I’m a bowel doctor and there are 3 things I do every day to keep cancer at bay – plus my top toilet tip

THERE are few people lucky enough to go through life without experiencing the odd bowel issue at some point.

Be it a bout of food poisoning, irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), there has been a surge in tummy complaints linked to diet, lifestyle, stress, genetics and environmental triggers.

And bowel cancer cases, particularly among younger adults in the UK, have also been rising, with a 25 per cent increase in under-50s diagnosed in the past 10 years.

But there's lots you can do to improve your bowel health.

Dr Reshma Rakshit, a Doctify-rated gastroenterologist, is well-versed in diagnosing and treating a wide range of bowel-related disorders.

As well as dishing out important advice to overhaul her patients' bowel health, there are certain rules she follows herself to keep her gut problem-free.

STAY REGULAR

The first thing you can do to ensure your bowel is in tip-top health is to listen to your insides.

Avoid putting off the urge to go for a number two, to help avoid constipation, erratic bowel movements, bloating and painful swelling of the belly, Dr Rakshit says.

To keep your bowel movements as regular as possible, she recommends following the other points below…

1. Fill up on fibre

Fibre is essential for your gut to work properly but can be quite complex, says Dr Rakshit.

Broadly, there are three types – soluble, insoluble and resistant starch.

She explains: “In simple terms, soluble fibre (for example oats, barley, apples, root vegetables like carrots and sweet potatoes, golden linseed, citrus fruits, bananas, peas, green beans) absorb water to form a gel-like material and increase the size and softness of your stools.

“Insoluble fibre doesn't dissolve in water, remains undigested, reaches the large intestine and thereby increases the bulk of the stool, which in turn allows the bowel to increase its movement and hence the transit.

“Examples include bran, wholewheat flour, brown rice, quinoa, beans, leafy green vegetables, most lentils, and peanuts.

“Resistant starch is a type of soluble fibre that gets broken down by our gut bacteria to produce products like short chain fatty acids which are beneficial for our health (by feeding the lining of our gut).

“This bacterial digestion is also responsible for gas (flatulence).”

Resistant starch is found in cooked and cooled rice, raw oats, beans and lentils.

As a whole, among fibre's benefits is to reduce the risk of bowel cancer, says Dr Rakshit.

One study published in 2011 showed a 10 per cent reduction in bowel cancer risk for every 10g/day increase in fibre.

The NHS advises 30g per day – this can be in the form of fruits and vegetables (at least five portions per day), wholegrains, nuts and seeds.

But Dr Rakshit adds: “If you introduce more fibre into your diet it needs to be done slowly to prevent excessive wind and bloating. Our gut takes time to get adjusted to it.

“Certain conditions like certain forms of IBS can get worse with excess fibre. Therefore any change should be done with the help of a healthcare professional.”

2. Go de-caff

Drinking non-caffeinated fluids like water, herbal teas and milk can help bowel health by promoting hydration, softening stools and potentially stimulating bowel movements, which can help prevent constipation and support overall digestive function.

Dr Rakshit recommends: “Aim to drink 1.5 to 2 litres of non-caffeinated fluids per day.”

3. Get moving

Exercise is beneficial for bowel health as it stimulates gut motility (movement), preventing constipation and promoting a healthy gut microbiome, which in turn improves overall digestion and gut function.

It's also shown to have an anti-inflammatory effect which has an impact on reducing risk of several cancers, including bowel cancer, said Dr Rakshit.

Studies have also suggested physical activity can lower the risk of bowel cancer, with some research indicating a reduction of up to 20 per cent.

As for what type of exercise is best, Dr Rakshit recommended: “Moderate to vigorous physical activity can lower the risk of bowel cancer, as recommended by the American Cancer Society.

“This is 150 to 300 minutes per week at an intensity which makes you slightly breathless.

“If you're generally sedentary, slowly increase the amount of exercise you do.

“This doesn't necessarily mean going to the gym. Other options include fast walks or jogs, taking the stairs rather than the elevator, parking away from the shops, walking the dog, home workouts with the help of free videos or apps.

“You can also swap less active hobbies with more active ones, including cycling, swimming and dancing.

“There are many apps online which can help get people started. The NHS also has a Couch to 5K programme, free for all to use.”

My top toilet tip…

If you find yourself suffering with constipation or straining when you go for a number two, Dr Rakshit advises raising your feet.

She said: “Allow the knees to be higher than your hips, leaning forwards and putting your elbows on your knees, bulging out your tummy whilst straightening your spine.

“Avoid straining. If nothing happens, stop trying, go for a walk, try a hot drink and when the urge comes try again.

“This takes time and patience to develop.”

Going to the loo: What's normal and what is NOT

PEEING

What's normal

There are lot's of fluctuations between people. But peeing between six and seven times in a 24-hour period is normal for most.

Four to 10 times a day can be normal for someone, too, according to Bladder and Bowel community.

It's normal to wake up in the night to pee.

And urine should be a champagne sort of colour.

Pee should come out in a steady stream and you shouldn't need to force it.

What's NOT normal

You might consider that your peeing habits have become abnormal if you:

• are going more often than you used to
• keep going in the night
• experience pain
• it doesn't feel like you fully 'empty'
• the stream is not steady or is weak
• leak urine
• see blood in urine

There are lots of things that can influence how much we pee.

Urge incontinence, overflow incontinence, and total incontinence all refer to disruptions in the way your bladder stores and gets rid of urine. You can read about them on the NHS website.

The causes range from an enlarged prostate, constipation, not drinking enough water, caffeine and medications.

Serious conditions such as prostate cancer can influence your peeing habits.

So get any changes cheked out!

POOING

What's normal

People tend to go for a poo once a day or three to four times a week.

As long as the stool is easy to pass and is smooth and sausage or snake shaped (yes, medically, that is how scientists describe a healthy poo on the Bristol Stool Chart!).

What's NOT normal

Any changes to pooing habits should be seen to by a doctor because they could signal bowel cancer.

The symptoms can include:

• Persistent constipation or diarrhoea
• Very dark stools, blood in stool or blood on the tissue paper
• Pencil-thin poos

Pancreatic cancer can also cause stools that are described as being pale, oily, difficult to flush and bad-smelling.

It's important not to brush off these symptoms – seeing a GP could be the difference between life and death.

Other health conditions that may change your bowel habits include IBS.

Stools that are hard, difficult to pass or pellet-like can signal constipation. Read how to ‘go' easier here.

READ MORE

A GP reveals how normal is your poo

Can you tell the healthy poos from the unhealthy ones?

The 5 things your pee is telling you

How getting up to pee in the night could be a sign of silent killer – when to see your doctor

AND… THE HABITS TO AVOID

Alongside things to do more of, Dr Rakshit lists habits worth avoiding.

Doing the following could lead to issues like piles, or even worse, bowel cancer, she warns.

1. Never ignore the urge

Don't put off going to the toilet when you feel the urge as delaying a bowel movement can contribute to constipation, says Dr Rakshit.

2. Don't strain

Straining when passing stools, often a sign of constipation, can be caused by a low-fibre diet, dehydration, lack of exercise, certain medications or underlying medical conditions like Irritable Bowel Syndrome (IBS).

Dr Rakshit said find the cause and treat it.

3. Ban your mobile

Taking your phone to the toilet might seem like a great source of entertainment, a good way to stay connected, or something to do while you wait.

But it can increase the time spent straining, leading to piles, bleeding and fissures, warns Dr Rakshit.

She adds: “It's also very unhygienic.”

4. Meat alert

With red meat and processed meat shown to increase bowel cancer risk, Dr Rakshit recommends keeping this to a minimum.

She advises: “Ways in which to do this include having meat free days, swapping red meat with fish, chicken or beans, pulses or lentils and reducing your portion of red meat or processed meat to less than 70g per day.”