, green beans, yellow bell pepper and purple cabbage plus dried spices like paprika, cumin and turmeric with brown rice and that’s another 10!
- INCREASE BITTER + ENZYME-RICH FOODS
To aid digestion and support bile flow, include plenty of chicory, watercress, rocket, ginger, artichoke and cumin.
- INCLUDE 1-2 TABLESPOONS OF GROUND FLAXSEED DAILY
Mix it into plain yoghurt and smoothies, sprinkle it over salads and stir fries.
- INCLUDE FERMENTED FOODS
These are foods that contain friendly bacteria (probiotics). Aim to have a daily serving of raw unpasteurised sauerkraut (fermented cabbage), kimchi (Korean fermented cabbage), live natural yoghurt and kefir.
- INCLUDE PREBIOTIC FOODS
Prebiotics are a type of dietary fibre that provide a food source for the beneficial gut bacteria (probiotics). Unlike probiotics, which are living microorganisms, prebiotics are non-digestible carbohydrates that are resistant to digestion in the small intestine and reach the large intestine intact, where they are fermented by gut bacteria, which promotes the growth and activity of beneficial bacteria. Prebiotic foods include onions, garlic, leeks, asparagus and Jerusalem artichoke.
‘Resistant starches’ are also a form of prebiotic fibre. Resistant starches are embedded in the coating of seeds, nuts, whole grains, lentils and beans and other forms of resistant starch include powders such as inulin and raw potato powder, green bananas, and white potatoes and rice that has been cooked and then cooled.
- KEEP YOUR DIGESTIVE TRACT HYDRATED
The amount of water needed per day will vary from person to person but go for a minimum of 1.5-2 litres of water (including herbal teas) to keep your colon hydrated and toxins and waste moving through it and out of the body.
In summary, the digestive processes contains many, intricate steps and having a better understanding of these steps can help you understand where things can go wrong and encourage you to give your digestion more attention at every mealtime. Digestive health and go awry at any stage of life for anyone, but in your 40s, the hormonal changes we experience can add an additional layer of complexity which just means we need to pay EVEN more attention to digestion and gut health from now on. Whilst the digestive process and what can go wrong can seem quite complex, I hope you can see that the steps you can take to support it all are not so complex at all! So, I hope you have found the above 8 steps to better digestion and gut health empowering and that you will take action where needed.
There is an entire module dedicated to gut health inside my Thrive Through Perimenopause online group programme and if you’d like to learn more about the entire programme and how to join, click here or if you feel you need 1-2-1 support, head over here or drop me an email at email@example.com.