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Toots, Poops and Other Oops


Gut Check

I may be 5-foot-3 and weigh 115 pounds soaking wet, but I can fell a football team with just one of my farts on a particularly bad night.

You cringed reading that, I know. But let's face it: With everything we put into our digestive system, and all the physical and emotional stress we subject it to, our gut is bound to bring on some not-so-special effects from time to time. We're talking badass gas and constipation. Frat-boyish as all this talk may seem, women are actually more prone than men to digestive tract troubles. One person in four suffers from some kind of digestive disorder, and 70 to 80 percent of people diagnosed with irritable bowel syndrome are women, according to the American Gastroenterological Association. "A woman's colon is longer and has more twists and turns than a man's," says Robynne Chutkan, MD, the founder of the Digestive Center for Women in Chevy Chase, Maryland, and the author of Gutbliss. "That means there's more opportunity for gas and feces to get stuck and for bloat-producing bacteria to breed."

We've taken an unflinching look at some of the more embarrassing and yet startlingly common tummy troubles that afflict fit women -- and found the clever fixes that will bring your stomach some serenity.

A Heart-to-Heart About the Fart

Solutions to your festering issues:

Sometimes my farts really stink -- like something died inside me.
Some farts are just extra air you swallowed that passes virtually fragrance-free. Those hot quiet ones that can clear a room are from food naturally fermenting and breaking down in your gut.

Neutralize it: Cauliflower, eggs, meat, and other sulfurous foods spawn the worst stench, so avoid them if you've got a date or a close-quarters conference coming up. Sulphites -- often added as a preservative to foods like dried fruit, deli meats and wine -- are also triggers. If your gas is truly noxious, it could be a sign that something isn't agreeing with you, Dr. Chutkan says. Track what you're eating (dairy products are common offenders), then try cutting back on likely suspects. Also, stay hydrated, exercise, and eat a fiber-rich diet to keep things moving, because bacteria feed on stool that sits around in your gut, producing gas.

Big salads turn me into a gas balloon.
Some of the healthiest foods, like veggies, beans, and legumes, unfortunately also contain large amounts of fiber, sugars, and starches that our body can't easily digest. Our gut bacteria gobble up those pesky leftovers and, in turn, release hydrogen and methane gas. Depending on your body's ability to break down these foods, eating hefty portions can add up to some big-time gas.

Neutralize it: Make hybrid salads by topping fresh lettuce, which isn't usually a gas culprit, with lightly cooked veggies. "Cooking breaks down some of the fiber and makes them easier to digest," says Laura Manning, RD, a clinical nutrition coordinator at Mount Sinai Medical Center in New York City. Soak and rinse chickpeas and beans to remove some of the indigestible carbs that make them notorious gas producers before tossing them into the mix. And serve your creation with low-fat dressing. Fat slows digestion, giving undigested carbs more time to ferment in our gut.

I'm bloated and gassy even when I haven't eaten.
You may be gulping air while drinking, talking, or chewing gum. It's also possible that bacteria growth in your gut has gone into overdrive, spilling over from your large intestine into your small intestine. "That can make you feel full. Some women even believe they look pregnant," says Amanda Pressman, MD, a gastroenterologist at the Women's Medicine Collaborative in Providence.

Neutralize it: Limit chatting while you're chewing, and don't wolf down meals. Ditch artificially sweetened gum and candies -- they contain sugar alcohols like sorbitol, which linger in the gut and provide prime fodder for bacteria. If nothing seems to help with your bloating and gassiness, you may have small intestine bacterial overgrowth. The condition is diagnosed with a breath test and can often be treated effectively with antibiotics and/or dietary changes.

Is there something about yoga that makes me fart?
There you are in down dog and ... whoops! Your heinie says a big old hi to the class. Exercise causes the brain to release endorphins that help stimulate the digestive system, which is why it's good for relieving constipation. The relaxation response triggered by yoga and meditation may also play a role, because it prompts the body to "rest and digest," says Ed Levine, MD, a clinical instructor of gastroenterology at Quinnipiac University School of Medicine. And all that twisting can force out air involuntarily.

Neutralize it: Before your next class, try relieving gas ahead of time with a few sets of pavanamuktasana, or "wind-removing pose": Lie on your back. Exhale and draw your knees to your chest, clasping both arms around them. Extend your left leg forward as you continue holding your right knee with both arms. Hold for one minute, then bring your left knee to your chest and hold with both arms again. Repeat on the other side and return to start. Exhale, then extend both legs forward. (Always start by extending your left leg; that sequence puts pressure on specific parts of the colon and pushes air out in the proper direction.) Also, avoid eating within an hour of class.

My gassiness gets worse around my period.
Fluctuations in estrogen, progesterone, prostaglandin and other hormones before and during menstruation can lead to constipation, diarrhea, bloating or gas in many women, says Elana Maser, MD, the director of the Women's Gastrointestinal Health Center at Mount Sinai Hospital.

Neutralize it: "Taking a daily fiber supplement like Metamucil or Citrucel and drinking plenty of water the week prior to and during menstruation can help minimize symptoms," Dr. Pressman says. Avoid ibuprofen and other nonsteroidal anti-inflammatory meds, which can aggravate digestive cramps and GI symptoms.

550_102257393_w.jpgDitch Runner's Trots

People still talk about how the elite runner Grete Waitz pooped in her shorts midrace and went on to win the New York City Marathon in 1984. It was no isolated incident: A study of marathon runners showed that 83 percent reported GI troubles while training, with diarrhea and urgent bowel movements topping the list. Even if your practice isn't as intense, you may know too well the mad dash to the nearest Port-a-Potty or wooded area. "It most commonly emerges as a problem at longer races," says Lewis Maharam, MD, known as the Running Doc. If the runs are cramping your exercise routine, Dr. Maharam offers these suggestions:

Eat three to four hours before an intense workout.

Stay hydrated. Contrary to what you may think, drinking too little while exercising may actually cause diarrhea. Drinking too much, though, can lead to dangerously low sodium levels. "The answer is to drink when you're thirsty. Heed the signals your body is sending you," Dr. Maharam says.

Cut culprits. Caffeine, dairy products, high-fat foods, and artificially sweetened candies, gum, and ice cream> can trigger the trots, so avoid them pre- and midrun. Also, go easy on sports gels, because some athletes report having a bad reaction to them. "There's no reason to use them for a run that's less than 10K," Dr. Maharam says.

Consume fiber strategically. A fiber-rich meal like brown rice, kale salad, and grilled chicken the day or night before an important run can help you "go" before you lace up. Experiment to find your sweet spot well in advance of the race. And avoid high-fiber foods on race day.

Skip the pre-workout pain meds. Ibuprofen and other NSAIDs are closely associated with stomach upset.

Red Flags

These symptoms could signal a serious condition. See your doc or a gastroenterologist ASAP.

Persistent bloating. If it's accompanied by unusual weight loss or gain, pain or fever, it can be a sign of inflammation, infection, ovarian or other cancers, or pelvic inflammatory disease.

Abnormal constipation. Paired with pain, cramping, abdominal swelling or fever, constipation that's unusual for you could indicate that a blockage is preventing your bowel from emptying.

Severe diarrhea. Runs that come with vomiting, fever and cramps could be the result of food poisoning or a parasite. Chronic diarrhea could be an indication of irritable bowel syndrome or more serious inflammatory bowel diseases like Crohn's or ulcerative colitis.

Should I Pop a Probiotic?

If you're having stomach problems, first make sure you're getting 20 to 30 grams of fiber a day. Fiber is a prebiotic, or a nondigestible ingredient that acts as fertilizer for the healthy bacteria (probiotics) in our guts, which improve digestion and help to prevent GI upsets. "My favorites are flaxseeds, chia seeds or one-third of a cup of All-Bran Bran Buds cereal," says Mark Moyad, MD, a FITNESS advisory board member. "Drink one to two cups of water for every five to 10 grams of fiber, because water softens stool and makes it easier to pass."

If normalizing your fiber intake doesn't tame your tummy troubles, add probiotic-rich foods like Greek yogurt with active cultures, sauerkraut (look for one with live cultures in the refrigerated section of the supermarket), kefir (a yogurt-like drink), or miso to your daily diet. Still feel off? Dr. Moyad suggests taking a once-daily probiotic supplement by Culturelle or Align, brands backed by good clinical research.

For GI issues that have lasted months, see a gastroenterologist, who can pinpoint the source of your problem. Many maladies, such as IBS, celiac disease, and lactose intolerance can be remedied with dietary changes and may not require medication, Dr. Moyad says.

Know Your Sh*t

Go on -- take a look (and a sniff), just for the health of it.

May indicate*

Pale, chalky: Liver disease

Yellow: A parasite like giardia

Green: Infection or antibiotics

Light brown: Need to eat more deeply pigmented leafy greens

Deep brown: Good health

Red: Presence of recently digested red food (like beets or cranberries) or any food with red dye (hello, red velvet cupcakes!); bleeding from the colon or hemorrhoids

Black: You're taking an iron supplement; bleeding high in the GI tract

May indicate*

Bits of visible plant matter (corn kernels, bits of lettuce) Good health

Very chunky undigested food particles: Digestive disease like Crohn's or ulcerative colitis, which may be accompanied by weight loss, blood, abdominal pain and/or diarrhea

May indicate*

Relatively odorless: Good health

Foul: Consumption of lots of sulfur-containing foods or processed meat; constipation; or GI problems like bacterial overgrowth, inflammation, infection, or lactose intolerance

Cut and consistency
May indicate*

Loose: Inflammation in the colon; viral, bacterial or parasitic infection; lactose intolerance or food allergies

Small pebbles: Diverticulitis, a condition in which small potholes in the intestine trap waste and become inflamed or infected

Pencil-thin: Inflammation or a more serious condition

Soft, thick, easy-to-pass log several inches long: Good health

Large and hard to pass: Feces have been sitting too long in your intestines; constipation; you're not drinking enough water. Up your fiber and drink more water.

May indicate*

Clean wipe: The Holy Grail of good pooping

Messy residue: Need to eat more fiber

Skid marks or accidental bowel leakage: Constipation, hemorrhoids, or pelvic floor dysfunction

May indicate*

Floats: Pancreatic disease (only if superstinky and oily; otherwise floating is fine)

Sinks to bottom of bowl: Good health

*Don't freak! These are possibilities, not diagnoses. Talk to your doc about concerns.