Why does alcohol make my poo go weird?
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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.
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The Salt Fix – by Dr. James DiNicolantonio
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This book has a bold premise: high salt consumption is not, as global scientific consensus holds, a serious health risk, but rather, as the title suggests, a health fix.
Dr. DiNicolantonio, a pharmacist, explains how “our ancestors crawled out of the sea millions of years ago and we still crave that salt”, giving this as a reason why we should consume salt ad libitum, aiming for 8–10g per day, and thereafter a fair portion of the book is given over to discussing how many health conditions are caused/exacerbated by sugar, and that therefore we have demonized the wrong white crystal (scientific consensus is that there are many white crystals that can cause us harm).
Indeed, sugar can be a big health problem, but reading it at such length felt a lot like when all a politician can talk about is how their political rival is worse.
A lot of the studies the author cites to support the idea of healthy higher salt consumption rates were on non-human animals, and it’s always a lottery as to whether those results translate to humans or not. Also, many of the studies he’s citing are old and have methodological flaws, while others we could not find when we looked them up.
One of the sources cited is “my friend Jose tried this and it worked for him”.
Bottom line: sodium is an essential mineral that we do need to live, but we are not convinced that this book’s ideas have scientific merit. But are they well-argued? Also no.
Click here to check out The Salt Fix for yourself! It’s a fascinating book.
(Usually, if we do not approve of a book, we simply do not review it. We like to keep things positive. However, this one came up in Q&A, so it seemed appropriate to share our review. Also, the occasional negative review may reassure you, dear readers, that when we praise a book, we mean it)
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Meningitis Outbreak
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Don’t Let Your Guard Down
In the US, meningitis is currently enjoying a 10-year high, with its highest levels of infection since 2014.
This is a big deal, given the 10–15% fatality rate of meningitis, even with appropriate medical treatment.
But of course, not everyone gets appropriate medical treatment, especially because symptoms can become life-threatening in a matter of hours.
Most recent stats gave an 18% fatality rate for the cases with known outcomes in the last year:
CDC Emergency | Increase in Invasive Serogroup Y Meningococcal Disease in the United States
The quick facts:
❝Meningococcal disease most often presents as meningitis, with symptoms that may include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status.
[It can also present] as meningococcal bloodstream infection, with symptoms that may include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a dark purple rash.
While initial symptoms of meningococcal disease can at first be non-specific, they worsen rapidly, and the disease can become life-threatening within hours. Immediate antibiotic treatment for meningococcal disease is critical.
Survivors may experience long-term effects such as deafness or amputations of the extremities.❞
~ Ibid.
The good news (but still don’t let your guard down)
Meningococcal bacteria are, happily, not spread as easily as cold and flu viruses.
The greatest risks come from:
- Close and enduring proximity (e.g. living together)
- Oral, or close-to-oral, contact (e.g. kissing, or coughing nearby)
Read more:
CDC | Meningococcal Disease: Causes & How It Spreads
Is there a vaccine?
There is, but it’s usually only offered to those most at risk, which is usually:
- Children
- Immunocompromised people, especially if HIV+
- People taking certain medications (e.g. Solaris or Ultomiris)
Read more:
CDC | Meningococcal Vaccine Recommendations
Will taking immune-boosting supplements help?
Honestly, probably not, but they won’t harm either. The most important thing is: don’t rely on them—too many people pop a vitamin C supplement and then assume they are immune to everything, and it doesn’t work like that.
On a tangential note, for more general immune health, you might also want to check out:
Beyond Supplements: The Real Immune-Boosters!
The short version:
If you or someone you know experiences the above-mentioned symptoms, even if it does not seem too bad, get thee/them to a doctor, and quickly, because the (very short) clock may be ticking already.
Better safe than sorry.
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Shoulder Mobility Hack (Measurable Results In 60 Seconds)
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Mobility usually improves with time and consistency, but there’s a quick hack that can enhance shoulder mobility in about 60 seconds:
Nerve-Gliding
This one’s a very specific technique, so we’re going to break it down a bit more than we usually do when talking about exercises.
First, assess your baseline mobility:
- Record yourself from the side.
- Lift your arm straight up with your palm facing inward.
- Keep your ribs down* and avoid arching your back.
- Make a note of your range, and any sensations.
*if you’re reading this and thinking “where else would my ribs go?”, if you try it you’ll understand
Radial nerve glide (back of arm to thumb):
- Start with your arm down, shoulder depressed.
- Internally rotate your arm (palm facing back/side).
- Flex your wrist (like accepting something being passed to you stealthily from behind).
- Lift your arm out and tilt your head in the opposite direction.
- Perform the nerve glide itself by straightening your wrist and head, then return.
- Repeat 10 times.
Musculocutaneous nerve glide (front of arm):
- Make a fist and depress your shoulder.
- Rock your wrist forwards/backwards, then hold it tilted back.
- Take your arm behind your back, extending your shoulder.
- Tilt your head to the opposite side.
- Perform the nerve glide itself by straightening your wrist and head, then return.
- Repeat 10 times.
For more on all of this plus—of course—visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
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For tennis star Destanee Aiava, borderline personality disorder felt like ‘a death sentence’ – and a relief. What is it?
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Last week, Australian Open player Destanee Aiava revealed she had struggled with borderline personality disorder.
The tennis player said a formal diagnosis, after suicidal behaviour and severe panic attacks, “was a relief”. But “it also felt like a death sentence because it’s something that I have to live with my whole life”.
A diagnosis is often associated with therapeutic nihilism. This means it’s viewed as impossible to treat, and can leave clinicians and people with the condition in despair.
In fact, people with this disorder can and do recover with adequate support. Understanding it is caused by trauma is fundamental to effectively treat this complex and poorly understood mental illness.
A stigmatising diagnosis
The name “borderline personality disorder” is confusing and adds greatly to the stigma around it.
Doctors first used “borderline” to describe a condition they believed was in-between two others: neurosis and psychosis.
But this implies the condition is not real in itself, and can invalidate the suffering and distress the person and their loved ones experience.
“Personality disorder” is a judgemental term that describes the very essence of a person – their personality – as flawed.
What is borderline personality disorder?
People with the disorder can express a range of symptoms, but high levels of anxiety – including panic attacks – are usually constant.
Symptoms cluster around four main areas:
- high impulsivity (leading to suicidal thoughts and behaviour, self-harm and other risky behaviours)
- unstable or poor sense of self (including low self-esteem)
- mood disturbances (including intense, inappropriate anger, episodic depression or mania)
- problems in relationships.
People with the disorder greatly fear being abandoned and as a result, commonly have distressing difficulties in interpersonal relationships.
This creates a “push-pull” dynamic with loved ones, as people with borderline personality disorder seek closeness, but push away those they love to test the strength of the relationship.
For example, they may escalate a small issue into a major disagreement to see if the loved one will “stick with them” and reinforce their love.
Conversely, if a loved one appears distant or fed up – for example, is thinking about ending the relationship – the person with borderline personality disorder will make major efforts to “pull” them back. This might look like a flurry of messages, expressions of despair, or even suicidal behaviours.
People with borderline personality disorder greatly fear being abandoned, making relationship issues common. Drazen Zigic/Shutterstock Who does it affect?
The disorder affects one in 100 Australians, although this is likely a conservative estimate, as diagnosis is based on the most severe symptoms.
Women are much more likely to be diagnosed with it than men – but why this is so remains a major debate, with political and sociological factors playing a role in making psychiatric diagnoses. Symptoms usually begin in the mid to late teens.
While an initial response to receiving a diagnosis can be comforting for some, it is commonly seen as a chronic, relapsing condition, meaning symptoms can return after a period of improvement.
Borderline personality disorder can fluctuate in intensity and mimic other conditions such as major depression, bipolar disorder, anxiety disorders and psychosis.
Estimates suggest 26% of presentations at emergency departments for mental health issues are by people diagnosed with personality disorders, particularly borderline personality disorder.
What causes it?
The main cause for borderline personality disorder appears to be trauma in early life, compounded by repeated traumas later.
Early life trauma can lead to biological changes in the brain that cause behavioural, emotional or cognitive shifts, leading to social and relationship issues. This is known as complex post-traumatic stress disorder.
Aiava has acknowledged the disorder is “mainly from childhood trauma”, although she has not given details about her specific experiences.
People with borderline personality disorder usually have complex post-traumatic stress disorder. But complex post-traumatic stress disorder doesn’t always result in a borderline personality disorder diagnosis.
Although the two disorders are not identical, they share many similarities, in particular that they are both caused by complex and repeated trauma.
However those with borderline personality disorder tend to experience more rage, emotional disturbances and have a greater fear of abandonment.
They also face greater stigma, whereas the term “complex post-traumatic stress disorder” doesn’t carry the same negative connotations and focuses on the cause of the condition – trauma – rather than “personality”, leading to better treatment options.
The recognition of the major role of trauma in borderline personality disorder is an important step forward in treating the disorder. But because of the stigma associated with it, using the diagnosis of complex post-traumatic stress disorder maybe a better step forward in the future.
Can it be treated?
There are many effective psychological therapies and other treatments for people with borderline personality disorder or complex post-traumatic stress disorder.
For example, dialectical behavioural therapy is a type of cognitive therapy that helps people learn skills such as tolerating distress, managing relationships, regulating emotions and practising mindfulness.
The treatment of people with post-traumatic stress disorder, including victims of war and rape, has taught us a lot about how to treat complex, underlying trauma. For example, with trauma-focused psychological therapies.
Other new treatments, such as eye movement desensitisation and reprogramming, have also shown to be effective.
Many people with borderline personality disorder who receive treatment and have supportive relationships are able to “outgrow” the condition. Others may need to continue to manage symptoms while pursuing a good quality of life.
Treating trauma, not personality
Rethinking borderline personality disorder as a trauma disorder enables a more effective and understanding approach for those with it.
Understanding what trauma does to the brain means newer, targeted medications can also be used.
For example, our research has shown how the brain’s glutamate system – the chemicals responsible for learning and making sense of one’s environment – is overactive in people with complex post-traumtic stress disorder. Medications that work on the glutumate system may therefore help alleviate borderline personality disorder symptoms.
Educating partners and families about borderline personality disorder, providing them support and co-designing crisis strategies are also important parts of total care. Preventing early life trauma is also critical.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Jayashri Kulkarni, Professor of Psychiatry, Monash University and Eveline Mu, Research Fellow in Women’s Mental Health, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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One More Way Exercise Improves Mental Health
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“Exercise improves mental health” is itself not a new idea. For example,
We talk often about “what’s good for your heart is good for your brain“, and it goes not just for reducing risk factors (see: What’s Your Vascular Dementia Risk?), but also for improving cognitive function, e.g: How Your Exercise Today Gives A Brain Boost Tomorrow
But it’s not just cognitive function! It boosts mood too: Running or yoga can help beat depression, research shows, even if exercise is the last thing you feel like
…and, for that matter, Behavioral Activation Against Depression & Anxiety ← of which, exercise is not a definitionally required component, but it’s one of the most common ones
It even goes for quite specific forms of depression, such as: Dancing vs Parkinson’s Depression
But, what’s new?
Fitness & emotional resilience
In few words: researchers (Dr. Katja Weiss et al.) found that that higher cardiorespiratory fitness was linked to lower anxiety, lower anger, and greater emotional resilience under stress.
Indeed, the paper got titled: Cardiorespiratory fitness is associated with lower anger and anxiety and higher emotional resilience
What they did: healthy adults were split into above average and below average fitness groups based on exercise used to estimate VO₂Max, then viewed 69 neutral or unpleasant images across two 30-minute sessions, with anger and anxiety measured before and after.
The findings were as follows:
- For anxiety: VO₂Max predicted lower trait anxiety (β = −0.456, p = 0.001), and participants below average in fitness had a 775% greater risk of shifting from intermediate to high anxiety after unpleasant images (OR = 8.754, 95% CI [1.202; 63.759]).
- For anger: lower VO₂Max predicted greater increases in state anger during unpleasant image exposure (β = −0.241, p = 0.003), and higher anger-out scores also predicted anger increases (β = 0.333, p = 0.040), with less fit individuals showing poorer anger control.
Limitations: small sample size (n=40), estimated VO₂Max, questionnaire-based self-reports of some data.
Nevertheless, it is consistent with the idea that physical health and emotional resilience are closely tied together, in what’s most likely a bidirectional relationship (e.g. either one being strong supports the other being strong, whereas either one being weak weakens the other).
See for example: The Stress Prescription (Against Aging!) ← this is about the work of the remarkable Dr. Elissa Epel, who has for the past 20 years specialized in the effect of stress on aging. She’s led groundbreaking research on cortisol, telomeres, and telomerase, all in the context of aging, especially in women, as well as the relationship between stress and weight gain. She was elected member of the National Academy of Medicine for her work on stress pathways, and has been recognized as a key “Influencer in Aging” by the Alliance for Aging Research. Indeed, she’s also been named in the top 0.1% of researchers globally, in terms of publication impact.
So you can tackle this one from both sides! As for what you can do from the psychological side, see: Building Psychological Resilience (Without Undue Hardship)
Want to improve your VO₂Max?
We’ve got you covered:
53 Studies Later: The Best Way To Improve Your VO₂Max
Take care!
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Rethinking Diabetes – by Gary Taubes
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We’ve previously reviewed this author’s “The Case Against Sugar” and “Why We Get Fat And What To Do About It“. There’s an obvious theme, and this book caps it off nicely:
By looking at the history of diabetes treatment (types 1 and 2) in the past hundred years, and analysing the patterns over time, we can see how:
- diabetics have been misled a lot over time by healthcare providers
- we can learn from those mistakes going forwards
Happily, he does this without crystal-balling the future or expecting diet to fix, for example, a pancreas that can’t produce insulin. But what he does do is focus on the “can” items rather than the “can’t” items.
In the category of criticism, one of the strategies he argues for is basically the keto diet, which is indeed just fine for diabetes but often not great for the heart in the long-term (it depends on various factors, including genes). However, even if you choose not to implement that, there is plenty more to try out in this book.
Bottom line: whether you have diabetes, love someone who does, or just plain like to be on top of your glycemic health, this book is full of important insights and opportunities to improve things progressively along the way.
Click here to check out Rethinking Diabetes, and rethink diabetes!
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