I’m a gut health dietitian – these are the questions people are too embarrassed to ask me

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Talking about gut health can be tricky for many, especially since issues like bloating, stomach growls, smelly gas or unusual bowel movements are often considered embarrassing. Yet, what happens in our digestive system impacts our overall wellbeing. As a gut health dietitian, I frequently encounter questions that people are hesitant to ask. Here are some of the most common ones, answered without shame or judgment, just facts, and maybe a bit of humour.

“Is there anything that makes farts or burps smell particularly bad? I feel like mine are especially smelly!”

Yes, some foods pack more of a punch than others. That could be due to a high intake of sulfur-rich foods, like eggs, red meat, garlic, onions and cruciferous veg such as broccoli and cabbage. So, what’s the science behind it?

When these foods are broken down in our bodies, they can release hydrogen sulfide, which is reminiscent of rotten eggs. As we all know, gas needs to escape somewhere and wind is usually the method.

A protein-heavy diet is often less fibrous and, while protein itself doesn’t cause smelly farts, the bacteria needed to break down undigested protein in the colon can produce strong odours. A diet lacking in fibre slows digestion down, giving that bacteria more time to ferment waste and produce more smelly gas.

“Is it normal to feel bloated?”

Bloating is one of the most common complaints I hear and sometimes even get shown. And, yes, some level of bloating is totally normal. Our gut is a living, breathing (well, almost) system full of bacteria, gases and moving components. When we eat, swallow air or break down fibre, gas is a natural by-product.

Occasional bloating, especially after a large or high-fibre meal, is usually nothing to worry about. But if it’s persistent, painful or impacting your day-to-day life, it’s worth digging deeper and speaking to your GP or a dietitian. Causes can include food intolerances, IBS, constipation or even swallowing too much air (hello fizzy drinks and fast eating).

Simple tweaks like slowing down with meals, eating regular-sized portions, avoiding skipping meals and having a 15-minute walk after eating can help. But if bloating is persistent and uncomfortable, it’s time to book an appointment.

“I’m terrified of passing wind during sex. Why does this happen and how can I avoid it?”

It’s a real fear and a surprisingly common one! First, let’s separate the two types of “air noises” that can happen during sex. Vaginal gas, also known as 'queefing', is air released from the vaginal canal, totally normal and nothing to do with digestion. It’s just physics – that I am certainly not qualified enough to explain – but I absolutely am silly enough to chuckle at the term ‘queefing’.

But if you’re talking about actual flatulence during intimacy, that’s also more common than you think. Sex involves movement, pressure and muscle relaxation, all of which can encourage gas to move. And if you’ve had a gassy meal, are constipated or experience IBS, the likelihood increases.

My advice would be not to try to stop it from happening. And honestly, if or when it happens, laughter is the best remedy. It’s a sign your gut is functioning and your partner probably won’t be as mortified as you think. A word of warning, too, if you don’t allow the body to expel gas when it wants, it may make matters worse. Increased gas, more trapped wind, discomfort and even more farts is the likely result. The best thing you can do is to avoid very gas-producing meals on your romantic evenings, such as beans, cruciferous veg (cauliflower, brussel sprouts) and carbonated drinks.

“Sometimes I have a sudden and desperate need to poo, followed by diarrhoea. What might be causing this?”

That urgent bathroom dash isn’t just you, and it can feel really distressing and isolating at times. Common causes include irritable bowel syndrome with diarrhoea (IBS-D), lactose or fructose intolerances, alcohol, caffeine sensitivity, high intake of artificial sweeteners, being on your period or even stress. I am lactose intolerant and although I can manage small amounts of lactose-containing foods, if I overdo it, I know I need to be left alone to fart unapologetically with a toilet nearby too.

Changes in your bowel habits near to or during your period are a result of fluctuating hormone levels during your cycle. Stress can also speed up gut motility, making food pass through you much more quickly, as your gut and brain are tightly linked via the gut-brain axis.

If you are unable to pinpoint a cause for your diarrhoea, I always recommend monitoring it. A food, mood and symptom diary could be very helpful to identify triggers, like specific foods or stressful situations. Frequent diarrhoea, especially if accompanied by weight loss, blood or waking you at night, should be checked by your doctor. But in many cases, symptoms can be managed with the right guidance that includes dietary changes, lifestyle and stress management practices.

“I think my high-protein diet is making me constipated. What will help while sticking to a high-protein, low-carb eating plan?”

High-protein diets can be great for satiety and muscle health, but they often fall short on fibre, especially if your main source of protein comes from meat. Carbs are essential for the body to survive; they are our brain’s main source of energy. If you’re cutting carbs, you’re not only starving yourself from an essential macronutrient, but you could also be starving the important ‘good’ bacteria in your gut. The key sources of fibre that these beneficial microbes love are found in wholegrains, legumes and fruit.

But fibre doesn’t only come from bread or pasta. Chia seeds, flaxseeds, leafy greens, nuts, courgettes and aubergines are all great sources of fibre that are lower in carbohydrates. If you’re planning to increase your fibre, remember to keep your fluid intake up, aiming for 8 to 10 cups a day, or at least two litres. Without it, things can grind to a halt. And remember, constipation isn’t just uncomfortable; long-term, it can lead to other gastrointestinal conditions such as diverticular disease.

“Why do I feel more bloated around my period?”

Hormones strike again. In the lead-up to your period, progesterone levels rise, which can slow digestion and cause constipation, bloating and water retention. When the uterus lining sheds during menstruation, prostaglandin levels increase to help facilitate contractions. Which could lead to bloating. Oestrogen fluctuations can also affect the gut’s sensitivity, making you more prone to discomfort. Add cravings, higher salt intake and mood changes into the mix, and it’s no wonder your gut feels off.

Gentle movement, staying hydrated and eating potassium-rich foods, such as bananas or sweet potato, can help reduce water retention which may be contributing to bloating. Foods containing magnesium, such as almonds and spinach, may also support digestion and ease cramps as they may relax digestive muscles.

“I don’t like fermented foods. Apart from yogurt, what else is good for your guts?”

It’s important to state that you don’t have to eat jars of kimchi to have a healthy gut. While fermented foods like kefir, sauerkraut and fermented milk drinks can be a source of live cultures, containing billions of friendly bacteria, they’re not the only route to good gut health. Said route can be hostile for those beneficial bacteria, as they need to survive the harsh acidic environment of the stomach in order to reach the large intestine alive (where it is most needed).

The real superstar is fibre, an essential nutrient for your gut that is often overlooked. Most people do not meet the recommendation of at least 30g fibre per day (for adults; 15 to 25g per day for children depending on their age). For young people aged 11 to 18 years, a staggering 96 per cent aren’t eating enough fibre.

Including a diverse variety of plant foods in your meals, aiming for 30 different plant-based foods a week, is key. Anything that derives from a plant counts, because plants contain prebiotics – the fuel for good gut bacteria. That includes wholegrains such as oats and quinoa, beans, chickpeas, nuts, seeds, herbs, spices, fruits and veg, even dark chocolate counts (yes, really). These foods are all a source of dietary fibres and chemicals called polyphenols, which feed the diverse community of microbes in your gut, known as your microbiota. So, if you can’t stand the tang of fermented foods, don’t worry, your gut has plenty of other favourites to choose from on the menu.

The bottom line…

Gut health is deeply personal, but also completely universal. We all burp, fart and feel bloated sometimes. There’s no such thing as a ‘gross’ question when it comes to your gut. The more we talk about it, the more we learn, and often, the answers are surprisingly simple. And while awkward questions might feel, well, awkward, your healthcare provider has likely heard it all before and can help you find real solutions that Googling in secret won’t.

If your symptoms are affecting your quality of life, are persistent or include red flags like blood, weight loss, or pain, don’t wait – book an appointment with your GP.

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