Gastritis

What is gastritis

Gastritis is an inflammation of the lining of the stomach, which can cause a great deal of irritation and discomfort.

Gastritis can be acute (sudden onset) or chronic (occurs gradually over time), but the effects are basically the same – an irritated stomach lining that causes pain, sometimes quite severe. Severe pain normally indicates that there is quite a lot of damage of the stomach lining and this needs to be treated quickly to prevent further damage and complications.

If gastritis becomes too severe or does not heal properly, it can cause ulceration of the stomach lining, which eventually can erode the lining and cause a peptic (or gastric) ulcer, which is a more serious condition.

Facts about gastritis

• Recurrent, long-term gastritis can develop into stomach cancer in some people
• Gastritis can lead to severe ulceration and erosion of the stomach lining from the stomach acid if it is not treated
• Sometimes gastritis can lead to the development of a peptic ulcer (an ulcer in the stomach)
• It is estimated that around 50% of the world’s population could be infected with higher than normal levels of the helicobacter pylori bacterium
• Slippery elm powder, an excellent herb for gastritis, can interfere with the absorption of some medications so ensure the herb and medication are taken at least 2 hours apart
• Many vitamins and minerals may not absorbed properly in people with gastritis so supplementation may be required
• Mild gastritis may not even produce any symptoms, but it still needs to be treated

Symptoms of gastritis

General symptoms of gastritis are:

• Bloating
• Burping
• Feeling of fullness (even when not a lot of food has been eaten)
• Gas
• Heartburn
• Indigestion
• Loss of appetite
• Nausea
• Stomach pain
• Upper abdominal pain

More serious symptoms of gastritis

The symptoms which need to be investigated are:

• Inability to sleep or lie down due to the stomach (gastric) pain
• Severe stomach pain
• Vomiting (of blood) may occur if there is ulceration
• Weight loss (not eating due to the pain)

Causes of gastritis

Gastritis can be caused by a number of factors:

• Alcohol (in excessive amounts) – heavy drinking causes a great deal of damage to the body and in particular damages the lining of the stomach
• Backflow of bile – if there is a back-flow of bile from the small intestine into the stomach, this can irritate the stomach lining, especially if this occurs often
• Bacteria overgrowth – certain bacteria can overgrow in the stomach (and other parts of the gastrointestinal system) which can damage the delicate pH balance of the stomach and allow them to proliferate even more. The bacterial overgrowth can be caused by a number of reasons, but ultimately the results is the same, an irritated stomach lining and gastritis symptoms. The bacteria most often responsible are: Helicobacter pylori and e.coli bacterium
• Constipation – excessive constipation can put an immense pressure on the whole gastrointestinal system, from the constant straining and dryness of the colon, which can weaken the function of the gastrointestinal system and enable infection and inflammation to occur
• Medications – certain medications can irritate the stomach lining, causing symptoms of gastritis. The medications that most commonly cause problems are: aspirin, non-steroid anti-inflammatory drugs (NSAIDs), naprogesic, but there are many others that can cause gastritis (including antibiotics)
• Stress – some people who are stressed, especially if the stress is excessive or prolonged, can have an overproduction of acid in the stomach, which can really irritate the lining, when there is no food in there to digest and no protection for the stomach lining from the stomach acids
• Vomiting – people who vomit excessively can cause a great deal of damage not just to the stomach, but also to the esophagus, when the stomachs acids are continuously being sent up from the stomach up the esophagus and through the mouth and expelled out. People who are the most likely to vomit excessively, are bulimics, but it can occur in people who have a severe gastrointestinal infection (bacterial gastroenteritis)

Prevention of gastritis

Non-preventable risk factors

Gastritis may be unpreventable in certain circumstances:

• Backflow of bile – a back-flow of bile from the small intestine back into the stomach can irritate the stomach lining and cause gastritis
• Bacterial overgrowth – if the helicobacter pylori bacteria overgrows in the stomach, it can cause severe irritation to the lining of the stomach, erosion in the lining of the stomach (gastritis) and even gastric ulcer. Overgrowth of the helicobacter pylori bacteria in the stomach is the most common risk factor for developing gastritis. Certain ethnic groups tend to have more incidence of helicobacter pylori overgrowth and subsequently gastritis
• Food poisoning – bacterial gastroenteritis, which is also known as food poisoning, can cause vomiting, irritation to the stomach lining and a number of of other symptoms associated with gastritis
• Gastric infection – people who get a really severe bacterial gastroenteritis (food poisoning) infection may vomit repeatedly. If the vomiting continues unabated, it can cause gastritis symptoms, which may be difficult to prevent
• Medications – there are a number of medications which cause an over-production of stomach acids and irritate the stomach lining. This effect is often temporary, but it can continue unabated in some people and continue to produce gastritis symptoms over the long term. The medications that most commonly cause problems are: aspirin, non-steroid anti-inflammatory drugs (NSAIDs), naprogesic, but there are many others that can cause gastritis (including antibiotics)

Preventable risk factors

There are ways to prevent gastritis from occurring:

• Adequate fibre in the diet – a low fibre diet is associated with poor digestive health as it helps the digestive system to function properly. Fibre, from plant sources, is essential for a healthy digestive system
• Healthy digestion – a healthy digestive system is less likely to be at risk for developing any gastrointestinal disorder, including gastritis. Ensure you eat adequate amounts of natural, unprocessed foods and have proper fibre intake.
• Limit alcohol intake – excessive alcohol intake is a known factor which causes gastritis, so limit alcohol intake to 1-2 drinks per day, with at least 2 days alcohol free each week. People with an addiction to alcohol should seek treatment to limit alcohol intake and to prevent gastritis (as well as a number of other health conditions asssociated with excessive alcohol intake)
• Reduce processed foods – a diet high in processed foods, with very little natural foods can cause an excess of stomach acid production, which can irritate the stomach lining, especially when it occurs over the long term and this can result in gastritis
• Reduce stress – excessive or prolonged stress can cause an overproduction of acid in the stomach, which can irritate the stomach lining and produce gastritis symptoms. People who feel stressed need to engage in stress reduction strategies to control their emotions and feel calmer

Complications of gastritis

There are several complications of undiagnosed, uncontrolled or long term, recurrent gastritis:

Gastric (or peptic) ulcer

If the gastritis becomes really severe or does not heal properly, even when medication or alternative/complementary treatments are recommended and applied, it can cause major ulceration of the stomach lining, which can eventually erode the stomach lining and cause a gastric (or peptic) ulcer.

People who have any of the symptoms of gastritis need to seek their doctor’s advice about their treatment options, in order to reduce symptoms and prevent serious complications such as a gastric (or peptic) ulcer.

Stomach cancer

In some cases of people who have recurrent and long-term gastritis, the damage to the stomach lining can initiate cancer of the stomach, which is a more serious condition.

People who have gastritis need to get it treated, either with conventional treatment or alternative/complementary treatment in order to reduce the symptoms and reduce risk of serious complications such as stomach cancer.

When to see a doctor about gastritis

People who have any of the symptoms of gastritis, should seek the advice of their medical practitioner, to determine if their symptoms indicate they have gastritis through a thorough diagnosis and for their doctor to recommend treatment options.

People with existing gastritis need to see their medical practitioner if:

• their symptoms get worse
• they start to get new symptoms not experienced previously
• medication (or alternative therapy) does not help reduce symptoms in the same way as previously

Diagnosis of gastritis

Initially, a doctor will perform the following tests to diagnose gastritis:

• Medical history – the doctor will ask a series of questions about the nature, duration and intensity of the symptoms and also when the symptoms started. The doctor will also ask if any activities make the symptoms specifically worse or better
• Physical examination – the doctor will examine the stomach area for pain or discomfort, by pressing down (gently to firmly) on various parts of the upper and lower abdomen while the patient is lying down
• Breath test – if overgrowth of the helicobacter pylori bacteria is suspected, then a breath test will be requested. In this test, the technician provides you with a special liquid to drink, which has a substance that is broken down in the stomach if the helicobacter pylori bacteria is present. This is tested by breathing into a breath analyser to detect if there is an infection of the helicobacter pylori bacteria and how much of the bacteria is present

Diagnostic tests

If conservative treatment does not resolve symptoms, then a special test will need to be performed by a specialist (gastroenterologist) to have a thorough look at the stomach, take a biopsy and to determine if there is another underlying condition:

• Endoscopy (or gastroscopy) – this is a diagnostic test which is performed under light sedation to definitely diagnose the cause of the stomach pain and the procedure is as follows:
  • Light intravenous sedation is given to the patient
  • Gastroenterologist inserts a sterile, flexible tube with a camera at one end inside the mouth and through the eosophagus into the stomach
  • Images are taken of the stomach lining
  • A small amount of the stomach lining is taken to perform test to determine cause of gastritis and to ensure it is not due to a malignancy
  • The procedure is usually performed on a day patient basis with patients spending only a few hours in the surgery
  • Follow-up includes a breath test to determine if treatment has killed off all the helicobacter pylori bacterium

Conventional treatment of gastritis

Initially, conservative treatment will be recommended for gastritis:

Dietary advice

• Avoid alcohol – drinking of any alcohol needs to be eased, or at least greatly limited to give the stomach lining a chance to heal properly
• Avoid the food triggers – spicy food, citrus fruit, acidic foods, chocolate, coffee, fatty foods, can all cause gastritis symptoms to get worse, so it will be recommended to limit intake of these foods (and any others that are known to the patient to trigger symptoms)
• Dietary modification – it is normally recommended, when there is a severe gastritis flare-up to eat very bland foods which are easily digested and do not cause much acid to be produced in their digestion. Foods such as cracker, rice, toast, ripe bananas, clear soup, baked or boiled potatoes, plain pasta are recommended until symptoms have cleared. It is advisable to avoid meat and other high protein foods during a severe flare-up as these foods can cause a great deal of acid to be produced to break down their proteins in order to be digested and absorbed by the body

Lifestyle advice

• Reduce stress – stress can cause excessive acid production which greatly irritates the stomach lining because if it is happening too much, the mucous lining gets eroded by the acid which gets to the lining to cause erosion and pain ensues
• Stop smoking – smoking causes problems with the stomach lining by irritating the mucous lining of the stomach, making symptoms worse and preventing complete healing

Medication

Different types and combinations of medications are prescribed depending on severity and duration of symptoms, which is part of conservative, first line conventional treatment for gastritis (usually with the dietary and lifestyle advice):

• Antacids – these are the first line of defence for mild to moderate gastritis, most contain calcium to provide protection for the stomach lining and help with healing. There is some controversy with their use, especially as most contain aluminium, which has been implicated in Alzheimer’s disease
• Histamine-2 receptor antagonist – these drugs work to inhibit acid production in the stomach, inhibiting histamine from switching on acid production. These drugs help to heal the irritation and damage to the stomach lining
• Proton pump inhibitors (PPI) – these drugs work to inhibit acid production in the stomach, to help enable healing of the irritation of the lining more quickly
• Other drugs – there are a number of other drugs that work to reduce stomach acid production and promote healing. Some of these medications that are used are: Sucralfate and Misoprostol

Diagnostic tests

If conservative treatment does not work, then a gastroscopy will be performed and further treatment of gastritis will depend on the findings of the endoscopy:

• If no bacterial infection is found, then usually no treatment advice is given other than the same dietary advise and to learn to relax (as stress causes more acid production in the stomach, which can damage the lining)
• If bacterial infection is found, especially if it is of the Helicobacter pylori bacterium, a combination of antibiotics and other stomach medications is recommended to eradicate the bacteria. After the medication protocol is completed, a follow-up course of treatment may be required if the first treatment did not work (or didn’t work adequately enough to reduce bacterium levels, which will be determined with a breath test)

Medication for helicobater pylori infection

Medication for gastritis caused by Helicobacter pylori bacterium infection is through a combination of antibiotics (to heal the bacterial infection) and proton pump inhibitors (PPIs), to reduce the acidity in the stomach so that the bacteria can be more effectively reduced and the stomach lining healed.

• Antibiotics – these are prescribed in combination with the PPI or H2 blocker drugs to get rid of the helicobacter pylori bacterium
• Proton pump inhibitors (PPI) – these drugs (H2 blockers) work to inhibit acid production in the stomach, to help heal the irritation of the lining more quickly

Alternative / complementary treatment of gastritis

Anyone who suspects they may have gastritis, should never try to self-medicate

Any type of medical condition needs to be diagnosed by a medical professional as the same symptoms could be confused with many other gastric disorders.

Always talk to your doctor about any supplements you want to take before trying them as they could interfere with the actions of any prescription medications.

Herbs

There are a number of excellent herbs which may help to provide relief for symptoms:

• Chamomile – the herb chamomile has calming and also has anti-inflammatory properties which can be used in cases of mild to moderate gastritis to relieve symptoms and relax the digestive system so that it can heal more quickly. In addition to this, chamomile tea is used to help the body relax, which can help reduce the symptoms associated with stress
• Marshmallow – a mucilaginous herb which provides protection of the stomach lining in the same way as slippery elm does; one caution is that it can lower blood sugar levels and cause “avitaminosis” (prevent proper absorption of vitamins and minerals) if used for prolonged periods
• Peppermint – as a tea, peppermint can help to calm the stomach and helps with proper digestion, especially if taken after a meal
• Slippery elm – this is an excellent herb which provides a protective mucilaginous (mucous-like, moist and sticky) layer around the stomach lining, protecting it from the acid in the gastric juices and greatly relieving symptoms and allows the stomach lining to heal and can assist with all types of gastritis, from mild to severe. Slippery elm is available in tablet or powder form – the powder needs to be mixed with water (or a little juice) and quickly drank to get the most benefits. This is a very safe herb that is not known to produce any adverse side effects when it is used correctly

Vitamins

There are a number of vitamins which may help to provide relief for symptoms:

• Folic acid – studies show that folic acid, the B-vitamin cofactor may be especially not properly absorbed in people with gastritis, so supplementation may be advised
• Vitamin A – the antioxidant vitamin A is essential in keeping the mucous membranes of the stomach lining healthy, which are damaged by the gastric acids and supplementation may be necessary
• Vitamin B12 – this B vitamin is required as it particularly stimulates the immune system to work properly and repair damage caused by helicobacter pylori. In addition to this, vitamin B12 may be not be able to be absorbed properly as the intrinsic factor may not be produced adequately
• Vitamin C – the antioxidant vitamin C is lowered when conventional medication is used to treat gastritis that is caused by helicobacter pylori. In addition to this, supplementation is advised as this vital nutrient may help to heal the tissues of the stomach lining more effectively and more quickly. Studies have shown that vitamin C (together with the bioflavonoids) can heal gastritis caused by helicobacter pylori in some people who may not be absorbing enough of this vitamin in the first place
• Vitamin E – studies have shown that vitamin E may be beneficial in preventing malignancies of the gastrointestinal tract, especially in those people with chronic gastritis

Minerals

There are a number of minerals which may help to provide relief for symptoms:

• Magnesium – this is an excellent mineral to calm muscles and other body tissue, which are inflamed and may be tense due to gastritis. Magnesium is required not just by the stomach, but every smooth muscle in the body, in order to function properly
• Zinc – the antioxidant mineral zinc has been shown in studies to help promote quicker healing of gastritis (and also ulcers) and provides a quicker reduction in symptoms, especially if it is combined with carnosine

Other nutrients

There are a number of other nutrients which may help to provide relief for symptoms:

• Bromelain – this is an enzyme which is found naturally in pineapples and can help with proper digestion. Bromelain is found to reduce stomach pain and other gastritis symptoms, especially if it is used with other digestive enzymes
• Digestive enzymes – these enzymes may be beneficial to assist with digestion in the stomach and intestine
• Essential fatty acids – the essential fatty acids omega 3 and GLA especially, provide anti-inflammatory properties to reduce severity of symptoms and promote healing
• Probiotics – the ratio of “good” and “bad” bacteria may be disturbed by gastritis and supplementation is required to rebalance the intestinal flora with the probiotic acidophilus

Dietary modifications

There are a number of dietary modification strategies which may help to provide relief for symptoms:

• Avoid alcohol – alcohol is a known irritant to the stomach lining and should be completely avoided until symptom are resolved; heavy drinking can cause gastritis
• Avoid certain foods – some foods can make symptoms worse in some people – coffee, tomato and tomato products, chocolate, citrus foods and juices and in some really sensitive people the herbs peppermint and spearmint can also aggravate symptoms
• Cabbage juice – the juice of cabbage contains “substance U” which has proven ulcer healing properties and it can help to reduce the ulceration of the stomach (or even eosophagus) mucosa and provide relief for symptoms, reducing their severity and duration
• Chew food properly – chewing allows the food to be broken up into smaller portions which do not require as much gastric juices to be produced in the stomach to break them down further for absorption
• Eat easily digested foods – to prevent high acid production in the stomach, it is advised to eat foods which are easily digested – bananas, rice, thin porridge, toast, crackers – while symptoms are at their worst
• Eat small meals – while the stomach lining is inflamed it is recommended to eat small meals to prevent the high and prolonged acid production required to break down a large meal
• Increase fibre intake – fibre can help with symptoms of chronic gastritis especially the soluble and mucilaginous fibres which protect the stomach lining from further damage (such as those in oats and psyllium). Try adding a small amount of fibre each day, to build up tolerance and help relieve symptoms slowly
• Limit liquids with meals – do not drink lots of water with a meal, drink it about 15 minutes before or 30 minutes after the end of a meal; the excessive water may dilute gastric juices which can cause insufficient digestion and abortion which can cause chronic gastritis and other digestive disorders

Lifestyle modifications

There are a number of lifestyle modifications which may help to provide relief for symptoms:

• Avoid reclining after meals – it is important to sit up straight after meals to allow proper digestion to take place; lying down can interfere with this process in a gastrointestinal system that is compromised and cause acid to come into the oesophagus which can burn
• Relax – stress is a trigger that can cause over- production of the acidic gastric juices, which make gastritis symptoms worse. Learn to relax by utilising any type of relaxation strategy – deep breathing, qi gong, meditation, tai chi, visualisation, yoga
• Stop smoking – smoking irritates the mucous lining of the stomach, making symptoms worse and preventing complete healing

Alternative treatments

• Naturopath – a naturopath can provide a regimen of dietary and lifestyle changes, as well as a herbal tincture (or tablets) to help heal symptoms. Each person’s symptoms are different, so you will need to consult a naturopath in person, to get a proper diagnosis and be provided treatment options

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with gastritis

Self care strategies

Gastritis requires some diligence in maintaining a healthy diet and some supplementation may be required to help heal the digestive system and reduce severity and duration of symptoms. The following are the strategies most recommended to achieve this:

• Avoid artificial additives – any type of artificial colour, flavour or preservative is potentially a trigger to worsen gastritis symptoms. Read food nutrition labels and avoid foods which have any numbers in the ingredient list, as these will invariably be some type of artificial additive
• Avoid artificial sweeteners – these can trigger severe diarrhoea symptoms so should be avoided. Always read food labels and avoid foods that are labelled “diet” or “no sugar”, as this invariably means they contain some type of artificial sweetener, such as: sorbitol, aspartame, saccharin (but there are others)
• Avoid cigarette smoke – people who smoke have to give up. This is just another reason to help with the decision to stop smoking. Cigarette smoke causes a number of problems with digestion and should be avoided. People who do not smoke should avoid exposure to second hand smoke from people who smoke around them
• Avoid coffee – it is advisable to avoid coffee as it can cause abdominal cramping and diarrhoea in many people with gastritis. There are a number of alternatives to coffee which are actually good for the digestive system (such as roasted dandelion root). There are a number of alternatives to coffee which are actually good for the digestive system (such as roasted dandelion root)
• Digestive and pancreatic enzymes – the digestive and pancreatic enzymes are released by the digestive to help digest foods that are eaten so that their nutrients can be absorbed through the bloodstream. Digestions starts mainly in the stomach and ends in the small intestine. The digestive and pancreatic enzymes help to increase the amount of food digested by reducing the load on the digestive system
• Essential fatty acids – the essential fatty acids, especially the omega 3 (DHA/EPA) and omega 6 (GLA) are vital for a properly functioning gastrointestinal system as they reduce inflammation that may be associated with this digestive disorder and this reduces severity and duration of symptoms. The best way to get adequate levels of the essential fatty acids is to eat 3-4 servings of oily fish each week and ensure it is deep ocean, wild fish (not farmed). The fish with the highest levels of omega-3 fatty acids are: mackerel, salmon, sardines, trout, tuna. People who cannot eat fish should try a supplement with balanced levels of each of the essential fatty acids and ensure it has been tested for mercury
• Exercise regularly – physical activity is a must for anyone with a digestive disorder as it helps to increase blood and lymphatic circulation. This helps to eliminate any toxins or unwanted substances more quickly out of the body. Exercise also increases the endorphins released and reduces stress
• Fibre – increasing the amount of fibre in the diet is vital for ensuring healthy digestion. The best types of soluble fibres is psyllium, which helps the intestinal flora digest food properly. The best ways to add psyllium or slippery elm to the diet are in: smoothies, milkshakes, sauces, yoghurt, breakfast cereal, muesli, dips. Suggested dosage is up to 2-3 teaspoons per day, but add it gradually if fibre hasn’t been an integral part of the diet previously, start with 1/2 teaspoon for a few days and add another 1/2 teaspoon every 4 days until at the 2-3 teaspoons a day level
• Food intolerances or sensitivities – these can be confirmed (if not known) through either an elimination diet or a blood test. An elimination diet involves removal of all the suspected allergens (such as dairy, gluten) as well as all processed foods and associated food additives and then re-introducing these foods, one at a time to determine if they have an adverse effect on digestion, or any other part of the body
• Limit alcohol – it may be necessary to stop drinking any alcohol while the intestines and the rest of the digestive system are in the process of healing and this is because alcohol is known to irritate the intestines
• Organic – another strategy to reduce the stress on the gastrointestinal system is to avoid foods which are not grown organically (without the use of pesticides and other chemicals and antibiotics). This helps the digestive system because it does not have to also try to detoxify the chemicals in the food in addition to trying to digest foods normally (which is not occurring in this condition). Not only this, but studies show that organic food has higher levels of all their nutrients than food not grown organically
• Probiotics – the “good” bacteria may be in short supply in the digestive system which could be contributing to the symptoms. Acidophilus and other probiotic bacteria are required to help re-populate the intestines with “good” bacteria, which help to properly digest foods and reduce the amount of undigested food that escapes the gut. People who are not lactose intolerant should also include yoghurt that has live cultures
• Reduce stress and relax – prolonged and unrelenting stress is not good for healthy digestion. While stress is not known to cause leaky gut syndrome, it certainly can make symptoms worse because it causes the parasympathetic nervous system to remain in stress mode, which means digestion and absorption is not effective as the nerve that controls it prevents it from happening properly
• Slippery elm – the herb slippery elm is necessary for intestinal health as it is required to heal the intestinal mucosa by providing a mucilaginous layer over the intestinal wall, which reduces the stress on the intestines and helps to heal the intestines more quickly
• Smaller meals – eat smaller meals to help reduce the load on the digestive system, which is not working properly and cannot handle larger meals, which can cause worsening of symptoms when the stomach and intestines struggles to handle the large amount of food eaten. Aim to have around 6 smaller meals each day
• Supplements – certain supplements may be required to help in the healing process by reducing the load on the intestines and reduce symptoms

Caring for someone with gastritis

Partner

The best way to help a partner with gastritis is to be supportive and sympathetic, but the following can be beneficial as well:

• Avoiding smoking inside – people with gastritis need to be away from any cigarette smoke, as it can exacerbate their symptoms
• Eating smaller meals – help your partner to eat smaller meals by joining them in eating smaller meals, as this helps support your partner a great deal. Cooking and eating smaller meals is one way to help reduce the load on the digestive system by reducing the amount of food that needs to be digested and absorbed
• Encourage a healthy diet – a healthy diet is one which has adequate amounts of fresh fruit and vegetables, wholegrains, legumes, protein and healthy fats and has little or no processed foods
• Encourage exercise – going for walks (or joining a gym together) with your partner is a great way to bond. Exercise helps to improve circulation, reduces stress and encourages better health overall

Friends

People who have a friend who has gastritis can support their friend by the following:

• Dinner parties – if you invite your friend to a dinner party, try to ensure there is food that they can eat. The best way to do this is to ask what foods are off limits for them and ensure to let them know beforehand which foods they should avoid
• Discourage alcohol – if your friend has gastritis, they should be limiting alcohol intake as it can cause a worsening of symptoms, so try to make your social meetings ones that are alcohol free

Parents

Parents of a child who has gastritis can support their child by:

• Avoid smoking inside – people with gastritis need to be away from any cigarette smoke, as it can exacerbate their symptoms
• Cooking smaller meals – this is one way to help reduce the load on the child’s digestive system by reducing the amount of food that needs to be digested and absorbed
• Probiotics – introduce some probiotics to the child’s diet, preferably in powder form as it can be more easily assimilated into other foods, but the tablets can also be taken if this is not successful
• Psyllium – find creative ways to add psyllium to foods (smoothies, breakfast cereal, muesli, sauces, shakes) in the child’s diet. Psyllium is a soluble fibre which has a gel-like consistency in the digestive tract and helps to promote the health of the whole gastrointestinal system
• Slippery elm – find creative ways to add slippery elm to foods (smoothies, breakfast cereal, muesli) in the child’s diet. Slippery elm is one of the herbs most beneficial for any type of digestive disorder, but especially one in which there is irritation and damage to the intestinal wall and the intestinal mucosa

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Last reviewed and updated: 14 May 2024