Abdominal Pain or Discomfort – What Could It Be?

Abdominal pain or discomfort is a common complaint during perimenopause and menopause and may be related to fluctuating hormone levels, period pain, dysregulation of periods or heavy bleeding. It’s important to always first rule out any sinister causes with your medical practitioner; however sometimes abdominal discomfort can be remedied using dietary and lifestyle techniques.

Could it be a food intolerance or hypersensitivity?

Many patients start noticing that after consuming certain foods their symptoms seem to get worse, however it’s not as simple as that. A food intolerance or hypersensitivity is different to a food allergy. It is much more insidious and may cause delayed symptoms therefore it may be difficult to identify and treat. 

Two common food intolerances that we see often are Fructose and Lactose intolerance.

Fructose intolerance:

If fructose is not absorbed properly in the gut, it begins to ferment quickly and produces gas causing bloating, pain, flatulence and sometimes diarrhoea.

Recent research suggests that it may affect about 30% of the population

High fructose natural fruits include grapes, watermelon, apples and all juices. Avoidance of processed foods is recommended as they may contain high fructose corn syrup to sweeten them. (1,2,3)

Lactose intolerance:

Lactose intolerance is an example of the body not producing enough lactase (the enzyme needed to break down lactose). Undigested lactose will also reach the gut and ferment and may cause bloating, gas, pain and distention. Symptoms may vary according to the amount of lactose ingested.

High lactose foods include cow’s milk and yoghurt.

(1,3,4,5)

Could it be altered gut flora?

There may be numerous reasons for gut flora to be altered and these include: antibiotic use, infection, poor diet or even stress. Alterations in gut flora may lead to an overgrowth of potentially harmful bacteria which may result in abdominal discomfort. Research is looking beyond abdominal symptoms though; surprisingly bacterial gut overgrowth may even be associated with conditions like depression and fibromyalgia. (1,6,7)

Is constipation causing your pain? How regular are you?

Sometimes abdominal pain can be as simple as noticing how often you go.

Do you have enough fibre in your diet? Are you eating enough fruit and vegetables? Whole grains? But most importantly how hydrated are you? If you notice that you are constipated make sure that you are drinking at least 8 cups of pure water every day. Eat more fruit, vegetables and unprocessed foods. Psyllium husk, chia seeds and flaxseeds are great additions to your diet and will aid elimination. If after attempting some of these small dietary changes; you are still constipated, please seek help from your health care professional or from one of our natural therapists here at the Australian Menopause Centre.

If you suspect you may have a food intolerance/hypersensitivity or altered gut flora contact your health care practitioner for further investigation

Could it just be stress???

Notice and understand your stress levels, remember we all react differently to stress. Whilst a situation that may seem benign to you; may elicit an emotional and stress response in others.

The gut has been described as having its own nervous system which is sometimes referred to as the “second brain” due to its extensive nature.

How often has your gut gone into turmoil just before a stressful event? Athletes describe the urgent need to rush to the bathroom just before their event begins. The terms “butterflies in my stomach” and a “knot in my gut” are used to describe the feeling of nervous tension. A “gut wrenching” story, is story filled with emotion, fear, devastation and suspense.

In people who suffer from irritable bowel syndrome – stress plays a big part in the overstimulation of the nervous system resulting in abdominal discomfort, altered bowel motility and generally interferes with the way in which we digest our food.

Noticing and documenting what situation precedes any irritable bowel syndrome symptom is really helpful in understanding your gut and how to manage it. (1)

Listen to your body

Notice your stress levels, monitor them and start taking control. Simple strategies like alternate nostril breathing, meditation, yoga, mindfulness, walking in nature, skin brushing, regular interaction with family and friends, physical contact or even just a hug – all might be just what you need to recalibrate and de stress.

If you would like further discussion regarding these symptoms, make a booking with one of our qualified nutritionists or naturopaths here at the Australian Menopause Centre.

If your symptoms persist though, seek medical attention immediately for further investigation in order to rule out any more serious conditions.

References:

1. Hectman L, Clinical Naturopathic Medicine,2012, Elsevier Australia, Chp 7
2. Gibson PR et al, Review article: fructose malabsorption and the bigger picture, Aliment Pharmocol Ther 2007:25: 349-63
3. Gibson PR & Shepherd SJ. Personal View: Food for thought Western lifestyle and susceptibility to Crohn’s disease. The FODMAP hypothesis. Aliment Pharmocol Ther 2005:21:1399-409
4. https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2018/07/Lactose-Intolerance-July-18.pdf
5. FSANZ.2006 http://foodstandards.gov.au/
6. Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA 2004:292(7):852-8
7. Pimentel M et al, A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. Ann Rheum Dis: 2004 63(4):450-2
8. McFarland LV &Dublin S, Meta-Analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol 2008:14:2650-61