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Many of us focus more on how our bellies look on the outside than how well they function on the inside. But more than 100 million women in the United States have gut health issues, and women are more likely to experience chronic digestive diseases than men.

The health of your gut may not seem nearly as important as, say, heart health or brain health. But, your digestive system is so complex — and so vital to your overall well-being — that it is often referred to as your second brain.

Your belly brain includes some 100 million neurons — the same type of cells you have in your “real” brain. It also comprises more than half of your immune system. And it produces 95 percent of your serotonin and 50 percent of your dopamine, two chemical messengers called neurotransmitters that are essential for sleep, memory, metabolism and emotional well-being.

While it’s common for women to tough out the unpleasant symptoms of gut problems, dysfunction in your gut can have a significant impact on your mental health, your hormones, your periods, your skin, your joints, your energy, your immunity, your risk of developing an autoimmune disease — not to mention your quality of life.

Don’t ignore tummy troubles.

When it’s healthy, your digestive system works so well that you may not think much about it. But when the gut needs your attention, it certainly knows how to get it.

These complaints from your gut should not be ignored. Feeling bloated, being constipated, having diarrhea or experiencing regular or frequent bouts of nausea, indigestion or heartburn is not normal, even if it is common.

Many women endure these problems and treat them as part of life — perhaps because talking about them is uncomfortable or because their symptoms have been overlooked or dismissed in the past.

Not all gut health issues lead to more serious problems, but any one of them can create a serious decrease in a woman’s quality of life. Addressing tummy troubles can not only bring relief, but also safeguard health.

What’s different for women?

Here’s a fun fact: Women are more likely than men to be supertasters — they can taste both bitter and sweet foods more strongly than men.

In fact, women have increased sensitivity to different types of stimulation throughout their GI tract. Those differences can lead to not-so-fun problems for women, such as:

  • Heartburn: Women’s esophageal muscles squeeze shut with more force than in men, so women who experience heartburn generally have less damage in their esophagus than men do, but their sensitivity to irritants means women tend to experience heartburn more strongly than men.
  • Irritable bowel syndrome (IBS): That same sensitivity also makes women more prone to IBS, a problem with the function of the large intestine that can cause abdominal pain, bloating, constipation and diarrhea. Unlike inflammatory bowel disease, IBS does not damage the intestinal lining; however, it is a sign that the bowel is not functioning as it normally would.
  • Inflammatory bowel disease (IBD): Changes in hormone levels due to menstruation, pregnancy or aging may be one reason that women are twice as likely as men to develop inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, which involve chronic inflammation of the digestive tract and can be debilitating and even life-threatening. Hormones may also influence the development of gallstones.
  • Pain and discomfort: Women’s digestive systems are also slower to empty from the stomach, the gallbladder and the large intestine, which may explain why women experience nausea and bloating, constipation and gallstones more often than men.
  • Problems with medications: Women have different enzyme systems than men in the small intestine and the liver, which can cause some women to respond differently to certain medications than men do.

Differences between men and women in how their digestive tracts function may be related to hormones in the body, the way the digestive system communicates with the brain or other factors. Even their construction is slightly different:

Women’s intestines are 10 centimeters longer than men’s, and because they share abdominal space with the reproductive organs, a woman’s gastrointestinal organs are usually more crowded in the abdominal cavity than a man’s.

It is important to understand the differences between the male and female GI tracts as these present unique symptoms in women (in diseases that can affect both men and women) or even exhibit distinctive diagnoses in women.

Happy belly, happy life.

Despite these differences, the ways to keep a belly happy are the same for women and men. Here are a few, effective tactics:

  • Drink more water and less alcohol and caffeine.
  • Eat a variety of mostly fresh, unprocessed foods. Prioritize fruits, vegetables, whole grains, beans and nuts — women need at least 25 grams of fiber each day.
  • Go easy: Eat small, more frequent meals to avoid overwhelming the GI tract. Chew your food thoroughly — it can ease the digestive process.
  • Manage your stress levels.
  • Mind your meds: If you are taking over-the-counter medications or prescription medications that are upsetting your stomach, ask your doctor about alternative solutions. Women use aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen more often than men, and those drugs can cause painful inflammation of the stomach known as gastritis.
  • Move your body. Physical activity gets your colon moving, which leads to more regular bowel movements. Exercise can also help manage irritable bowel symptoms.

These lifestyle habits can keep your gut happily humming along. They also happen to be helpful for preventing and managing lots of other physical and mental health issues.

Call in the reinforcements.

Sometimes digestive problems need more than just these lifestyle adjustments. If you are struggling with symptoms, consider whether you might benefit from getting help from a health care provider.

Take counsel.

Research showing the link between stress, mental wellness and gut health just keeps getting stronger. If you are having trouble managing stress or symptoms of anxiety and depression, talking with a counselor can be deeply beneficial — for both of your brains. A doctor can also prescribe antidepressants, which in some cases can help relieve digestive symptoms as well as other symptoms of anxiety and depression.

Pay attention to the microbiome.

The lining of your gut, like every surface of your body, is covered in friendly bacteria that help you digest food and absorb or synthesize nutrients. This tiny, powerful micro-ecosystem is called the microbiome, and while there is still a lot we don’t know about it, studies show that it plays an important role in gut health — and in overall health.

A good example is IBS, a condition affected by the microbiota — gut-brain axis.

Eating prebiotic and probiotic foods can help restore or maintain balance in your microbiome.

  • Prebiotic foods, such as whole grains and some fruits, give your gut microbiome good fuel. When your gut bacteria eat prebiotics, they create short-chain fatty acids that are used by gut cells, immune cells, the heart, and many other organs and cells to promote immune function and health.
  • Probiotic foods such as fermented yogurt, pickles, kimchee and kombucha add more live bacteria to your happy microbiome family.

Numerous products are marketed as pre and probiotics. Physicians can recommend probiotics beneficial in certain disease states. A registered dietitian can help you find the right probiotic which has the right strain and colonies of bacteria that can be beneficial to gut health.

Treat digestive diseases.

There are several common digestive diseases that can plague women and men, and that require treatment by a provider.

  • Celiac disease — An autoimmune mediated gluten sensitivity affecting one percent of the population
  • Diverticulitis — Inflammation of pouches that form in the digestive tract
  • Gall bladder disease — Women often have a slower emptying gallbladder, predisposing them to more gallbladder disease, such as gallstones.
  • GERD — A condition in which stomach acid or bile irritates the esophageal lining. Interestingly, in women, the sphincter between the stomach and esophagus closes more tightly, so there is less damage to the esophagus. However, women have increased sensitivity, so they are often more symptomatic.
  • Irritable Bowel Disease — A group of conditions that cause abdominal pain and changes in bowel habits. It is more common in women than men.
  • Inflammatory bowel diseases — Chronic immune mediated inflammation of the GI tract.
  • Colon cancer — It is the third most common cancer in women. It is a preventable cancer, and early detection is a lifesaver.

If you are experiencing symptoms any of these conditions, schedule an appointment with your provider to see if you need testing for a digestive disorder.

Understand food allergies or sensitivities.

Food sensitivity or intolerance is different than a food allergy, which triggers an immune response that can be severe and even life threatening. If you have a food sensitivity, it means that your body can’t properly digest a certain food, or a food bothers your digestive system, causing abdominal pain, nausea, gas and diarrhea.

The most common food sensitivities include:

  • Lactose intolerance caused deficiency in the enzyme lactase, not to be confused to milk allergy. Milk allergy is a more severe form where there is a true allergy to the milk protein.
  • MSG, which is an additive found in many foods.
  • Gluten, a protein found in wheat, barley and other grains. Gluten intolerance is different from celiac disease, an autoimmune-mediated sensitivity to gluten. Unlike celiac disease which causes more long-term effects on the body than gluten sensitivity, gluten intolerance results in short-term symptoms, such as bloating.

Today, there are a lot of at-home food sensitivity tests on the market, but the science behind them is not conclusively shown to be effective. Moreover, being told that you should avoid several foods or entire food groups due to a food sensitivity may lead to problems with nutrient deficiency and disordered eating. If you are concerned about food allergies and intolerances, press pause on ordering that sensitivity test and talk to your doctor first.

When in doubt, ask your health care provider.

Symptoms of digestive dysfunction can be confusing: they can overlap; they can mimic other problems; they can wax and wane in severity. The bottom line? Don’t suffer through gut issues — get help. Your whole body, including both your brains, will benefit.

About WakeMed Gastroenterology

Suffering with tummy trouble? Our advanced team of dedicated physicians provide exceptional care, diagnostics and treatments for patients suffering with a range of gastrointestinal issues. We also have a multidisciplinary team specialized and trained in women’s issues in gastroenterology — comprising of physicians, dietitians and physical therapist.

Learn more about WakeMed Gastroenterology. Call 919-350-5318 to schedule an appointment.

About WakeMed Primary Care

Not sure of the root of your stomach pain? WakeMed Physician Practices features board-certified primary care, internal medicine and family medicine physicians conveniently located throughout the Triangle. Our exceptional and compassionate providers and care teams pride themselves on developing long-term relationships with their patients and their families to treat a variety of conditions.

Learn more about WakeMed Primary Care. Call 919-350-9100 to schedule an appointment.



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Deepa Reddy MD