Positive Health Online

Eight year old Rebecca came to see me with her mother. Rebecca's abdomen was permanently bloated and distended and she suffered from chronic constipation. She had been suffering symptoms for quite some time and numerous visits to the GP had resulted in laxatives.

She had been prescribed lycopodium by her homeopath and this had helped a great deal but only gave symptomatic relief.

Rebecca's general health was very good. Her diet was very well balanced and contained plenty of fruit and vegetables. She had not taken any antibiotics. Chronic constipation under these circumstances always leads me to suspect wheat and to a lesser extent, dairy produce as potential culprits. Rebecca's mother had tried taking her off wheat but found that it had not made any significant difference.

She had relied on brands of commercially produced gluten and wheat free foods. Many of these foods, whilst free of gluten, contain additives and very large amounts of sugar.

In susceptible people, partially digested wheat protein or gluten passes complete into the colon where it sticks to the gut wall like chewing gum. If combined with mucus and other intestinal debris it forms a barrier on the gut wall blocking intestinal secretions and preventing the lubrication of the contents of the colon. It is particularly inadvisable to give wheat to very young children before the age of two (especially if there is a family history of allergy), as their digestive systems are undeveloped.

Gluten is present in many grains but in order not to make the diet unnecessarily restrictive I suggested that Rebecca only avoid wheat gluten which is the most indigestible kind. Rebecca was allowed to have oats because they have low allergy potential and because they contain slow release sugars which help keep energy levels up some time after they have been eaten. She could also eat corn cakes, rice cakes and buckwheat or corn pasta as well as lots of wholegrain rice which is very good for hydrating the bowel.

I advised Rebecca not to drink cow's milk. Humans are the only mammals (except for domesticated animals) that consume milk after weaning.

Milk neutralizes stomach acid, making it less effective at breaking down proteins including wheat gluten. Milk also encourages excessive mucus production in the gut and it promotes the unhealthy alkaline-producing bacteria of which we will hear more later.

The argument for milk drinking is its calcium content. However, milk is not well absorbed because there is little magnesium in milk. Without adequate magnesium, the body cannot use calcium properly.

Magnesium also has a muscle relaxant effect and is very helpful for constipation. I encouraged Rebecca to eat more magnesium rich foods such as Brazil nuts, bananas and in moderation, very dark 70 per cent cocoa solid chocolate.

Cheese was limited to a weekly 200g sheep cheese which Rebecca loved. The proteins in sheep's milk cheese are easier to digest than those in cow's milk cheese. Rebecca was very disappointed that she could not have ice cream. According to Ayurvedic medicine, cold food and drink dampens the metabolic fire or agni which compromises digestion. Ice cream is particularly indigestible since it contains cold fat.

I suggested Rebecca take a probiotic supplement before breakfast on an empty stomach. Human intestines contain around a kilo of bacteria, some beneficial and some disease causing. Probiotics reduce the numbers of pathogenic bacteria by competing with them for adhesion to the colon wall.[1]

Good bacteria help constipation by helping to form soft, bulky and well lubricated stools which pass through the colon swiftly. In addition, the acidic environment created by the good bacteria stimulates the bowel to expel the faeces more frequently. A four week Canadian study which involved giving probiotics to 70 people with chronic constipation found that 89 per cent reported an improvement in symptoms.[2]

The type of food eaten greatly affects the predominance of bacteria in the gut. Dr Wynne of Reading University specializes in probiotic research. In one of his studies, Dr Wynne found that the levels of the beneficial lactobacillus strain increase to their highest numbers when rice is fed into the gut. Interestingly wheat produced the lowest numbers of lactobacillus.[3]

Good bacteria ferment lactose by converting it to lactic acid. This is how milk is soured; live yoghurt is beneficial despite being a dairy food, because fermentation has altered the character of the milk solids. Smoothies usually go down well with children, containing live soya, sheep or goat yoghurt, soya milk and tinned (in natural juice) or fresh soft fruit such as strawberries, raspberries, mandarins etc.

After two weeks on the diet Rebecca's tummy was completely flat and her bowel movements were regular. A piece of cake containing wheat, eaten a few weeks into the diet had caused immediate bloating. One value of an exclusion diet is that when an offending food is removed, when it is re-introduced, if it is not tolerated by the body a noticeable reaction will often occur making it easy to identify as a problem food.

The simplest (and cheapest) way to test your child for food intolerance is to remove the food from their diet for at least five days.

Then give the food in its purest form, for example, shredded wheat (preferable to cake as you won't know if any reaction is to the eggs, milk or other ingredients). Constipation and stomach ache are not the only symptoms. Runny nose, sneezing, headaches and hyperactive behaviour are other ones which may occur over the next 48 hours.

Rebecca's case is another example of how fine-tuning a basically healthy diet can have profoundly positive effects. Rebecca's mother was very well informed about health and diet and she had tried cutting out wheat. But she had not succeeded in solving her daughter's symptoms. Once again a good reason for consulting a nutritional therapist!

References

1. Fuller R, Gibson GR. Modification of the intestinal microflora using probiotics and prebiotics. Scand J Gastroenterol. 32 suppl 222: 28-31. 1997.
2. Koebnick C, Wagner I, Ising K, Stern U. Ernaehrungs-Umschau. 48. 392-396. 2001.
3. Steer T et al. Perspectives on the role of the human gut microbiota and its modulation by pro- and prebiotics. Nutrition Research Reviews. 13: 229±254 229. 2000.