How to deal with common digestive problems

By Sally Wadyka,

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While indigestion and other gastrointestinal (GI) troubles can occur at any stage of life, they tend to become more common as we age. That doesn’t mean they’re inevitable, though. “These aren’t necessarily just a normal part of aging that you have to live with,” says Brijen Shah, an associate professor of gastroenterology and geriatrics at the Icahn School of Medicine at Mount Sinai in New York.

Adopting some lifestyle changes can make a big difference. We asked GI experts for their insights about what to do — and not do — to combat some of the most common digestive issues.


What it is: Whether it’s occasional or chronic heartburn — called gastroesophageal reflux disease (GERD) — the symptoms are the result of stomach acid flowing back into your esophagus. “The lower esophageal sphincter [a muscular ring] is the door between your stomach and your esophagus,” says Vijaya Rao, an assistant professor of medicine at UChicago Medicine. “Acid reflux happens when that door opens too frequently.”

What makes it worse: Carrying excess weight, especially around the middle, puts external pressure on the lower esophageal sphincter. In a 2021 study published by the journal JAMA Internal Medicine, people who had a body mass index under 25 (the cutoff point for being overweight) were 31 percent less likely to experience GERD than those who were overweight.

What makes it better: In addition to maintaining a healthy weight, the JAMA study found that four other lifestyle factors lowered the risk of GERD: not smoking; limiting coffee, tea and soda to no more than two cups per day; exercising 30 minutes or more per day; and eating a healthy diet — one that’s rich in whole grains, fruits and vegetables, and low in red meat and added sugars.

“If everyone adhered to the five factors, it could prevent 40 percent of GERD cases in the U.S.,” says Andrew T. Chan, one of the study’s authors.

Some people may need to avoid or at least minimize certain foods, including caffeine, fatty foods, alcohol, chocolate, peppermint, garlic, onions, citrus, tomatoes and carbonated beverages.

“But I tell my patients that I don’t expect them to completely give up everything they love,” says Mona Rezapour, a gastroenterologist at UCLA Health. Keep a diary of the foods you eat and when symptoms occur. “In a couple of weeks, a pattern might emerge.” Then you can focus on cutting down or eliminating the foods that seem to be triggers.

Rezapour also suggests waiting two to three hours after a meal to lie down, because lying down can relax the lower esophageal sphincter. “You want gravity to work for you to help push food down into your digestive system,” she says. And when you do lie down, elevate your head with an extra pillow or by adding blocks under the head of your bed.


What it is: Straining to have bowel movements or going less frequently.

What makes it worse: With age, gut motility (the ability of your digestive system to move food through) can slow down. Not eating enough fiber, drinking enough water, or getting enough exercise can also cause or worsen constipation.

What makes it better: “A high-fiber diet is important, but not all fiber is equal,” Rezapour says. Soluble fiber, found in foods such as apples, citrus fruits and oats, bulks up stool, so too much of it can exacerbate the problem. “Insoluble fiber [found in whole grains and vegetables] pulls water into the stool and helps ease constipation.” (Be sure to drink water when you increase fiber.) Staying active also promotes motility.


What it is: A buildup of gas in the digestive system can leave you feeling overly full (bloated) and gassy. You may have stomach pains and feel the need to pass gas or burp to relieve pressure.

What makes it worse: Constipation can leave you feeling perpetually bloated. Gas can also be produced by swallowing too much air when you’re eating. Sucking on hard candies or chewing gum cause you take in more air. And certain foods (such as beans and cruciferous vegetables such as cabbage and broccoli) can cause gas, as can suddenly increasing your fiber intake.

What makes it better: You could cut out foods known to increase gas, but you shouldn’t. “Many are really healthy foods,” Rao says. “I also see that people who eliminate foods that are high in fiber because they cause gas end up with constipation.” A better solution is to increase your intake of high-fiber and gas-producing foods slowly to allow your digestive system time to adapt.

Some experts also suggest a probiotic supplement. “An imbalance in your gut bacteria causes dysfunction in your GI system,” Rezapour says. “For some people, probiotics seem to help relieve gas, bloating and pain.” But the evidence isn’t conclusive, so talk to your doctor. As with all supplements, the Food and Drug Administration doesn’t verify that probiotics have what manufacturers say they do, so you cannot be sure you’re ingesting exactly what the label claims.

Lactose intolerance

What it is: Lactose, the sugar in milk, is broken down by the enzyme lactase. Lactase production decreases with age, which can lead to diarrhea and other GI symptoms when you eat dairy products.

What makes it worse: Consuming milk or other foods that have lactose.

What makes it better: You might not have to give up all dairy or rely on lactose-free milk or lactase supplements. (There’s not much evidence that the latter work all that well anyway.) Some dairy foods have little or no lactose, such as cheddar and Swiss cheeses. And the bacteria that is used to make yogurt can “digest” the lactose in the milk. Also, research suggests that many lactose intolerant people can handle up to 15 grams of lactose — about what’s in a cup of milk — at a time, especially with a meal.

 Copyright 2021, Consumer Reports Inc.

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