Case Study: constipation and bloating

This month’s case study is 30 year old ‘Amy’ who came to the Clinic to help with constipation and bloating


For as long as I can remember I had had ‘sluggish’ bowels but always thought this was normal for me. I was talking to a friend about it and she was horrified to hear that I only opened my bowels once or twice a week (if I was lucky)! She asked if I felt unwell with it – bloated and tired and I admitted that I felt incredibly bloated but again just thought that was me and my body. I did find this quite unpleasant if I wanted to go out for the evening and wear something quite ‘figure hugging’ because I looked 6 months pregnant and felt very self-conscious. During the day I usually disguised this with baggy tops! I decided to visit my doctor to see if there was anything I could do. She suggested that I eat plenty of roughage in my diet including lots of bran and wholemeal bread. She also prescribed me a laxative.


I went away and put this into place and it sounded strange but my bowels seemed to be even more blocked and I was experiencing a lot more bloating and lower abdominal pain. All of the roughage just felt like it was swelling and ‘bunging me up’. I took the laxative which did get things moving, but left me feeling quite ‘raw’ inside. I told my friend about this and she suggested I should see a nutritionist who would know more specifically the foods to eat or cut out. She had been to see a nutritionist at The Dr Glenville Clinic for general health and highly recommended I go. I phoned the number straight away and explained to one of the practitioners what my symptoms were and she said they could help.


Before my first consultation I was sent a comprehensive questionnaire to complete and return for the nutritionist to review before meeting me. I was very excited by this and set about filling it in. It really made me think about how I was feeling and symptoms like lack of energy, bloating and excessive wind came up.


I met with the nutritionist 2 weeks later and she went through my questionnaire with me, asking me lots of questions and then summarising what she thought was happening and then giving me recommendations to help. The nutritionist explained that stress can be a major contributing factor to constipation.  The stress response in humans is designed to allow you to flee or fight a foe or enemy.  These occasions make extra demands on our energy and you would not be eating at that time.  Energy is therefore naturally diverted away from the digestive tract at times of stress.  The natural movement of the bowel stops (causing constipation) and the natural secretion of enzymes that help us to digest our food is reduced. She said that I should never ‘eat on the run’ and always set time aside for eating. I admitted that I was guilty of rushing my lunch at work and sometimes missing out altogether because I rarely felt hungry. She said this was commonly associated with constipation because if the bowel is not emptied the digestive system can feel like it is permanently full. 


The nutritionist was alarmed at how much wheat and bran I was consuming and I explained that my doctor had recommended this to ‘get things moving.’ She said that ironically, although high bran based diets have always been recommended, we now know that too much wheat can create more of a ‘binding’ effect and actually slow down gut function and make bloating a lot worse. She explained that more and more people are becoming intolerant to wheat because we simply overload our systems with it, plus the way that modern day wheat is grown and indeed loaves of bread are made is very different to 30 years ago. Modern day wheat has a higher gluten (protein) content making it ‘sticker’ and more indigestible.


I didn’t realise just how dangerous it could be not to have a daily bowel movement. She basically said that the toxins generated from our liver (from foods we eat, fumes we inhale and our own hormones) simply get reabsorbed back into the bloodstream, rather than being excreted through the bowel. In the longer term this can lead to malabsorption of vital nutrients, feeling lethargic, hormone imbalance and even an increased risk of colon cancer.


She asked me to avoid all wheat (including bread, pasta, cereals, biscuits and cakes) for the next month and use alternatives like brown rice, rye crispbreads and oats. I thought this would be really hard but so many places now offer wheat free options. The nutritionist also asked me to incorporate golden linseeds on a daily basis as these act as a natural ‘bulking agent’, thereby promoting a healthier motion, plus more effective and natural than the laxative my doctor had prescribed. She had asked me to increase my intake of water which was something I struggled with. She said that warm water with a little squeeze of fresh lemon makes it easier to drink.


The nutritionist recommended that I also perform a stool analysis to check my levels of good and bad bacteria as an imbalance of these can worsen the constipation. Of course, I had to start the programme first in order to get my bowels regulated before I could provide my samples!


Within 2 days my bowels were working! I could not believe the difference in my stomach. I had no bloating, I felt so much lighter and felt more energised. I managed to perform the stool analysis and sent my samples off to the lab as requested. It was actually a lot easier than I thought it would be! I was really enjoying my new way of eating and didn’t feel I was missing out at all. Even going out for dinner with friends there was always a wheat free option. I found that I was generally eating better and getting more fresh foods because where I would have eaten a sandwich for lunch I was having fish, hummus, eggs and salad.


We arranged my follow up consultation to allow time for the results of my stool analysis to be back. Before looking at the results, the nutritionist asked me how I had been getting on and I told her that I didn’t know myself! I had gone from having one or two bowel movements a week to going every day! The results of the stool test showed I had very low levels of the good bacteria, particularly bifidobacterium. She explained that having low levels of the good bacteria makes us more bloated and the bowels become more sluggish. She recommended that I take a supplement containing this good strain of bacteria to help ‘recolonise’ my colon.


The nutritionist was very pleased with my progress and recommended that I return in another 12 weeks to review me. She said that I may not need to avoid wheat altogether in the longer term, but to certainly keep it to the minimum and not go back to how I was when I first came to the clinic! I knew that I would never to that! All I can say is thank you so much to The Dr Marilyn Glenville Clinic for all their help and support and I just wish I had found out about them sooner.


This Christmas I’ll be wearing my party dress without worrying how bloated I look and I certainly won’t be tempted to eat all the bread rolls on the table!


Marilyn’s Comment


Constipation is such a common ‘condition’ in our modern day lives – we have less time to actually go to the toilet and our diets contain so much more wheat and processed foods and less fresh food. Unfortunately there is still a lot of confusion surrounding constipation and it is still widely recommended (particularly by the medical profession) that a high wheat-fibre and bran diet is consumed. However, this is just one case where in fact too much can make digestion worse. Providing good, wholesome substitutes are eaten in its place like brown rice and oats, there are no implications to cutting wheat (or certainly reducing it) out of the diet.


Amy’s story is a good example of just how important it is to listen to your body and not just ‘put up’ or ‘get used’ to a symptom. The digestive system is one of the most important systems in the body because if this isn’t functioning optimally it can have a wide ranging impact on our entire body.


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