We may not like to bring it up at cocktail parties (or especially over dinner), but let's be honest: One of our number-one health concerns has to do with going number-two.
Up to 70 million Americans deal with digestive problems like constipation and irritable bowel syndrome (IBS), according to the National Institutes of Health, and women tend to be way more likely than men to get gastrointestinal (GI) ailments. Two-thirds of IBS sufferers, for instance, are female, and we're also twice as likely as men to get constipated (oh, joy).
"Women tend to be more sensitive to changes or movement in the abdomen," explains Health's Medical Editor Dr. Roshini Rajapaksa, a gastroenterologist at NYU Langone Medical Center. You don't have to resign yourself to a lifetime of tummy troubles, though. Read on to learn the cutting-edge treatments and little lifestyle changes that will keep gut issues from cramping your style.
Problem No. 1: Irritable bowel syndrome
The lowdown. The classic sign of IBS is abdominal pain that goes away after a bowel movement, or is linked to diarrhea or constipation. Women are especially prone: "They may have more bowel hypersensitivity, so nerves there overrespond to stimuli such as food or stress, causing increased gut activity," says Dr. Douglas Drossman, professor of psychiatry at the University of North Carolina-Chapel Hill.
What it feels like. Ab discomfort that continues for at least three months, plus bloating, the urge to "go," a change in your stool's consistency, and/or mucus in your stool.
Rx. Your doctor can test to rule out other conditions, like a bacterial infection. Luckily, about half of cases improve with dietary tweaks. Start by cutting back on whole-grain breads and cereals, coffee, chocolate, and nuts—all can trigger symptoms. Probiotics may also help. If not, your doc might try antispasmodic drugs to control spasming in the colon, or antidepressants (surprise!) to reduce pain.
Problem No. 2: Heartburn
The lowdown. Heartburn's the result of stomach acid backing up into your esophagus (also known as acid reflux). What you eat—and drink!—plays a big role. Foods like tomato sauce and beverages like coffee relax your esophageal sphincter, which can allow acid to flow backward. Fatty fare is another culprit, because it lingers in your stomach. Smoking, stress, and nonsteroidal anti-inflammatory pain relievers like ibuprofen can bring on heartburn, too. Being overweight is also a risk factor, says Dr. Gina Sam, director of the Mount Sinai GI Motility Center in New York City. "That's one reason we're starting to see more reflux—the obesity crisis," she says.
What it feels like. Burning pain in your chest after eating or when lying down. If you've developed gastroesophageal reflux disease (GERD)—meaning you have heartburn three times a week or more—you may also have a dry cough.
Rx. Steer clear of trigger foods and drinks. Elevating the head of your bed with blocks and taking OTC proton pump inhibitors to block acid production can help. (So can losing weight, if you need to.) If you find yourself popping heartburn meds more than once or twice a week for more than three months, see your doctor. The good news is most cases respond to prescription meds.
Problem No. 3: Constipation
The lowdown. If you suddenly have fewer than three bowel movements a week, you may be constipated, Rajapaksa says. "It can be more of an issue as women get into their late 30s or 40s, because they tend to become less active, and because of perimenopause," she notes. You can also get clogged up when you travel; blame dehydration, lack of exercise, and jet lag.
What it feels like. You have to strain to make a bowel movement, and you have hard, dry stools.
Rx. "Add four glasses of water a day to what you're already consuming," Dr. Rajapaksa says. Second, ramp up the fiber: You need at least 25 grams each day. (A packet of instant oatmeal has 4 grams.) Next, exercise daily, even if it's just a walk, to stimulate your gut. You can also try a stool softener. If you're still stuck after four days, see your doctor, who can check to see if an underlying condition, like hypo-thyroidism, could be causing the problem.
Problem No. 4: Gastroenteritis
The lowdown. This is any irritation of the stomach and intestines, caused by bacteria or viruses—think a stomach bug or "Montezuma's revenge."
What it feels like. Nausea, pain, low-grade fever, diarrhea, and/or vomiting.
Rx. To avoid dehydration, sip water, Gatorade, or ginger ale, or suck on ice chips. After 24 hours, start on the BRAT diet (bananas, rice, applesauce, toast). If you haven't kept liquids down for 24 hours, have a fever, or have been puking for more than two days, see your doctor—you could have a bacterial infection.
Gut check: Colon cancer
Colon cancer is the third most common cancer in women, which means that getting screened starting at age 50 (and earlier if you've got risk factors, like a family history) is imperative.
Though there are several ways to screen for it, the gold-standard test is the colonoscopy. During this procedure, your doctor inserts a colonoscope (a thin tube with a video camera on the end) through your rectum while you're under sedation so he can examine your entire colon. If he sees something suspicious (like a polyp), he can remove it. The downside: You have to go through a colon cleanse—usually involving laxatives—and stick to a diet of clear liquids for at least 24 hours before the test.
If your results are normal, though, you typically don't need to repeat it for another 10 years. Still squeamish? Talk to your doctor about other screening methods—including a virtual colonoscopy, sigmoidoscopy, or double-contrast barium enema, which can be less invasive and don't involve sedation. If he sees anything problematic, though, you'll still need a regular colonoscopy to remove it.