The 5 things I NEVER do as a bowel doctor to slash my risk of cancer, constipation and ulcers
A HEALTHY bowel is crucial for optimal digestion as well as overall health.
It can help your body absorb nutrients from food, maintain a healthy immune system, and influence overall well-being by affecting factors like mental health, energy levels, and the balance of gut bacteria.
Failing to maintain good bowel health could open you up to unpleasant health issues, including ulcers and even cancer.
Evidence suggests bowel problems, such as irritable bowel syndrome (IBS) and bowel cancer, are on the rise in the UK, according to recent reports.
In particular, there's been a noticeable increase in younger adults being diagnosed with bowel cancer.
This means looking after our bowel health is more important than ever, and one person who knows this best is Dr Subramaniam Ramakrishnan, Consultant Physician and Gastroenterologist at Nuffield Health.
As well as diagnosing and treating bowel-related conditions, Dr Ramakrishnan makes sure to keep his gut in tip-top shape.
He revealed five things he always avoids to optimise bowel health.
1. Be sedentary
Being sedentary means spending a large amount of time sitting or lying down while awake, with very little physical activity.
It's often associated with activities like watching TV or using a computer, and has been linked to a range of health problems, including heart disease, type 2 diabetes and high cholesterol.
But Dr Ramakrishnan explained it can also affect your gut.
He told The Sun: "Being sedentary can lead to slow movement of the gut, proneness to constipation, and a higher risk of obesity."
Studies have shown a sedentary lifestyle may play a causal role in the development of many gastrointestinal diseases.
For example, one study published in January 2024 found sedentary behaviours were associated with elevated incident irritable bowel syndrome (IBS) risk.
A sedentary lifestyle is believed to contribute to the development of IBS by disrupting normal bowel function through mechanisms like reduced blood flow to the gut due to prolonged sitting, impacting gut motility, increasing stress levels, and potentially altering the gut microbiome.
Whether it's running, swimming, cycling, or dancing, a cardio workout will do wonders at stimulating your bowels.
Even if you don't feel up to a full-on workout, try going for a brisk 30-minute walk.
2. Not get enough sleep
Inadequate sleep is associated with increased risk of heart disease, mental illness, and obesity, and can also impact bowel health, said Dr Ramakrishnan.
Studies have shown it can impact the bowel by disrupting hormone balance, increasing stress hormones like cortisol, which can lead to issues like increased intestinal permeability, inflammation in the gut, and changes in gut microbiota composition.
This can potentially cause symptoms like bloating, abdominal pain, and diarrhoea.
A study published in August 2024 also indicates sleep disorders are linked to an elevated risk of constipation.
The NHS recommends that adults sleep seven to nine hours per night.
If you struggle to sleep, establishing a sleep routine, relaxing and unwinding before bed, and creating a peaceful sleep environment are all things that can help.
3. Drink too much alcohol
Alcohol can have many adverse health effects, including weakening of the heart muscle, depression and anxiety.
But Dr Ramakrishnan also shared some of the complications linked to bowel health.
He said: "Alcohol consumption can lead to gut microbiome alterations, inflammation, and ulcers of the digestive
system (gastritis, ulcer disease), as well as pancreatitis, pancreatic cancer, and liver disease leading to cirrhosis and bowel cancer."
A paper published in 2007 showed alcohol consumption can interfere with the function of all parts of the gastrointestinal tract.
For example, in the small intestine, alcohol inhibits the absorption of numerous nutrients.
Alcohol is linked to an increased risk of developing several types of cancer including bowel cancer.
It can damage the cells that line the inside of the bowel, which makes it more likely for cancer to develop, warns Bowel Cancer UK.
Men and women are advised not to drink more than 14 units a week on a regular basis - 14 units is equivalent to six pints of average-strength beer or 10 small glasses of lower-strength wine.
To cut down your alcohol intake, try swapping strong beers or wines for ones with a lower strength, try alcohol-free drinks or a selection of mocktails, and try having several drink-free days each week.
4. Smoke
Smoking is a major risk factor for bowel health, increasing the risk of bowel cancer, Crohn's disease, and other conditions.
Dr Ramakrishnan added: "Smoking increases the risk of gullet, stomach, and pancreatic cancer, and worsens conditions in those
who may be prone to inflammatory bowel disease (Crohn’s disease)."
People who smoke are more likely to develop polyps (non-cancerous growths) in the bowel, which could turn into cancer if they’re not treated.
And Crohn's & Colitis UK says smoking if you have Crohn's has been linked to more severe disease and complications.
These include strictures, narrowing in the bowel that can cause a dangerous blockage, and perianal disease, which is Crohn's around the bottom.
Find out eight easy and cheap ways to quit smoking for good.
5. Eat ultra-processed foods
Ultra-processed foods are high in refined sugars, refined starch, and trans fats, which contribute to chronic inflammation.
As well as disrupting gut health, they can lead to obesity, which is a risk factor for many cancers.
Dr Ramakrishnan said: "Ultra-processed food intake increases the risk of obesity, which in turn increases the risk of breast, uterine, and bowel cancer."
A study published in 2022 found eating a lot of ultra-processed foods is linked to an increased risk of developing bowel cancer in men, because men are more likely to follow an unhealthy diet.
How ultra processed is YOUR kitchen?
Ultra processed foods (UPFs) were defined by Brazilian researchers who made the NOVA classification system. It breaks foods into groups depending on how processed they are. The most natural foods are in group 1, while the most processed are in group 4.
The groups do not entirely indicate how healthy a food is. However, it does indicate how processed it is - and studies have linked UPFs to a number of diseases.
How does your kitchen compare to the following groups?
Unprocessed or minimally processed foods (group 1)
- vegetables and fruits (fresh or frozen)
- dried fruits with no added sugar, honey, or oil
- grains and legumes (chickpeas, lentils)
- meat, poultry, fish, seafood, eggs
- milk without added sugar
- plain yogurt with no added sugar
- nuts and seeds
- spices and herbs
- tea, coffee, water
Processed culinary ingredients (group 2)
- iodized salt
- salted butter
- sugar and molasses from cane or beet
- honey extracted from combs
- syrup from maple trees
- vegetable oils crushed from olives or seeds
- butter and lard from milk and pork
- starches extracted from corn and other plants
- vegetable oils with added anti-oxidants
- vinegar with added preservatives
Processed foods (group 3)
- canned vegetables, fruits, and legumes
- fruits in syrup
- salted or sugared nuts and seeds
- salted cured or smoked meats
- canned fish
- artisanal breads and cheese
Ultra-processed foods (group 4)
- pop and fruit drinks
- sweetened yogurt
- sweet or savoury packaged snacks (e.g., cookies)
- candies and cake mixes
- mass-produced packaged breads and buns
- margarines and spreads
- breakfast cereals
- cereal and energy bars
- energy drinks
- instant soups, sauces, and noodles
- poultry and fish nuggets, hot dogs
- many ready-to-heat products: pre-prepared pies, pasta, and pizza dishes
Top tip for keeping bowel health in check
As well as not smoking, limiting alcohol intake, getting enough sleep, and moving, Dr Ramakrishnan says one of the best things you can do for bowel health is eat a healthy, balanced diet with adequate protein, fats, and carbohydrates, and limiting calories to individual body needs.
He added: "Also avoid snacking between principal meals.
"All the above helps protect and replenish the gut microbiome, which in turn prevents both gut-related diseases and diseases of other organs.
"A diet that is not balanced is likely to result in a higher chance of being overweight, which in turn makes one prone to diabetes, obesity, heart disease, and cancer.
"Avoiding snacking is the best way to reduce calorie and ultra-processed food intake, thereby reducing weight gain."
For an overall diet to follow, try the Mediterranean diet, says Dr Ramakrishnan.
He said: "The Mediterranean diet is considered one of the healthiest options, with an excellent combination of foods that supply all the essential nutrients.
"Fruit and vegetables, legumes, lean meat from fish and poultry, and olive oil are all good examples of this."
Red flags for bowel health
Knowing your normal bowel pattern can help you notice any worrying changes.
The Bristol Stool Scale is a well-established way to keep track of this.
Dr Ramakrishnan said: "Many people don’t even keep a mental record of when they have moved their bowels or what type of stools they pass!"
He added: "Any significant changes to this pattern or bleeding from the back passage are signs that could indicate an underlying problem, and you should seek advice."