Gut Check, Part I

By Lauren Russell
No matter how good you look in a belly shirt, your innards are hardly a pretty sight. Your gastrointestinal (GI) tract deals with the dirty work of your body: Digesting food for nutrients and sending out the trash. This noisy, smelly, squishy system includes the esophagus, a 10 inch-long tube; the stomach, a fist-size bag of muscle; 20 feet of small intestine; and 6 feet of large intestine (aka the colon). With no Google map, we're often left wondering what the holdup (or the rush) is in there and why normally dependable routes suddenly cause trouble. But because of the unappealing issues that arise, talking about your own highway problems isn't as easy as discussing rush-hour traffic. "There's definitely embarrassment, and women tend to suffer in silence," says Jacqueline Wolf, M.D., a women's GI disease specialist at Harvard Medical School. Still, considering that digestive problems—from constipation to acid reflux—affect up to 70 million people, we should muster the guts to find out what's going on beneath our navels.


How long does it take for food to travel through my system?

The majority of the trip averages 24 hours, says Patricia Raymond, M.D., a gastroenterologist in Chesapeake, Virginia. Once a steak hits your stomach, roughly 3 liters of hydrochloric acid begin to turn it into paste. About 30 minutes later, the food sludge travels to the small intestine, which immediately absorbs the nutrients and sends them to your bloodstream. The leftovers move into the colon, where any remaining liquid is sucked out, and they solidify into feces. This detritus takes from 1 to 4 days to snake its way through your colon and into your sewer system, depending on how much fiber your waste contains, says Michael Levitt, M.D., director of research at the Minneapolis Veterans Affairs Medical Center.

Is eating lots of fiber really that important?

Uh, yeah. Fiber is a component of all plant-based foods, such as whole grains, fruits, and vegetables. You don't digest fiber, so it acts like a Brillo pad for the intestines, scrubbing out bad cholesterol and soaking up water so that waste can glide through. Chances are you're not eating enough (the average person ingests only 7 grams daily, though the RDA is 25—about six servings of fruit or vegetables and two slices of whole-grain bread). To stay regular, beef up your produce intake. Or take a daily 1,500-milligram fiber supplement of psyllium husks, suggests Mehmet Oz, M.D., professor of surgery at Columbia University and co-author of You: On a Diet. But if you need immediate action, try a laxative with sennosides, stool-softening agents that help liquids mix with the cement in your pipes.

Why does my stomach gurgle when I'm hungry?

"It's very much like the Pavlov's dog effect," Dr. Raymond says. "You see the food, you smell the food, your saliva glands start to go, and your stomach starts to go." That sets off a chain reaction of churning, grinding, and spasms in the intestines meant to help food move through the system. If there's not much in there to move, there's nothing to muffle the noise, so the gurgling is louder. Dr. Raymond compares the effect to the way a partially filled water balloon makes more sound than a full one. But bellies rumble even after you've gorged. Called borborygmi, these are simply the sounds of digestive enzymes and gas moving through the intestines.

Is there any way to avoid farting?

Don't go to Jim Carrey movies.

Seriously, why do I fart? And can I prevent it?

We all expel up to 2 liters of gas a day. This gas comes from two sources: "You either swallow air or you make it from various foods," Dr. Levitt says. When you take in air from carbonated drinks and chewing gum, it doesn't smell when it comes out the other end. Noxious emissions happen anywhere from 30 minutes to 3 hours after you eat, when bacteria that live in your colon dine on leftovers your small intestine can't digest, creating smelly gas as a by-product.

Since everything we eat leaves a meal for bacteria, you really can't stop natural gas production. A liquid diet would eliminate most of the fumes because fluids usually leave too little residue for bacteria to get a hold of. A more reasonable solution is to avoid foods on date night that create especially pungent odors. Sulfur-rich items like eggs, broccoli, cauliflower, and cabbage produce hydrogen sulfide, which smells like rotten eggs. Beans also create a mighty stink because we lack the enzymes to fully digest the complex sugars they contain (Beano, a natural supplement you take with food, provides the missing enzymes). The sound, however, is all you. A fart becomes audible when you tighten up, Dr. Raymond says. "If you just relax and let the gas come out, you may have smell, but you won't have that noise."

How often should I be making a deposit?

Think quality, not quantity. At any given time, you're lugging around 5 to 7 pounds of waste, and you won't always need to discard the same amount. "People fixate on their poop frequency," Dr. Oz says, "but what they should look at is a range that is acceptable." In general, you should be going at least once every 6 to 48 hours. "It's when you're not comfortable that we worry," Dr. Raymond says. Straining to get anything out or to hold anything in could indicate problems, from lactose intolerance to irritable bowel syndrome, requiring medication.

What's a healthy bowel movement supposed to look like?

C'mon, plenty of us watch Extreme Makeover, so we can bear taking a peek at what we leave in the toilet. A bowel movement should be shaped like an "S" or a banana because "that's the shape of your rectum," Dr. Oz says. And, like a banana, it should be about 1 1/2 inches in diameter. Any wider and you're at risk for tiny cuts around the anus. Your stool should also be fairly full and soft, but not so light that it floats like a noodle—a sign you're not digesting fats properly. Under normal circumstances, bile dyes waste a range of brown, green, and yellow hues. But dark red or black stool could be caused by bleeding (a sign of a stomach ulcer), and white or very pale movements mean your gall bladder could be blocked—both cause to see a doctor.

I hear that bacteria in yogurt are good for my stomach. Why?

Despite all the Purell and Lysol on store shelves, we actually need some bacteria. About 400 species of microbes reside in the large intestine. These one-celled creatures are essential for GI functioning: They help digest your food, strengthen your immune system, and manufacture some essential vitamins. Problems arise when antibiotics meant for germs wipe out the good guys as well. Killing good bacteria allows undesirable organisms to start growing, says Cynthia Robertson, M.D., integrative medicine specialist and gastroenterologist in San Diego. That's why so many of us get that lovely one-two punch of a yeast infection right after treating a bladder infection. Eating yogurt with acidophilus or taking probiotic supplements restores good bacteria.

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