Gut health is now a top wellness priority for many, thanks to a growing body of research which suggests the state of your gut influences everything from your mood to sleep quality.
“Gut health is about much more than whether you’re bloated or how often you go to the toilet,” says Dr Megan Rossi, dietitian, author, gut health scientist and founder of The Gut Health Doctor. “The gut interacts extensively with the immune system, metabolism and the gut–brain axis.” A healthy gut even produces more mood-regulating microbes such as serotonin (95 per cent of which is made in the stomach).
“In an ideal world, a healthy gut is one that you don’t have to think about too much,” says Rossi. “You’re generally free from troublesome digestive symptoms such as bloating, abdominal pain or reflux – as a rough guide, experiencing these less than once a month.”
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Trainline and Virgin Atlantic investigated for ‘drip pricing’
Caption: SAN FRANCISCO, CALIFORNIA – MAY 12: A Virgin Atlantic Airline plane is taxiing to takeoff from San Francisco International Airport (SFO) in San Francisco, California, United States on May 12, 2026. (Photo by Tayfun Coskun/Anadolu via Getty Images)
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Trainline, Virgin Atlantic and Red Driving school are all under investigation for “drip pricing” – where mandatory charges are added on separately from the headline price, or added later in the buying process.
A wider crackdown
The investigations come as part of a wider crackdown by the Competition and Markets Authority (CMA) over concerns that customers were not being shown the total price upfront.
Exclusive
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Newsletter (£)
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Why companies do it
“Drip pricing” leaves customers facing unexpected costs and can affect competition between businesses, as a firm can falsely present cheaper prices than a competitor to attract more customers.
Caption: Justice hammer or gravel on a table and justice scale at the background, concept image
Photographer: David Talukdar
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Source: Moment RF
Caption: A close-up shot of a young man’s hands opening an empty leather wallet, symbolizing financial struggle, poverty, and money problems.
Photographer: Virojt Changyencham
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If the CMA finds there has been a breaking of the law, it can force businesses to pay compensation to affected customers and fine them up to 10 per cent of their global turnover.
The firms being investigated
Trainline is being investigated over booking fees for coach and train tickets imposed at checkout.
Virgin Atlantic is being investigated over whether mandatory resort fees and local taxes are included in the upfront prices of their package holidays.
Red Driving School is being investigated for how a mandatory booking fee and “digital” fee have been charged to customers booking driving lessons.
2 min read
What the companies have said
Caption: A lphone showing the Trainline app button. Trainline has revealed it made a record amount from ticket sales last year, but its share price plummeted on Thursday amid concerns over Government plans for a rival national ticketing app. Picture date: Thursday March 13, 2025. PA Photo. The London-listed firm made ?5.9 million from selling tickets in the year ending February, 12% up from the year before but at the bottom end of guidance given in October. Trainline makes most of its money by taking a commission on ticket sales for coach and rail journeys, and benefitted from fewer train strikes last year than in 2023. See PA story CITY Trainline. Photo credit should read: Yui Mok/PA Wire
Photographer: Yui Mok
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Copyright: PA
Trainline
“We are taking proactive steps to enhance how certain fees are presented to our customers.”
Virgin Atlantic
“We are reviewing the points raised by the CMA carefully and will co-operate fully with its investigation.”
Caption: SAN FRANCISCO, CALIFORNIA – MAY 12: A Virgin Atlantic Airline plane is taxiing to takeoff from San Francisco International Airport (SFO) in San Francisco, California, United States on May 12, 2026. (Photo by Tayfun Coskun/Anadolu via Getty Images)
Photographer: Anadolu
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Source: Anadolu
There has been an increase in people being scammed online for driving tests and lessons (Photo: David Jones/PA)
Red Driving School
“[We] always values both transparency and consumer satisfaction in all of our interactions with our customers.”
Caption: JOINT BASE ANDREWS, MARYLAND – AUGUST 11: U.S. President Donald Trump speaks to reporters after stepping off Air Force One on August 11, 2026 in Joint Base Andrews, Maryland. Trump was asked about the secret decoy flight he took out of Turkey in a military aircraft. The president was returning to Washington, DC after traveling to Ohio to attend the 2026 Patriot Games. (Photo by Anna Moneymaker/Getty Images)
Photographer: Anna Moneymaker
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Copyright: 2026 Getty Images
world news
Everything you need to know about the US midterms
On 3 November, voters from all over the United States will cast their ballots in the midterm elections, which could reshape Congress and make it harder for Donald Trump to pass policy.
Who is up for election?
All 435 seats in the House of Representatives, the lower house of Congress, and around a third of the 100 seats in the Senate (the upper house). Trump’s Republican Party currently holds a slim majority in both.
Caption: WASHINGTON, DC – AUGUST 12: The U.S. Capitol building is seen at sunset on August 12, 2026 in Washington, DC. (Photo by Kevin Carter/Getty Images)
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Caption: ATLANTA, GEORGIA – AUGUST 13: U.S. House Minority Leader Hakeem Jeffries (D-NY) speaks onstage at “The New Power Structure: Black Politics in the Age of Resistance” panel during the 2026 National Association of Black Journalists Convention at Atlanta Marriott Marquis on August 13, 2026 in Atlanta, Georgia. (Photo by Nykieria Chaney/Getty Images)
Photographer: Nykieria Chaney
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Copyright: NYKIERIA CHANEY
To take control of the House, the Democrats, who are favoured to win here, will need to win three seats, whereas in the Senate, it will be more difficult, with them needing to net four seats.
Why do they matter?
While Trump’s name will not be on the ballot, the midterms are viewed by many as a referendum on the US President, who will be a major influence on how many voters approach this year’s midterms.
Perhaps more importantly, if the balance of power in Congress shifts to the Democrats, Trump would become a “lame-duck” President and struggle to push through legislation.
Analysis
3 min read
5 min read
History does not favour Trump
The incumbent party is usually predicted to lose the midterms, with the president’s party only gaining congressional seats four times since 1902.
The trend is unlikely to change for Trump, who has become an especially divisive President with a current approval rating of -23 per cent.
Caption: US President Donald Trump during an executive order signing in the Oval Office of the White House in Washington, DC, US, on Monday, Aug. 10, 2026. President Donald Trump is expected to sign an executive order Monday that would recommend breaking up the combined measles, mumps and rubella vaccine into three separate shots and unilaterally overhauling the national childhood vaccination recommendations. Photographer: Bonnie Cash/UPI/Bloomberg via Getty Images
Photographer: Bloomberg
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Source: Bloomberg
3 min read
Will Trump let himself lose?
Many commentators have predicted Trump will lose the midterms, but this is not a typical President, and these elections may set off a new threat to American democracy.
Caption: WASHINGTON, DC – JANUARY 17: Virginia National Guard soldiers are issued their M4 rifles and live ammunition on the east front of the U.S. Capitol on January 17, 2021 in Washington, DC. After last week’s riots at the U.S. Capitol Building, the FBI has warned of additional threats in the nation’s capital and in all 50 states. According to reports, as many as 25,000 National Guard soldiers will be guarding the city as preparations are made for the inauguration of Joe Biden as the 46th U.S. President. (Photo by Samuel Corum/Getty Images)
Photographer: Samuel Corum
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Copyright: 2021 Getty Images
Trump’s rhetoric and actions have drawn widespread concerns about how he might seek to overrule the will of voters and challenge results he doesn’t like.
Is a September heatwave around the corner?
The UK is currently in a much-needed cooler period after the heatwaves of July and early August, but the Met Office has suggested that we could see high temperatures return going into September.
Caption: A walker protects themselves from the sun on the scorched grass of Hyde Park, in central London on August 9, 2026, as another heatwave threatens the capital this week. England and Wales recorded the driest July since records began. Some counties across England saw less than one millimetre of rain during the entire month of July. (Photo by Peter Nicholls / AFP via Getty Images)
Photographer: PETER NICHOLLS
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Heatwave ‘can’t be ruled out’
The Met Office has predicted there is a “chance that late-season hot spells or heatwaves develop, especially in the South” in the first 12 days of September.
Caption: DORCHESTER, ENGLAND – AUGUST 10: An aerial view of the dried out ground of Maiden Castle Iron Age hillfort, on August 10, 2026 in Dorchester, United Kingdom. Drought has been declared across seven areas of England; East Anglia; Hertfordshire and the whole of London; Thames Valley; Hampshire & the Isle of Wight; Devon & Cornwall; the West Midlands; Wessex (covering Dorset, Somerset, Wiltshire, and south Gloucestershire). (Photo by Finnbarr Webster/Getty Images)
Photographer: Finnbarr Webster
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Caption: LONDON, UNITED KINGDOM – AUGUST 13: People seek relief from extreme heat as temperatures reach 36????C in London, United Kingdom on August 13, 2026. The UK Met Office issued an amber heat warning for London and several other areas due to the high temperatures. (Photo by Rasid Necati Aslim/Anadolu via Getty Images)
Photographer: Anadolu
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Niamh Murray, an operational meteorologist at the Met Office, said a September heatwave “can’t be ruled out” but that it was too soon to say “with any real confidence” if it will happen, as temperatures will naturally drop as we head towards autumn.
A dry autumn
Despite showers expected throughout the rest of August, the Met Office’s long-range forecast indicates that autumn is likely to be drier than average.
This means there is little chance that the drought situation will be alleviated, with the Environment Agency suggesting that “weeks of above-average rainfall” will be needed.
3 min read
3 min read
Cutting bills could be used as an incentive to reduce water usage as millions of people live in drought
go deeper on this topic
What UK can learn from Europe about using water bills to fight drought
Some water companies across England are trialling tiered billing systems which leave heavy water users facing higher prices for every drop – all in a bid to protect supplies from dwindling.
Sales of battery
electric vehicles hit a record high last year.
Leon Poultney, a writer who specialises in cars, gives his EV recommendations, and the ones that should be avoided.
Renault 5 E-Tech
Starts at £22,995 for the smaller battery
Available with either a 40kWh battery or a larger 52kWh pack, that offers almost 255 miles, the latest, retro-inspired Renault 5 is both a joy to behold and a hoot to drive.
The interior has been lavished with a level of detail that’s typically reserved for more expensive cars.
4 min read
Mercedes-Benz CLA
A champion of EV efficiency
It offers a remarkable 491 mile range on a single charge from the 85kWh battery.
It is a technological masterclass inside with the ability to option screens that span the entire width of the dashboard, including an optional display for the front passenger.
Priced from £37,400
2 min read
Porsche Macan GTS
It’s a lot of money to part with, but this is arguably all the car you will ever need.
The £89,000 Macan is a premium SUV that somehow manages to blend Porsche’s reputation for dynamics and sporty driving with everyday practicality.
The 95kWh batteries can go from 10 to 80 per cent in as little as 21 minutes from the fastest public charging outlets.
Kia EV 9
With the business class-style six seat configuration costing a staggering £76,995, it is by far the most expensive Kia ever made, but it backs up its financial demands with a suite of genuinely useful and impressive onboard technology.
MG IM6
It’s fast, goes a long way between stops and charges relatively quickly but the interior is bland, the onboard technology is infuriating and the experience is devoid of emotion.
BYD Dolphin Surf
All of its gadgetry can’t disguise the fact that performance is weak, even for a typically zippy EV, the ride is fussy at slower speeds and it’s not in the least bit enjoyable to drive on a country road.
While good value (prices start at £17,935) for the 200-mile max range, there are more interesting options from Hyundai, Citroen and Renault for similar money.
Leapmotor T03
It attempts to wow with tech, much of which hinders, rather than helps.
There’s no tangible benefit over mounting your phone to the dash.
Simply an average driving experience, adequate range and slow charging speeds.
2 min read
The kitchen gadgets and products a food editor swears by, all under £25
The kitchen gadgets under £25
Caption: best kitchen gadgets
Victorinox paring knife
It’s comfortable to hold, with a point sharp enough for scoring pastry.
ProCook cast iron pan
For unbeatable searing and heat-retention, cast iron is the top choice.
Tesco chopping board
Priced at just £22, I’ve yet to find another board that matches it for sheer value and quality.
The kitchen gadgets under £25
Pyrex jug
It is the perfect vessel for blending smooth sauces, melting butter, or warming stock. It won’t stain like plastic and the red measurements never fade.
Salter scales
“I’ve had my slim little set of Salter Disc Scales for over a decade, and I’m delighted to see they are still made to exactly the same reliable design today.”
Microplane grater
It uses photo-etched stainless steel teeth that stay razor-sharp for a decade, something the lookalike copycats simply can’t match.
Braun hand-held blender
It’s an essential for everything from making velvety soup to getting the lumps out of white sauce.
Bodum cafetiere
As well as delivering great results, cafetieres are easy to clean and there’s no ongoing filter paper costs or pod recycling to deal with.
5 min read
The kitchen gadgets under £25
Oxo peeler
What truly sets it apart is the chunky, rubberised handle that absorbs pressure and stays completely non-slip, even if your hands are wet. It is inexpensive and incredibly durable.
Falcon pie dish
Made by fusing porcelain onto heavy-gauge steel for smooth durability, it is dishwasher, freezer, hob, air-fryer and oven-safe.
The golden rules for a happy, secure relationship
Psychiatrist and neuroscientist Dr Amir Levine, author of bestselling book Attached, explains why we behave the way we do in love.
Caption: Happy woman walking with male partner in vineyard during sunset. Elderly couple are touring in field against sky. They are enjoying during weekend.
Photographer: Morsa Images
Provider: Getty Images
Source: Digital Vision
Golden rules for happy relationships
Start with your own behaviours
The foundation of a secure, connected life is being what I call CARRP: that means being consistent, available, responsive, reliable and predictable. All of these qualities can be enacted in small gestures every day.
Side view of affectionate happy couple sitting in the cozy cafe. – stock photo. (Photo: Getty)
Son’t assume your partner knows how you think (Photo: ljubaphoto/Getty/E+)
Express your needs
People need consistency and connection to feel safe. This is not, ‘You hurt my feelings by never replying to me’, it’s more ‘this is the kind of contact that helps me feel secure’.
Golden rules for happy relationships
Unhappy married couple facing away from each other in a quiet home, concept of emotional distance, loneliness in relationship and family problems – stock photo. (Photo: Getty)
The appendix ‘inflammation’ rule
If a relationship repeatedly inflames your nervous system, you need to disengage and deprioritise it.
Lean on community
You don’t need hundreds of friends. You need people and places that regularly remind you that you belong.
Caption: Happy couples talking while walking embraced during spring day in a meadow.
Photographer: skynesher
Provider: Getty Images
Source: E+
Candid shot happiness and togetherness Asian mother supporting daughter try to standing and walking first time and positive emotion – stock photo. (Photo: Getty)
Stop blaming childhood
Humans are much more complicated than: ‘this happened to you, therefore you are doomed to be anxious’.
Caption: Financial problems. Worried middle-aged woman holding utility bills, managing monthly household budget, sitting on bed feeling anxious. Cost of living concept
Photographer: MementoJpeg
Provider: Getty Images
Source: Moment RF
Reach for a
secure script
When something unsettles you in a relationship, your first reaction is not always the most accurate one.
If you’re anxious, your brain may jump very quickly to: ‘this is the beginning of the end’. If you’re avoidant, your brain may say: ‘this person wants too much from me, I need to get away’. So one very practical thing you can always do is pause and ask: ‘What would a secure person do here?’
Loneliness elsewhere
When people talk about loneliness, they often assume it means you don’t have enough people in your life. But you can be surrounded by people and still feel lonely if those relationships leave you feeling excluded, ignored or disconnected.
Frustrated lonely shy guy sitting apart of others teenagers – stock photo. (Photo: Getty)
What to do
Build a community that works for your temperament and gives you regular, reliable moments of connection.
You can still be kind to people while not treating them as someone who belongs in your inner circle.
Explain what you need. Sometimes people simply don’t realise how you are experiencing them.
Check in with people: does this person actually feel that I’m reliable? Do they experience me as predictable? That’s the only way that you can start to become more secure.
Do some foods leave
you feeling hungry rather than satiated? Experts say there are…
Foods that leave you hungrier
A bowl of cereal and glass of orange juice
More refined cereals are digested quickly, and fruit juice, whilst one of your five-a-day, contains less fibre than whole fruit. This might mean you find yourself hungry again within 1-2 hours of eating this breakfast.
No more orange juice. (Photo via pixaby)
It’s estimated ultra processed foods make up at least half of the average UK diet (Photo: Getty)
Swap the orange juice for a whole orange, the cereal for oats and milk or serve it with Greek yoghurt or a boiled egg. This would increase the fibre and protein content; two nutrients strongly linked with fullness.
Foods that leave you hungrier
Caption: Gail’s croissant
Image taken from https://gails.com/collections/breakfast/products/croissant
Croissants
These pastries are made primarily from refined flour and butter, and are relatively low in protein and fibre.
Toast and jam
It is mostly carbohydrate and without protein or fibre, it is digested quickly, leaving you feeling hungry.
Caption: Toasted bread and white background
Photographer: Daniel Tamas Mehes
Provider: Getty Images
Source: iStockphoto
Copyright: Minden jog fenntartva!
Yakitori’s on the menu at the Japanese restaurant – but what exactly is it? (Photo: Reuters)
Sushi
Shop-bought packs can contain a lot of white rice, which is digested quickly, and the protein content is often modest.
Foods that leave you hungrier
Sarawak laksa is one of many varieties of this noodle soup (Photo: Tham Kee Chuan/Getty)
Vegetable soup
On its own, it is often very low in protein and calories, so hunger can return quickly.
Pizza
Unless it’s loaded with veggies, it’s probably pretty low in fibre.
Best pizza in Britain named – and owner reveals the secret to its success (Photo: James Linsell Clark/SWNS)
The Government has announced that the sugar tax will be extended to milkshakes (Photo: Scott Suchman)
Smoothies
Liquids are generally less filling as they require little chewing which may not trigger satiety signals.
Foods that leave you hungrier
‘Aged 14, I started what I considered to be my own little business selling confectionary,’ writes Beauty Dhlamini (Photo: Getty)
Snack bars
They are ideal for a quick pick-me-up, but if reducing hunger is what you’re after, it’d be better to swap it out.
Low-fat yoghurt
A full-fat plain Greek yoghurt with berries and seeds tends to be much more filling due to the protein, fat and fibre.
Which yoghurts are the best options? (Unsplash)
Caption: BANGKOK, THAILAND – OCTOBER 17: A “KT Herbalist”, a Kratom cocktail made from Kratom, coffee and siamese herbs is seen at Teens of Thailand, a bar in Bangkok’s Chinatown on October 17, 2021 in Bangkok, Thailand. In April 2021, the start of Thailand’s third and most deadly wave of the COVID-19 pandemic, the Thai government banned the sale of alcohol in restaurants and bars, crippling the already suffering food and beverage industry. With a lack of government aid and support, some bars have shuttered their doors in hopes of reopening post-lockdown, while others shuttered their doors for good. But six months into Thailand’s most recent lockdown, Niks Anuman-Rajadhon, owner of Teens of Thailand, a gin bar located in a renovated shophouse in Bangkok’s Chinatown, decided that instead of waiting for the government to allow the sale of alcohol again, they would take advantage of Thailand’s recent legalization of Kratom. Kratom is a locally grown herbal drug with mild opioid and stimulant effects and was reclassified from a type-5 narcotic to a legal-to-grow herb in August 2021. While Thailand prepares for a tentative reopening on November 1st, the alcohol ban and curfew are set to continue, leaving business owners questioning if the country can revive its suffering tourism industry. (Photo by Lauren DeCicca/Getty Images)
Photographer: Lauren DeCicca
Provider: Getty Images
Source: Getty Images AsiaPac
Alcohol
On an empty stomach, it can actually increase your appetite.
What to eat instead
Instead of thinking about avoiding foods, think about what you can add to them.
Add beans, lentils or shredded chicken to your vegetable soup and pasta.
Thicken your smoothies with Greek yoghurt, chia seeds and oats.
Apple slices with peanut butter, yogurt with berries and hummus with oat biscuits are better snack options than a pre-made snack bar.
Have alcohol alongside a balanced meal containing protein and fibre.
How to age well
without pain
Will Harlow, a physiotherapist
for the over-50s and author of Independence for Life, shares
the key signs you’re ageing
badly – and what to do about it.
How to know
Ageing well is maintaining the ability to do what you want you want for as long as you want without needing help. Everyone is talking about longevity but what’s the point in living longer if the last decade is painful and you’re [totally] reliant on people?”
The signs to look out for
Senior woman on sofa feeling and suffering from back pain. – stock photo. (Photo: Getty)
The most obvious early warning sign of bad ageing is pain says Harlow.
Another is losing confidence in doing daily tasks, which can quickly lead to a lack of independence.
One call Harlow often receives is people calling after having a fall and struggling to get up.
4 min read
How to age without pain
Many will worry about not saving enough for retirement (Photo: Alex Tihonov/Getty/Moment RF)
Not just stopping
When people retire, they often put their feet up and stop. Your body really is use it or lose it.
Sleep
Throughout our entire lives, Harlow says we need between seven and nine hours of sleep.
Naps before 1pm can lead to better cognitive performance in the following hours (Photo: Lord Henri Voton/Getty Images)
Caption: Maribel Ezcurra, 77, a retired milling machine mechanic, practices tai chi with fellow seniors in a park in the Playa neighborhood of Havana, Cuba, Wednesday, April 15, 2026. (AP Photo/Ramon Espinosa)
Photographer: Ramon Espinosa
Provider: AP
Source: AP
Social isolation
The lack of connection can increase the risk of premature death by
as much as 29 per cent.
Strength training
It really is the proxy for
overall independence.
The more muscle mass you have, the less chance of heart disease, diabetes, falls and even anxiety, depression and dementia.
Caption: This is a photo of a senior man helping his wife lift weights. See PA Feature HEALTH Physio. WARNING: This picture must only be used to accompany PA feature HEALTH Physio. PA Photo.Picture credit should read: Alamy/PA.
NOTE TO EDITORS: This picture must only be used to accompany PA Feature HEALTH Physio.
Photographer: Alamy
Provider: Alamy/PA
Source: PA
The brain can be linked to muscle mass too, Harlow says. It’s not just about being able to lift things. It gives you more energy, better sleep and you’ll look and feel better.
How to age without pain
Daily habits
Do short bursts of exercise, between 30 and 60 seconds, in otherwise dead time during the day.
Fit more walking into your day (Photo: andreswd/Getty/E+)
Sleep can affect your heart health (Photo: Flashpop/Getty/Digital Vision)
Stretch in bed
Take joints through a full range of motion for five minutes to loosen it before getting up.
Don’t crash diet
It can increase the decline of muscle mass and bone density, which needs to be avoided.
Calorie counting every day can be a pain (Photo: Getty)
How to age without pain
(Photo: Inga Erhan/ Gingagi/ Getty).
Protein
Harlow advises 1.6 grams per kilogram of body weight to stop muscle loss alongside resistance training.
Don’t wait
Harlow finds that many patients put off making a change to their lifestyle until their lives are consumed by pain.
Menstrual pain, woman with stomachache suffering from pms at home, endometriosis, cystitis and other diseases of the urinary system – stock photo. (Photo: Getty)
Caption: Close-up view of female jogger tying laces of her sport shoes before running exercise routine. Motivation, healthy lifestyle and fitness concept.
Photographer: Xavier Lorenzo
Provider: Getty Images
Source: Moment RF
Recovery
For most people, it’s about reducing the number of times per week you’re exercising, not reducing intensity.
The three ageing tests to do
Lie completely flat on the floor and get back up to a standing position using any technique. This should take less than 10 seconds.
See how many times you can sit on the chair and stand back up again in 30 seconds. Men should be aiming for more than 14 times and women 12.
The single-leg stand, which involves standing on one leg and balancing for 10 seconds. Everyone should be able to do that and for those under 65, Harlow asks them to do it with their eyes closed.
That doesn’t mean being entirely symptom-free. “A little bloating after a particularly high-fibre meal for example is completely normal and isn’t necessarily a bad thing,” says Rossi. “When our gut microbes ferment certain fibres (which is generally a beneficial process), gas is naturally produced as a by-product. So, we shouldn’t become fearful of every bit of bloating.”
The distinction, she explains, is when symptoms become frequent or start to interfere with day-to-day life. Here are some potential signs your gut may not be functioning well, and what to do about it.
You’re regularly constipated
How often you go isn’t the only measure of constipation, explains specialist gut health dietitian Rosie Abbott. “For example, if you regularly take more than a few minutes to go, need to strain, pass hard stools or never feel like your bowels have completely emptied, these can all be signs of constipation, even if you’re opening your bowels every day.”
Equally, if you’re opening your bowels fewer than three times a week, it’s worth investigating. “There are lots of potential causes. One of the first things I’d look at is whether you’re getting enough fibre – and enough fluid alongside it, because fibre needs fluid to do its job properly,” says Rossi. “Physical inactivity can contribute, too, as can certain medications, changes in routine and ignoring the urge to go. Stress and the gut–brain axis can also influence gut movements, and in these cases just adding more fibre can make symptoms worse. This is why it’s important to understand the why behind your constipation.”
Importantly, Rossi adds: “Persistent constipation can sometimes have an underlying medical cause, so if it’s new, unexplained or isn’t improving, speak to your doctor rather than simply adding more and more fibre.”
How often you go isn’t the only measure of constipation, explains specialist gut health dietitian Rosie Abbott
You feel like you need to undo your trousers by the end of the day
Bloating “can feel like you’ve got a balloon in your gut,” Rossi explains. “While distension is when you can actually see your abdomen expand. Some people also experience pain alongside it.” There are more than 20 different triggers for bloating she will consider when working with patients in her clinic. “Sometimes it’s simply that someone has increased their fibre intake too quickly and hasn’t given their gut microbes time to adapt – what I call becoming ‘fibre fit.’ Other possibilities include constipation, or lactose intolerance, or consuming lots of sugar alcohols (or polyols) which are found in some sugar-free products. Small intestinal bacterial overgrowth is another cause, although in reality it’s less common than social media suggests.”
You seem to be getting sick frequently
“Around 70 per cent of the body’s immune cells are located within or associated with the gut, and there’s constant communication between our gut microbes, the intestinal barrier and immune system,” Rossi explains. “So, if you’re the one that always seems to catch every bug going around, it might mean your gut needs some support. For example, you might not be getting enough plant diversity (your gut bacteria love all different types of plants). It might also mean it’s worth adding a specific probiotic that contains both LGG and BB-12 strains (scientific name for types of bacteria), as this combination has been clinically proven to reduce not only symptoms but duration of infections like cold and flu.”
Very loose or frequent stools, or very hard or infrequent stools
“Regularly having very loose or watery stools, needing to open your bowels frequently, or at the other extreme having hard stools that are difficult or infrequent to pass, can indicate diarrhoea or constipation,” says Chloe Hall, registered dietitian and gut health specialist. “There are many possible causes, including diet, medications, IBS, food intolerances or an underlying gastrointestinal condition such as coeliac disease or inflammatory bowel disease (IBD).”
You have to follow an increasingly restrictive diet to control your gut symptoms
“This is one I see frequently in clinic,” Rossi says. “Someone starts by removing one food because it makes them uncomfortable, then another, and before long they’re avoiding entire food groups just to keep their symptoms under control. That’s a sign to investigate what’s actually driving the symptoms rather than continuing to restrict.”
The problem with unnecessary restriction, she adds, “is that it can reduce nutritional adequacy and plant diversity and can have a significant impact on someone’s relationship with food and quality of life.”
You experience lots of particularly smelly wind
“Everyone produces wind, and its smell can be affected by what we eat and by the bacteria in our gut,” Abbott says. “A noticeable increase in wind or a change in its smell, particularly alongside bloating or a change in bowel habit, can sometimes indicate that your digestion isn’t working as well as it could. Diet, constipation, stress, food intolerances and changes in the gut microbiome can all contribute.”
Changes in gut and digestive issues you should never ignore
“The important message is that common gut symptoms aren’t always IBS, food intolerance or ‘a sensitive gut,’” Rossi says. “For bowel cancer, red flags include blood in your stool or bleeding from your bottom, an unexplained persistent change in your normal bowel habits, unexplained weight loss, persistent abdominal pain or a lump, and unusual tiredness or shortness of breath, which can be associated with anaemia (picked up with a simple blood test).”
“For ovarian cancer, persistent bloating is particularly important because it’s very easy to mistake it for a digestive issue. Other symptoms include pelvic or abdominal pain, feeling full unusually quickly or losing your appetite, and needing to urinate more frequently or urgently.
“Coeliac disease is another important one because it doesn’t always present as the stereotypical diarrhoea after eating gluten,” she adds. “It can present with persistent unexplained gut symptoms, abdominal pain or bloating, diarrhoea or constipation, fatigue, unexplained weight loss or iron-deficiency anaemia. It’s therefore important that coeliac disease is considered before someone is simply labelled as having IBS. And importantly, don’t start a gluten-free diet before you’ve been properly tested for coeliac disease as removing gluten can affect the accuracy of the tests.”
How to know when it’s time to speak to a specialist
“It can be completely normal to experience some digestive symptoms now and again,” Abbott says. “These don’t necessarily mean there is something wrong with your gut. What matters is whether symptoms are persistent, troublesome or represent a significant change from what is normal for you.”
That said, if you notice a new, persistent or unexplained change in your bowel habit, or experience any red-flag symptoms, your first port of call should be your GP, Abbott continues. “They can take a detailed history and, where appropriate, arrange initial investigations such as blood tests or stool tests. Depending on your symptoms and the results, they may refer you to a gastroenterologist or another specialist for further assessment.”