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.

Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will have it this year.

Chronic pain, of which back pain is the most common, is the world’s most disabling health problem. Its economic impact dwarfs other health conditions.

If you get back pain, how long will it take to go away? We scoured the scientific literature to find out. We found data on almost 20,000 people, from 95 different studies and split them into three groups:

• acute – those with back pain that started less than six weeks ago
• subacute – where it started between six and 12 weeks ago
• chronic – where it started between three months and one year ago.

We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.

Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.

More pain doesn’t mean a more serious injury

Most acute back pain episodes are not caused by serious injury or disease.

There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.

Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.

The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.

The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.

Reduce your chance of lasting pain

Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:

• understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain
• reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.

How to reduce your pain sensitivity and learn about pain

Learning about “how pain works” provides the most sustainable improvements in chronic back pain. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.

These programs have been in development for years, but high-quality clinical trials are now emerging and it’s good news: they show most people with chronic back pain improve and many completely recover.

But most clinicians aren’t equipped to deliver these effective programs – good pain education is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.

When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just been told it’s all in their head.

Community-driven not-for-profit organisations such as Pain Revolution are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than 80 local pain educators and supported them to bring greater understanding and improved care to their colleagues and community.

But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.

Sarah Wallwork, Post-doctoral Researcher, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia

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