Digestive Health

The body uses food as fuel to provide energy and raw materials for work, play and growth. The digestive system helps to break down the different foods we eat into a form that is useful to the body's cells. It also helps to transport the various components of these foods to every part of our body.

A large component of the digestive system is the digestive tract, or gastrointestinal (GI) tract. The GI tract runs from the mouth to the anus and is approximately nine meters long, from end to end. Damage or improper care of the GI tract would result in the inefficiency of energy delivery to the cells of the body. In turn, the body's cells would be unable to obtain the energy needed for proper functioning.

Some common gastrointestinal complications may include:

Celiac Disease
Constipation
Gastroesophageal Reflux Disease (GERD) or Heartburn
Inflammatory Bowel Diseases: Crohn's and Ulcerative Colitis
Irritable Bowel Syndrome (IBS)
Lactose Intolerance

Celiac Disease

Definition
Celiac disease is a condition affecting the digestive tract. It is a condition in which the inside lining of the small intestine is damaged by the individual's hypersensitivity to gluten. For this reason, Celiac Disease is also known as gluten-intolerance. The destruction to the absorptive surface results in the body's inability to digest and absorb nutrients such as protein, fat, carbohydrates, vitamins and minerals that are necessary for good health.

Gluten is a structural protein component that is commonly found in wheat, rye, barley, and oats. The toxic part of gluten is the prolamin component:
The gluten found in corn and rice does not contain this toxic portion and can be consumed by those diagnosed with Celiac Disease.

Gluten has made itself useful in the production of many packaged and processed foods due to its binding properties in flour. For instance, gluten can be found in various breads, baked goods and some less obvious foods such as ice cream.

Statistics

An estimated 1 in 200 people in Canada are affected by Celiac Disease.

Symptoms

A range of symptoms may be present. Symptoms may appear singularly or as a combination of the following:

Some of these symptoms are not unique to Celiac Disease, and can also occur in many other more common diseases.

Generally, symptoms of untreated Celiac Disease indicate that malabsorption is present due to the damaged small intestine.

Diagnosis

Diagnosis may come from one or more of the following:

Treatment

Currently, there is no known cure for Celiac Disease. However, effectively treating and controlling the condition requires following a diet that is strictly gluten-free for life. Removing gluten from the diet entirely results in a disappearance of symptoms as the intestinal lining is permitted to heal.
It then becomes necessary to receive knowledgeable dietetic counseling and to frequently become updated with the contents of commercial foods. In addition, the processed and packaged foods today have many hidden sources of gluten. Particular care must be taken in the selection of soups, luncheon meats and sausages.
Some hidden sources of gluten include:
When purchasing commercial food products, make sure to read the ingredient list carefully. Any products containing even the slightest amount of gluten must be avoided. Ingredients that have an unspecified grain origin should be also avoided.
More information can be sought from:

Canadian Celiac Association
5170 Dixie Road, Suite 204 Mississauga, Ontario
L4W 1E3

Call toll free: 1-800-363-7296
Phone: 905-507-6208
Fax: 905-507-4673
Email: celiac@look.ca
Website: www.celiac.ca

What is Gluten-Free and What is Not?

Food Group Foods Allowed
Grains Rice, corn, soy, arrowroot, potato, and tapioca-containing products
Breads Breads may contain flour prepared from white/brown rice, potato, tapioca, arrowroot, pea, corn, or bean,
Cereals Including those from corn meal, millet, buckwheat, hominy, puffed rice, and cream of rice
Malt/Malt Flavouring Derived from corn
Pastas Made from rice, corn, and/or beans
Vegetables Fresh, frozen, dried, or canned products with labels indicating they are free of thickening agents (because they often contain wheat flour)
Fruits Fresh, frozen, dried, or canned
Meats Fresh, frozen, and canned
Dairy Products All aged hard cheeses
Pasteurized processed cheeses - cottage cheese, cream cheese
Ice cream free of gluten stabilizers
Salad Dressings Many, but not all salad dressings are gluten-free.
Apple, wine and rice vinegars are generally acceptable
Drinks & Juices Freshly brewed coffee, tea, chocolate made from powdered cocoa
Carbonated drinks and juices made from fresh fruit
Condiments & Additives Soy sauce not containing wheat or barley
Hydrolyzed or textured soy and corn vegetable protein
Corn malt
Starch (raw or modified from arrowroot, corn or maize, potato, and tapioca)
Vegetable gum from carob, locust bean, cellulose gum, guar gum, gum arabic, gum acacia, gum tragacanth, xanthan gum


Food Group Foods Not Allowed
Grains Anything made with or containing wheat, barley, rye, oats, spelt and kamut
Most packaged rice mixes, such as Rice-a-roni.
Breads, Cereals or Crackers Containing wheat starch, wheat and oat bran, graham, wheat germ, and bulgar
Malt flavouring of unspecified origin
Pastas Regular spaghetti, macaroni, and noodles
Vegetables Products containing thickening agents that may use food starches and stabilizers with
gluten (thickening agents often contain wheat flour)
Fruits As with vegetables, avoid prepared fruits containing thickening agents found in fruit pie fillings
Dairy Products Cheese foods including spreads, soft cheeses, and dips often contain gluten
Some ice creams may contain gluten ice cream stabilizers
Salad Dressings Containing grain vinegars including distilled, white vinegar or unspecified vinegar
Some contain emulsifiers and stabilizers with gluten
Drinks & Juices Some brands of flavoured coffee, herbal tea, and instant cocoa mixes, including malted milk

Grain-derived drinks including Ovaltine
Condiments& Additives Many soy sauces contain gluten
Products with grain vinegar, including catsup and mustard
Soups or broths containing bouillon
Unspecified texturized or hydrolyzed vegetable protein, vegetable gum from oats and any other product
containing an unspecified flour or cereal additive
Barley malt, wheat starch, caramel candy may contain gluten
Read labels on margarine to check for flour additives
Flavouring made with alcohol
Some spray coatings for "non-stick" uses have unspecified ingredients added

*Modified from NASPGHN


Gluten-free Recipes

50 Fabulous Gluten-free Recipes
Grammas Cookie's Kitchen

Reference

Canadian Celiac Association
NASPGHN - Celiac Disease: A Guide for Children and their Families
Simon Frasier University - About Celiac Disease

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Constipation

One of the most common gastrointestinal complaints in North America is constipation.

Definition

Constipation can be defined as infrequent or hard, dry bowel movements, or difficulty in evacuating stool. Usually it is a short-term disorder and is not always considered serious, although it can be troublesome.

Causes

The colon, or large bowel, functions to withdraw water from the liquid stool, so that by the time it reaches the rectum, the stool becomes soft. The extraction of excess water causes the stool to become hard and therefore difficult to expel.

A lazy colon is one that does not contract properly, or contracts too slowly that it fails to move the stool towards the rectum. In this case, too much water is absorbed and the hard, dry stool develops.

Conditions that can cause a sluggish contracting bowel include:

The Dietitian's Recommendations for Treatment

To correct and prevent constipation, it is essential to consume foods high in bran, fibre and roughage. A diet with sufficient fibre, 20 to 35 grams per day, helps maintain soft, bulky stool

Foods that add bulk to your diet:

See Guidelines for Good Nutrition - Dietary Fibre

Managing Mild-to-Moderate Constipation
References

American College of Gastroenterology
Jackson Gastroenterology

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Gastroesophageal Reflux Disease (GERD) or Heartburn

Definition

Gastroesophageal Reflux Disease (GERD) or heartburn is a common complication in which there is a backflow of acid from the stomach into the esophagus.

GERD is often unrecognized as its symptoms are easily misunderstood. It is generally a treatable disease, yet serious complications can result if left untreated or if treated improperly.

Reflux is the result of the relaxation of the muscle at the base of the esophagus, called the lower esophageal sphincter (LES), to the point at which it allows the acidic stomach contents to travel upwards and re-enter the esophagus.
Acid indigestion is the painful burning sensation that results from the irritation of the esophageal lining due to excessive exposure to stomach acid.

Symptoms
The Dietitian's Recommendations for Treatment

Possible treatment options can include lifestyle modifications, prescription medications, and/or surgery.
Dietary and lifestyle changes are among the most significant modification that can help alleviate the discomfort.
Some common approaches to help control GERD or heartburn:

Foods to Avoid
Eating Habits to Avoid
Lifestyle/Exercise Changes

Reference

American College of Gastroenterology
Canadian Association of Gastroenterology
GERD Information Resource Centre

Inflammatory Bowel Diseases: Crohn's and Ulcerative Colitis

Definition

Inflammatory bowel disease (IBD) refers to the development of inflammation in the small or large intestine lining. As a result, the inflammation interferes with the ability of the intestine to absorb and be motile (the ability of the bowel to contract and move food along the digestive tract). With abnormal ability to contract and abnormal ability to absorb, the bowel's function is impaired. There are two types of IBD, namely Crohn's Disease and Colitis.



Crohn's Disease is a chronic (ongoing) inflammatory disease that is known to cause patchy inflammation, ulcers, and bleeding in the digestive tract. It can originate anywhere within the digestive tract. Crohn's Disease tends to affect women more than men

Ulcerative Colitis affects only the inner layer of the colon, or large bowel. It begins in the rectum and spreads upward. Colitis is known to affect men more often than women.

Statistics

Approximately 150,000 Canadian men, women and children have IBD. Diagnosis usually is made in individuals between the ages of 15 and 25 years, or 45 and 55 years.

Causes

Currently, there is no exact cause of IBD; however, the following are some known facts of the disease:

Symptoms

The Dietitian's Recommendations for Treatment

Some individuals may need to reduce the amount of fibre intake or the amount of dairy products in the diet.

Generally, eating a healthy diet is the key to good health. Eating balanced meals means including a variety of foods from all food groups as outlined in Canada's Food Guide to Healthy Eating

Reference

American College of Gastroenterology
Crohn's and Colitis Foundation of Canada

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Irritable Bowel Syndrome (IBS)

Definition

Irritable Bowel Syndrome (IBS) is a gastrointestinal condition that is largely due to the abnormal functioning of the muscle in the large intestine, or colon.

Causes

Knowledge of IBS remains incomplete.

Statistics

It is estimated to affect 13% to 20% of Canadians, and is more commonly experienced by women than it is by men.
It usually starts at an early age (20s and 30s), and recurs from time to time. It rarely starts past the age of 55 years.

Symptoms

Individuals suffering with IBS have altered patterns of intestinal muscle contractions contributing the following symptoms:
The Dietitian's Recommendations for Treatment

Various therapeutic interventions have shown to reduce IBS symptoms. Such therapies include:
Dietary modification entails:
Reference

American College of Gastroenterology
Canadian Society of Intestinal Research
Jackson Gastroenterology

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Lactose Intolerance

Definition

Lactose is the natural sugar contained in milk and milk products. Individuals who are lactose intolerant lack an adequate amount of the enzyme lactase needed to completely digest, or break down, the lactose. Undigested lactose creates intestinal distress since the milk sugar remains in the colon and ferments.


Symptoms

Symptoms of lactose intolerance may include some or all of the following:
Individuals may experience such symptoms for 15 - 30 minutes to as long as several hours after lactose digestion.

Dietary Recommendations and Tips to Improve Tolerance

The level of lactose tolerance varies according to the individual; however, most people can digest small amounts of lactose in their diet.

Milk

Yoghurt

Cheese  

Reading food labels is important because foods other than dairy may contain lactose. Terms to watch for in the ingredient lists are: