As we enter the festive season it’s a good time to think about what all those celebratory alcoholic drinks can do to your gut.

Alcohol can interfere with the time it takes for food to go through your gut (also known as the “transit time”). In particular, it can affect the muscles of the stomach and the small bowel (also known as the small intestine).

So, how and why does alcohol make your poos goes weird? Here’s what you need to know.

Diarrhoea and the ‘transit time’

Alcohol’s effect on stomach transit time depends on the alcohol concentration.

In general, alcoholic beverages such as whisky and vodka with high alcohol concentrations (above 15%) slow down the movement of food in the stomach.

Beverages with comparatively low alcohol concentrations (such as wine and beer) speed up the movement of food in the stomach.

These changes in gut transit explain why some people can get a sensation of fullness and abdominal discomfort when they drink vodka or whisky.

How long someone has been drinking a lot of alcohol can affect small bowel transit.

We know from experiments with rats that chronic use of alcohol accelerates the transit of food through the stomach and small bowel.

This shortened transit time through the small bowel also happens when humans drink a lot of alcohol, and is linked to diarrhoea.

Alcohol can also reduce the absorption of carbohydrates, proteins and fats in the duodenum (the first part of the small bowel).

Alcohol can lead to reduced absorption of xylose (a type of sugar). This means diarrhoea is more likely to occur in drinkers who also consume a lot of sugary foods such as sweets and sweetened juices.

Chronic alcohol use is also linked to:

• lactose intolerance
• overgrowth of small bowel bacteria and
• reduced absorption of fats from the pancreas not producing enough digestive enzymes.

This means chronic alcohol use may lead to diarrhoea and loose stools.

How might a night of heavy drinking affect your poos?

When rats are exposed to high doses of alcohol over a short period of time, it results in small bowel transit delay.

This suggests acute alcohol intake (such as an episode of binge drinking) is more likely to lead to constipation than diarrhoea.

This is backed up by recent research studying the effects of alcohol in 507 university students.

These students had their stools collected and analysed, and were asked to fill out a stool form questionnaire known as the Bristol Stool Chart.

The research found a heavy drinking episode was associated with harder, firm bowel motions.

In particular, those who consumed more alcohol had more Type 1 stools, which are separate hard lumps that look or feel a bit like nuts.

The researchers believed this acute alcohol intake results in small bowel transit delay; the food stayed for longer in the intestines, meaning more water was absorbed from the stool back into the body. This led to drier, harder stools.

Interestingly, the researchers also found there was more of a type of bacteria known as “Actinobacteria” in heavy drinkers than in non-drinkers.

This suggests bacteria may have a role to play in stool consistency.

But binge drinking doesn’t always lead to constipation. Binge drinking in patients with irritable bowel syndrom (IBS), for example, clearly leads to diarrhoea, nausea and abdominal pain.

What can I do about all this?

If you’re suffering from unwanted bowel motion changes after drinking, the most effective way to address this is to limit your alcohol intake.

Some alcoholic beverages may affect your bowel motions more than others. If you notice a pattern of troubling poos after drinking certain drinks, it may be sensible to cut back on those beverages.

If you tend to get diarrhoea after drinking, avoid mixing alcohol with caffeinated drinks. Caffeine is known to stimulate contractions of the colon and so could worsen diarrhoea.

If constipation after drinking is the problem, then staying hydrated is important. Drinking plenty of water before drinking alcohol (and having water in between drinks and after the party is over) can help reduce dehydration and constipation.

You should also eat before drinking alcohol, particularly protein and fibre-rich foods.

Food in the stomach can slow the absorption of alcohol and may help protect against the negative effects of alcohol on the gut lining.

Is it anything to worry about?

Changes in bowel motions after drinking are usually short term and, for the most part, resolve themselves pretty efficiently.

But if symptoms such as diarrhoea persist beyond a couple of days after stopping alcohol, it may signify other concerning issues such as an underlying gut disorder like inflammatory bowel disease.

Researchers have also linked alcohol consumption to the development of irritable bowel syndrome.

If problems persist or if there are alarming symptoms such as blood in your stool, seek medical advice from a general practitioner.

Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

You may have seen some new ways to describe when someone is autistic and also has attention-deficit hyperactivity disorder (ADHD). The terms “AuDHD” or sometimes “AutiADHD” are being used on social media, with people describing what they experience or have seen as clinicians.

It might seem surprising these two conditions can co-occur, as some traits appear to be almost opposite. For example, autistic folks usually have fixed routines and prefer things to stay the same, whereas people with ADHD usually get bored with routines and like spontaneity and novelty.

But these two conditions frequently overlap and the combination of diagnoses can result in some unique needs. Here are five important things to know about AuDHD.

1. Having both wasn’t possible a decade ago

Only in the past decade have autism and ADHD been able to be diagnosed together. Until 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) – the reference used by health workers around the world for definitions of psychological diagnoses – did not allow for ADHD to be diagnosed in an autistic person.

The manual’s fifth edition was the first to allow for both diagnoses in the same person. So, folks diagnosed and treated prior to 2013, as well as much of the research, usually did not consider AuDHD. Instead, children and adults may have been “assigned” to whichever condition seemed most prominent or to be having the greater impact on everyday life.

2. AuDHD is more common than you might think

Around 1% to 4% of the population are autistic.

They can find it difficult to navigate social situations and relationships, prefer consistent routines, find changes overwhelming and repetition soothing. They may have particular sensory sensitivities.

ADHD occurs in around 5–8% of children and adolescents and 2–6% of adults. Characteristics can include difficulties with focusing attention in a flexible way, resulting in procrastination, distraction and disorganisation. People with ADHD can have high levels of activity and impulsivity.

Studies suggest around 40% of those with ADHD also meet diagnostic criteria for autism and vice versa. The co-occurrence of having features or traits of one condition (but not meeting the full diagnostic criteria) when you have the other, is even more common and may be closer to around 80%. So a substantial proportion of those with autism or ADHD who don’t meet full criteria for the other condition, will likely have some traits.

3. Opposing traits can be distressing

Autistic people generally prefer order, while ADHDers often struggle to keep things organised. Autistic people usually prefer to do one thing at a time; people with ADHD are often multitasking and have many things on the go. When someone has both conditions, the conflicting traits can result in an internal struggle.

For example, it can be upsetting when you need your things organised in a particular way but ADHD traits result in difficulty consistently doing this. There can be periods of being organised (when autistic traits lead) followed by periods of disorganisation (when ADHD traits dominate) and feelings of distress at not being able to maintain organisation.

There can be eventual boredom with the same routines or activities, but upset and anxiety when attempting to transition to something new.

Autistic special interests (which are often all-consuming, longstanding and prioritised over social contact), may not last as long in AuDHD, or be more like those seen in ADHD (an intense deep dive into a new interest that can quickly burn out).

Autism can result in quickly being overstimulated by sensory input from the environment such as noises, lighting and smells. ADHD is linked with an understimulated brain, where intense pressure, novelty and excitement can be needed to function optimally.

For some people the conflicting traits may result in a balance where people can find a middle ground (for example, their house appears tidy but the cupboards are a little bit messy).

There isn’t much research yet into the lived experience of this “trait conflict” in AuDHD, but there are clinical observations.

4. Mental health and other difficulties are more frequent

Our research on mental health in children with autism, ADHD or AuDHD shows children with AuDHD have higher levels of mental health difficulites than autism or ADHD alone.

This is a consistent finding with studies showing higher mental health difficulties such as depression and anxiety in AuDHD. There are also more difficulties with day-to-day functioning in AuDHD than either condition alone.

So there is an additive effect in AuDHD of having the executive foundation difficulties found in both autism and ADHD. These difficulties relate to how we plan and organise, pay attention and control impulses. When we struggle with these it can greatly impact daily life.

5. Getting the right treatment is important

ADHD medication treatments are evidence-based and effective. Studies suggest medication treatment for ADHD in autistic people similarly helps improve ADHD symptoms. But ADHD medications won’t reduce autistic traits and other support may be needed.

Non-pharmacological treatments such as psychological or occupational therapy are less researched in AuDHD but likely to be helpful. Evidence-based treatments include psychoeducation and psychological therapy. This might include understanding one’s strengths, how traits can impact the person, and learning what support and adjustments are needed to help them function at their best. Parents and carers also need support.

The combination and order of support will likely depend on the person’s current functioning and particular needs. https://www.youtube.com/embed/pMx1DnSn-eg?wmode=transparent&start=0 ‘Up until recently … if you had one, you couldn’t have the other.’

Do you relate?

Studies suggest people may still not be identified with both conditions when they co-occur. A person in that situation might feel misunderstood or that they can’t fully relate to others with a singular autism and ADHD diagnosis and something else is going on for them.

It is important if you have autism or ADHD that the other is considered, so the right support can be provided.

If only one piece of the puzzle is known, the person will likely have unexplained difficulties despite treatment. If you have autism or ADHD and are unsure if you might have AuDHD consider discussing this with your health professional.

Tamara May, Psychologist and Research Associate in the Department of Paediatrics, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.