Taking care of your digestive system is important when it comes to your overall physical and emotional wellbeing. A healthy digestive system ensures that the food you consume gets broken down properly and that the nutrients in those foods get absorbed by your body. When the microorganisms in your gut are in perfect balance, you are also more likely to have a stronger immune system and better hormonal health and less likely to develop digestive diseases.
World Digestive Health Day is celebrated every year on 29 May, to raise awareness of various digestive conditions and the importance of caring for your gut health every day.
We asked Dr Stephen Tsao, Specialist in Gastroenterology and a consultant at Raffles Internal Medicine Centre, for his tips to keep your digestive system in tip-top shape.
Q: What are the most common digestive diseases among Singaporeans?
Dr Tsao: The most common ones I see, and their symptoms, include:
- Gastro-oesophageal reflux disease (GORD) – Symptoms: heartburn, lower chest discomfort, the feeling that your food is “stuck” upon swallowing
- Non-ulcer dyspepsia (NUD) – Symptoms: upper abdominal discomfort (especially after eating), feeling bloated post-meal, poor digestion, nausea, belching
- Irritable bowel syndrome (IBS) – Symptoms: abdominal discomfort or pain (can be more generalised), can be associated with diarrhoea or constipation or both, bloating and flatus
- Constipation – Symptoms: lack of bowel movement, difficulty with defaecation, hard, dry stools, passing pellet-like stools
These diseases are closely associated with our lifestyle habits, for example, poor dietary choices, lack of rest, smoking and alcohol consumption, and insufficient physical activity. Patients with these symptoms usually have normal investigation results, which means that there are no pathological issues with their digestive system.
More specific triggers or causes of these diseases include:
- GORD: Generally, smokers are more prone to experiencing acid reflux. Our dietary choices and eating habits also have a direct effect –common food triggers include carbonated drinks, alcohol, oily food and chocolate, to name a few. Overeating may also cause acid reflux.
- NUD: Certain foods may trigger the symptoms – oily food, spicy food and coffee, for instance. Irregular meal times and overeating are frequent triggers as well.
- IBS: Certain foods may trigger symptoms like pain and bloating. Fermentable sugars (fermentable oligosaccharides, disaccharides, monosaccharides and polyols [FODMAPs]) in our diet may also be a contributing factor. These sugars are poorly absorbed and may lead to symptoms. Avoiding or excluding foods that are high in FODMAPs, like stone fruits, lactose-containing foods, and sweeteners like high-fructose corn syrup and agave, may improve symptoms.
- Constipation: This condition is often due to the inadequate intake of dietary fibre and/or fluids. We need both in order to maintain regular bowel movements. A lack of physical activity can also be a contributing factor.
Stress is one common factor that can lead to all of the above diseases and conditions. Stress can negatively impact our general wellbeing and in turn trigger these symptoms. It’s common for patients to complain of poor sleep quality and inadequate rest as well, which may worsen their digestive symptoms.
Find out more on how to get good quality sleep and a better night’s rest.
Q: Digestive cancers are on the rise. What are the statistics for these cancers in Singapore?
Dr Tsao: According to 2016-2020 data published by the Singapore Cancer Registry:
Male (Total cancers: 39,393)
Colon Cancer [ranked 1] – 16.5% (6,513 cases)
Gastric Cancer [ranked 7] – 4.3% (1,698 cases)
Female (Total cancers: 41,360)
Colon Cancer [ranked 2] – 13% (5,364 cases)
Gastric Cancer [ranked 9] – 2.8% (1,151 cases)
Q: More and more young people are being diagnosed with colon cancer. Can you explain why?
Dr Tsao: Clinical studies have indicated a rise in the incidence of colon cancer in people below 50 years old. At present in most countries, colorectal cancer screening starts at 50 years old, however, there is a discussion to lower the starting age to 45.
Early-onset colon cancer more often has a genetic component, but the majority of these cases is sporadic (that is, isolated). It’s therefore believed that lifestyle factors like excess body weight, high consumption of processed meat, low consumption of dietary fibre, smoking, alcohol consumption and low physical activity, can increase one’s risk of developing colon cancer at an earlier age.
Q: How can we keep our digestive system healthy and reduce our risk of digestive diseases?
Dr Tsao: For one, I advise you to stop smoking and to only drink alcohol in moderation. When it comes to diet, opt for fresh, lean meat over fatty, processed meat, and consume plenty of vegetables and fruit so you get adequate dietary fibre. Besides being high in fibre, fruit and vegetables are also packed with important vitamins, minerals and antioxidants.
People with IBS-type symptoms may wish to explore low-FODMAP diets.
Don’t forget to drink 1.5 to 2 litres of fluid every day – plain water is best. If you are physically active, spend a lot of time outdoors and perspire a lot, drink more.
Finally, exercise regularly and make sure you get sufficient rest.
Here are more tips to help keep your gut healthy.
Q: How important is dietary fibre for digestive health?
Dr Tsao: Dietary fibre promotes healthy and regular bowel movements, to help rid the body of waste. Infrequent bowel movements may contribute to digestive issues such as bloating and abdominal discomfort. Fibre also helps lower our cholesterol by reducing its ability to be absorbed by the body.
Foods high in fibre include broccoli, beans, berries, whole grains, apples, nuts and avocado.
Q: How do processed foods negatively impact our digestive health?
Dr Tsao: Food processing alters the provision of macronutrients to our gut. Processed foods are also high in fat and sugar and low in dietary fibre, which may negatively affect our gut bacteria by causing an imbalance in our gut microbiome.
Q: What’s considered a healthy bowel movement, in terms of frequency and the ease of the movement? And how do you know if you’re constipated?
Dr Tsao: Most people move their bowels either daily or every other day. However, some individuals move their bowels several times a day or once every few days – this is normal for them.
Common symptoms of constipation include a reduction in the frequency of bowel movements, difficulty moving your bowels, inadequate emptying of your bowels, and passing hard, dry stools.
Q: How do prebiotics and probiotics help with our digestive health?
Dr Tsao: Studies have found that our gut microbiome plays an important role in maintaining our digestive health. On the other hand, a disturbance in the microbiome may trigger a negative immune response, increasing our risk of developing various diseases. Taking care of our gut microbiome is therefore essential. Prebiotics are a source food for our gut microorganisms, helping them grow and thrive. Probiotics, on the other hand, contain a variety of microorganisms that are beneficial to our gut bacteria and can help us maintain a healthy gut microbiome.
Promotion: Keep your gut microbiome healthy with Raffles ProBio Daily Defense (60 capsules for $62.10). ProBio Daily Defense helps to promote and support intestinal health and immune health. These capsules contain probiotic strains that are resistant to stomach acid, ensuring that live bacteria reach the intestine. For more information, go to raffleshealth.com/raffles-probio-daily-defense-60s.html.
SAFRA members can enjoy 15% discount off regular-priced Raffles Health supplements. Valid at Raffles Health retail store at Raffles Hospital only. Other terms and conditions apply.
Note: Please consult your GP or physician before embarking on any diet or treatment plan.
SAFRA members enjoy corporate rates on General Practice (GP) Services at Raffles Medical clinics, and Enhanced Health Screening from $477.90 at Raffles Health Screeners. For more details, click here.
For the full list of healthcare benefits for SAFRA members, go to safra.sg/promotions/
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