The truth about carbs

"Carbs" are a hotly-debated topic, especially in the weight loss world, due in no small part to the popularity of low-carb diets such as the Atkins, Dukan and South Beach.

The "carbs are bad" mantra from Dr Atkins and co. has left many people confused about carbohydrates and their importance for our health, including maintaining a healthy weight.

Dietitian Sian Porter says: "Carbohydrates are such a broad category and people need to know that not all carbs are the same and it is the type, quality and quantity of carbohydrate in our diet that is important.

"While we should reduce the amount of sugar in our diet, particularly added sugars, we should base our meals on starchy carbs, particularly the less processed wholegrain varieties.

"There is strong evidence that fibre, found in wholegrain versions of starchy carbs for example, is good for our health.”

On this page you can find out all you need to know about carbohydrates, their health benefits, healthier sources of carbohydrates and how they can help you lose weight.

Many people don't get enough fibre.

We are advised to eat about 18g a day.

What are carbs?

Carbohydrates are one of three macronutrients (nutrients that form a large part of our diet) found in food – the others being fat and protein. Hardly any foods contain only one nutrient and most are a combination of carbohydrates, fats and proteins in varying amounts. There are three different types of carbohydrates found in food: sugar, starch and fibre.

• Sugar is found naturally in some foods, including fruit, honey, fruit juices, milk (lactose) and vegetables. Other forms of sugar (for example table sugar) can be added to food and drink such as sweets, chocolates, biscuits and soft drinks during manufacture, or added when cooking or baking at home. Find out more about sugar.
• Starch, made up of many sugar units bonded together, is found in foods that come from plants. Starchy foods, such as bread, rice, potatoes and pasta, provide a slow and steady release of energy throughout the day. Find out more about starchy foods.
• Fibre is the name given to the diverse range of compounds found in the cell walls of foods that come from plants. Good sources of fibre include vegetables with skins on, wholegrain bread, wholewheat pasta and pulses (beans and lentils). Find out more about fibre.

Why do we need carbs?

Carbohydrates are important to your health for a number of reasons.

Energy
Carbohydrates should be the body's main source of energy in a healthy balanced diet, providing about 4kcal (17kJ) per gram. They are broken down into glucose (sugar) before being absorbed into the bloodstream. From there, the glucose enters the body's cells with the help of insulin. Glucose is used by your body for energy, fuelling all of your activities, whether going for a run or simply breathing.

Unused glucose can be converted to glycogen found in the liver and muscles. If more glucose is consumed than can be stored as glycogen, it is converted to fat, for long-term storage of energy. High fibre, starchy carbohydrates release sugar into the blood more slowly than sugary foods and drinks.

Disease risk
Vegetables, pulses, wholegrain varieties of starchy foods, and potatoes eaten with their skins on are good sources of fibre. Fibre is an important part of a healthy balanced diet. It can promote good bowel health, reduce the risk of constipation, and some forms of fibre have been shown to reduce cholesterol levels.

Research shows diets high in fibre are associated with a lower risk of cardiovascular disease, type 2 diabetes and bowel cancer. Many people don't get enough fibre. On average, most people in the UK get about 18g of fibre a day. We are advised to eat an average of 30g a day.

Calorie intake
Carbohydrate contains fewer calories gram for gram than fat, and starchy foods can be a good source of fibre, which means they can be a useful part of a weight loss plan. By replacing fatty, sugary foods and drinks with high-fibre starchy foods, it is more likely you will reduce the number of calories in your diet.

Also, high fibre foods add bulk to your meal helping you feel full. "You still need to watch your portion sizes to avoid overeating," says Sian. "Also watch the amount of fat you add when cooking and serving them: this is what increases the calorie content."

Should I cut out carbohydrates?

While we can most certainly survive without sugar, it would be quite difficult to eliminate carbohydrates entirely from your diet. Carbohydrates are the body's main source of energy. In their absence, your body will use protein and fat for energy.

It may also be hard to get enough fibre, which is important for a healthy digestive system and to prevent constipation. Healthy sources of carbohydrates such as starchy foods, vegetables, fruits, legumes and lower fat dairy products are also an important source of nutrients such as calcium, iron and B vitamins.

Cutting out carbohydrates from your diet could put you at increased risk of a deficiency in certain nutrients, leading to health problems, unless you're able to make up for the nutritional shortfall with healthy substitutes.

Replacing carbohydrates with fats and higher fat sources of protein could increase your intake of saturated fat, which can raise the amount of cholesterol in your blood – a risk factor for heart disease.

When you are low on glucose, the body breaks down stored fat to convert it into energy. This process causes a build-up of ketones in the blood, resulting in ketosis. Ketosis as a result of a low carbohydrate diet can be linked, at least in the short term, to headaches, weakness, nausea, dehydration, dizziness and irritability.

Try to limit the amount of sugary foods you eat and instead include healthier sources of carbohydrate in your diet such as wholegrains, potatoes, vegetables, fruits, legumes and lower fat dairy products. Read the British Dietetic Association's review of low-carb diets, including the paleo, Dukan, Atkins, and South Beach diets.

Don't protein and fat provide energy?

While carbohydrates, fat and protein are all sources of energy in the diet, the amount of energy that each one provides varies:

• carbohydrate provides: about 4kcal (17kJ) per gram
• protein provides: 4kcal (17kJ) per gram
• fat provides: 9kcal (37kJ) per gram

In the absence of carbohydrates in the diet your body will convert protein (or other non-carbohydrate substances) into glucose, so it's not just carbohydrates that can raise your blood sugar and insulin levels.

If you consume more calories than you burn from whatever source, you will gain weight. So cutting out carbohydrates or fat does not necessarily mean cutting out calories if you are replacing them with other foods containing the same amount of calories.

Are carbohydrates more filling than protein?

Carbohydrates and protein contain roughly the same number of calories per gram but other factors influence the sensation of feeling full such as the type and variety of food eaten, eating behaviour and environmental factors, such as portion size and availability of food choices.

The sensation of feeling full can also vary from person to person. Among other things, protein-rich foods can help you feel full and we should have some beans, pulses, fish, eggs, meat and other protein foods as part of a healthy balanced diet. But we shouldn't eat too much of these foods. Remember that starchy foods should make up about a third of the food we eat and we all need to eat more fruit and vegetables.

How much carbohydrate should I eat?

The Government's healthy eating advice, illustrated by the Eatwell Guide, recommends that just over a third of your diet should be made up of starchy foods, such as potatoes, bread, rice and pasta, and another third should be fruit and vegetables. This means that over half of your daily calorie intake should come from starchy foods, fruit and vegetables.

What carbohydrates should I be eating?

Data from the National Diet and Nutrition Survey, which looks at food consumption in the UK, shows that most of us should also be eating more fibre and starchy foods and fewer sweets, chocolates, biscuits, pastries, cakes and soft drinks with added sugar. These are usually high in sugar and calories, which can increase the risk of tooth decay and contribute to weight gain if you eat them too often, while providing few other nutrients.

Fruit, vegetables, pulses and starchy foods (especially wholegrain varieties) provide a wider range of nutrients (such as vitamins and minerals) which can benefit our health. The fibre in these foods can help to keep your bowels healthy and adds bulk to your meal, helping you to feel full.

Sian says: "Cutting out a whole food group (such as starchy foods) as some diets recommend could put your health at risk because as well as cutting out the body's main source of energy you'd be cutting back essential nutrients like B vitamins, zinc and iron from your diet."

How can I increase my fibre intake?

To increase the amount of fibre in your diet, aim for at least five portions of a variety of fruit and veg a day, go for wholegrain varieties of starchy foods and eat potatoes with skins on. Try to aim for an average intake of 30g of fibre a day.

Here are some examples of the typical fibre content in some common foods:

• two breakfast wheat biscuits (approx. 37.5g) – 3.6g of fibre
• one slice of wholemeal bread – 2.5g (one slice of white bread – 0.9g)
• 80g of uncooked wholewheat pasta – 7.6g
• one medium (180g) baked potato (with skin) – 4.7g
• 80g (4 heaped tablespoons) of cooked runner beans – 1.6g
• 80g (3 heaped tablespoons) of cooked carrots – 2.2g
• 1 small cob (3 heaped tablespoons) of sweetcorn – 2.2g
• 200g of baked beans – 9.8g
• 1 medium orange – 1.9g
• 1 medium banana – 1.4g

Can eating low GI (glycaemic index) foods help me lose weight?

The glycaemic index (GI) is a rating system for foods containing carbohydrates. It shows how quickly each food affects glucose (sugar) levels in your blood, when that food is eaten on its own. Some low GI foods, such as wholegrain foods, fruit, vegetables, beans and lentils are foods we should eat as part of a healthy balanced diet. However, using GI to decide whether foods or a combination of foods are healthy or can help with weight reduction can be misleading.

Although low GI foods cause blood sugar levels to rise and fall slowly, and which may help you to feel fuller for longer, not all low GI foods are healthy. For example, watermelon and parsnips are high GI foods, while chocolate cake has a lower GI value. Also, the cooking method and eating foods in combination as part of a meal, will change the GI rating. Therefore, GI alone is not a reliable way of deciding whether foods or combinations of foods are healthy or will help you to lose weight.

Find out more about the glycaemic index (GI).

Do carbohydrates make you fat?

Any food can be fattening if you overeat. Whether your diet is high in fat or high in carbohydrates, if you frequently consume more energy than your body uses you are likely to put on weight. In fact, gram for gram, carbohydrate contains fewer than half the calories of fat and wholegrain varieties of starchy foods are good sources of fibre. Foods high in fibre add bulk to your meal and help you to feel full.

However, foods high in sugar are often high in calories and eating these foods too often can contribute to you becoming overweight. There is some evidence that diets high in sugar are associated with an increased energy content of the diet overall, which over time can lead to weight gain.

"When people cut out carbs and lose weight, it's not just carbs they're cutting out, they're cutting out the high-calorie ingredients mixed in or eaten with it, such as butter, cheese, cream, sugar and oil," says Sian. "Eating too many calories – whether they are carbs, protein or fat – will contribute to weight gain."

Can cutting out wheat help me lose weight?

Some people point to bread and other wheat-based foods as the main culprit for their weight gain. Wheat is found in a wide range of foods, from bread, pasta and pizza, to cereals and many other foods. However, there is no evidence that wheat is more likely to cause weight gain than any other food.

Unless you have a diagnosed health condition such as wheat allergy, wheat sensitivity or coeliac disease, there is little evidence that cutting out wheat and other grains from your diet would benefit your health. Grains, especially wholegrains, are an important part of a healthy balanced diet. Wholegrain, wholemeal and brown breads give us energy and contain B vitamins, vitamin E, fibre and a wide range of minerals.

White bread also contains a range of vitamins and minerals, but it has less fibre than wholegrain, wholemeal or brown breads. If you prefer white bread, look for higher-fibre options. Grains are also naturally low in fat.

Find out if cutting out bread could help ease bloating or other digestive symptoms.

Should people with diabetes avoid carbs?

Diabetes UK recommends that people with diabetes should try to eat a healthy balanced diet, as depicted in the Eatwell Guide, and to include starchy foods at every meal. Steer clear of cutting out entire food groups. It is recommended that everyone with diabetes sees a registered dietitian for specific advice on their food choices. Your GP can refer you to a registered dietitian.

Diabetes UK says there is some evidence which suggests that low-carb diets can lead to weight loss and improvements in blood glucose control in people with type 2 diabetes in the short term. However, it is unclear whether the diet is a safe and effective way to manage type 2 diabetes in the long term.

Weight loss from a low-carb diet may be because of a reduced intake of calories overall and not specifically as a result of eating less carbohydrate. There is also not enough evidence to support the use of low-carb diets in people with type 1 diabetes.

Douglas Twenefour, Diabetes UK clinical adviser, says: "When considering a low-carbohydrate diet as an option, people with diabetes should be made aware of possible side effects such as the risk of hypoglycaemia (low blood sugar). We also advise that people with diabetes discuss the amount of carbohydrate to be restricted with their healthcare team.

"The best way to manage diabetes is by taking prescribed medications and by maintaining a healthy lifestyle that includes plenty of physical activity and a balanced diet that is low in saturated fat, salt and sugar and rich in fruit and vegetables, without completely cutting out any particular food groups."

Read Diabetes UK's review of the evidence on low-carb diets and their conclusions.

What's the role of carbohydrates in exercise?

Carbohydrates, fat and protein all provide energy, but exercising muscles rely on carbohydrates as their main source of fuel. However, muscles have limited carbohydrates stores (glycogen) and they need to be topped up regularly to keep your energy up. A diet low in carbohydrates can lead to a lack of energy during exercise, early fatigue and delayed recovery.

When is the best time to eat carbohydrates?

When you should eat carbohydrates particularly for weight loss is the subject of much debate, but there's little scientific evidence that one time is better than any other. It is recommended that you base all your meals around starchy carbohydrate foods, try and choose higher-fibre, wholegrain varieties when you can.

Should you cut out bread to stop bloating?

Is eating bread giving you bloating and other digestive symptoms? If so, you could be "sensitive" to wheat. Cutting out bread or changing the type you eat may help.

What's with wheat?

There are three key health problems caused by wheat.

• Wheat allergy: reactions usually begin within minutes and include itching, rash, tongue or lip swelling and wheezing. See your GP for referral to an NHS allergy clinic.
• Coeliac disease: also known as gluten intolerance, is a common digestive condition where your intestine can't absorb gluten found in wheat, barley, oats and rye. See your GP for a blood test.
• Wheat sensitivity: symptoms like bloating, cramps, diarrhoea and sickness come on quite slowly, usually hours after eating wheat. There is no diagnostic test.

More and more of us claim to suffer from a wheat allergy, so we shun bread and other wheat-based foods like pasta and cereals.

Genuine food allergy is, in fact, rarely to blame, say experts. But wheat sensitivity (also known as wheat intolerance) or simply trouble digesting wheat is increasingly common.

Bread-related gut symptoms

"Probably one-third of patients in my allergy clinic complain of digestive symptoms such as bloating, diarrhoea, vomiting and stomach pain after eating bread," says Isabel Skypala PhD, specialist allergy dietitian at the Royal Brompton and Harefield NHS Foundation Trust.

She says allergy is unlikely to be the culprit, but bread-related symptoms are real and wheat could be to blame.

"Some people find certain foods are simply hard to digest and wheat appears to be one of those," she explains.

Read more about food intolerance.

The health problems caused by wheat

There are three key health problems caused by wheat:

• Wheat allergy – reactions usually begin within minutes and include itching, sneezing and wheezing. See your GP for referral to an NHS allergy clinic.
• Coeliac disease – is a condition where the intestine lining can't absorb and is damaged by gluten-containing foods including wheat, barley, oats and rye. See your GP for a blood test.
• Wheat sensitivity – symptoms like bloating, cramps, diarrhoea and sickness come on quite slowly, usually hours after eating wheat. There’s no diagnostic test.

What to do if wheat triggers digestive symptoms

If your symptoms are severe and long-lasting, especially if you have blood in your stools (poo), vomiting or painful stomach cramps, see your doctor to rule out a medical condition.

If you have bloating or other minor symptoms after eating bread, Dr Skypala recommends that you try an elimination diet. This is where you completely cut out wheat from your diet for four weeks, then bring it back in gradually to see if symptoms reappear.

"When you bring wheat-based foods back in, I recommend trying Weetabix or pasta first for a few days before starting on bread. It’s better to start with wheat in a more pure form, as bread has so many other ingredients," Dr Skypala says.

Is it wheat intolerance or sensitivity?

If your symptoms return, it confirms you’re sensitive to wheat and will also show you which foods are especially troublesome. Some people may only have problems with pasta, for example, while others are fine until they eat bread.

If you are sensitive to wheat, or you have trouble digesting it, the main way to relieve your symptoms is to embark on a wheat-free or partially wheat-free diet.

Foods that contain wheat

• Bread
• Pasta
• Cereals
• Couscous
• Cakes and pastries
• Biscuits
• Doughnuts
• Hydrolysed vegetable protein (HVP)
• Beer
• Soy sauce

Wheat-free foods

These foods are a great alternative to wheat-based ones:

• Porridge, Rice Krispies and corn flakes
• Buckwheat pasta
• Quinoa

The main sources of wheat

• Bread
• Pasta
• Cereals
• Couscous
• Cakes and pastries
• Biscuits
• Doughnuts
• Hydrolysed vegetable protein (HVP)
• Beer
• Soy sauce

These wheat-free foods are a great alternative:

• Porridge, rice crispies and cornflakes
• Buckwheat pasta
• Quinoa
• Popcorn

How to go on a wheat-free diet

Cutting out bread and other foods containing wheat shouldn’t harm your health, if you do it properly.

Wheat is one of our staple foods and lots of wheat products, such as breakfast cereals, are fortified with vitamins and minerals.

In the past, there was a danger of running short of essential nutrients like B vitamins and iron if you cut out wheat. But nowadays there’s a good range of widely available wheat-free alternatives that won’t compromise a balanced diet.

Read more about vitamins and minerals.

"There are great wheat substitutes that you can buy off the supermarket shelf now. Go for gluten-free bread and try other types of grains, such as quinoa, corn and rice," says Dr Skypala. "Just make sure you substitute other equally nutritious foods for the wheat-based ones you’re cutting out."

Be sure to cut out all wheat from your diet. Some sources of wheat are obvious, such as bread, but others are less so, such as soy sauce.

Tummy-friendly breads

The good news is that you might not need to cut out bread completely.

Some people with wheat sensitivity have no problems when they eat toast (cooked wheat tends to be easier to digest), sourdough bread, bread cooked with flour made from French wheat, or any bread from a specialist bakery, rather than a supermarket.

"Bakeries in supermarkets use the Chorleywood bread-making process, which cuts out the second rising, to speed up the baking. People seem to have more problems digesting supermarket breads, so I’d always recommend avoiding store-bought loaves," says Dr Skypala.

The anti-bloat FODMAP diet

A specific type of wheat-free diet may help certain people with wheat sensitivity.

Designed originally for people with irritable bowel syndrome (IBS), the low-FODMAP diet is now being recommended by dietitians to people who have problems digesting wheat.

It’s not a catchy name, but FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are types of carbohydrates that aren’t easily broken down and absorbed by the gut.

Essentially, the diet entails cutting out fermentable (FODMAP) foods that can cause bacterial growth, leading to diarrhoea and bloating. That means cutting out wheat and other fermentable foods such as onion, apple, pears, mushrooms, honey, cabbage and sometimes milk.

Good foods to help your digestion

The occasional fry-up or boozy night is unlikely to give you anything more than a short-lived stomach upset. But overindulge too often and you could be storing up trouble for yourself. Here's a tummy-friendly diet to aim for.

Fill up on fibre to prevent constipation

It's a good idea to try to eat more fibre or "roughage", as most people in the UK don't get enough. A diet rich in fibre can help digestion and prevent constipation. Aim for the recommended dietary intake of 30g of fibre a day.

For a healthy bowel, you need fibre from a variety of sources, such as:

• wholemeal bread
• brown rice
• fruit and veg
• beans
• oats

Some people find cereals and grains bring on bloating and irritable bowel syndrome. If that's the case, get your fibre from fruit and vegetables instead.

Read more about how to boost your fibre intake.

Drink plenty of fluids to aid digestion

It's important to keep drinking, especially water. It encourages the passage of waste through your digestive system and helps soften poo.

Fibre acts like a sponge, absorbing water. Without fluid, the fibre can't do its job and you'll get constipation.

A good way to make sure you're getting enough fluids is to drink a glass of water with every meal. Avoid caffeine drinks as they can cause heartburn.

How to choose healthier drinks.

Cut down on fat for a healthy gut

Fatty foods, such as chips, burgers and fried foods, are harder to digest and can cause stomach pain and heartburn.

Cut back on greasy fried foods to ease your stomach's workload.

Try to eat more lean meat and fish, drink skimmed or semi-skimmed milk, and grill rather than fry foods.

Go easy on spice to avoid tummy troubles

Many people love spicy food and it doesn't bother their digestive system. Others find their tummy is upset when they have spicy food.

It's not just scorching hot foods like chillies that trigger heartburn. Milder but flavourful foods like garlic and onion can also bring it on.

If spicy foods give you heartburn, stomach pain or diarrhoea, go easy on them in future. If you already have a problem like heartburn or an irritable bowel, avoid them completely.

Beware gut symptom triggers

Some people find particular foods cause them problems. Acidic foods such as tomatoes, citrus fruits, salad dressings and fizzy drinks can trigger heartburn, while wheat and onions may cause irritable bowel syndrome.

And if you cannot digest lactose (the sugar in milk) you'll develop wind and diarrhoea after drinking milk or eating dairy products, including cream, cheese, yoghurt and chocolate.

Try to stay away from foods and drinks that trigger your digestive symptoms. One way to work out which foods cause your symptoms is to keep a food diary.

Choose the right drinks to ease digestion

Drinks with caffeine, such as coffee, colas, tea and some fizzy drinks, boost acid in the stomach, leading to heartburn in some people.

Fizzy drinks in general tend to bloat the tummy, which can also lead to heartburn.

To make digestive problems less likely, choose drinks that aren't fizzy and don't contain caffeine, such as herbal teas, milk and plain water.

If you can't do without your coffee or builder's tea, limit your intake to one or two cups a day.

Try tummy-friendly yoghurt

Probiotics are so-called "friendly bacteria" that also occur naturally in the gut and have been linked to all sorts of digestive health benefits, including helping irritable bowel syndrome and traveller's diarrhoea.

You can take probiotics as supplements (available from health food shops) or in live yoghurt, which is a good natural source.

You'll need to take them every day for at least four weeks to see any beneficial effect.

Read more about probiotics.

Five lifestyle tips for a healthy tummy

Digestive problems and stomach upsets can be prevented, relieved and even banished by simple lifestyle changes.

Beat stress to ease tummy troubles

You may have noticed a feeling of unease in your stomach during times of stress. That's because anxiety and worry can upset the delicate balance of digestion.

In some people stress slows down digestion, causing bloating, pain and constipation, while in others it speeds it up causing diarrhoea and frequent trips to the loo. Some people lose their appetite completely.

Stress can also worsen digestive conditions like stomach ulcers and irritable bowel syndrome.

One solution is to avoid eating when you're feeling very anxious, stressed or unhappy.

It also helps your digestion if you avoid arguing at the dinner table, as getting angry can put you off your food or make eating harder. Try to keep mealtimes happy and relaxed.

For more advice, read our articles on managing stress.

Stop smoking to prevent reflux

Smoking can weaken the muscle that controls the lower end of the oesophagus (gullet) and allow acid from the stomach to travel in the wrong direction back up the oesophagus, a process known as reflux.

Reflux causes the symptoms of heartburn (a burning sensation in the chest) and can bring on or aggravate stomach ulcers and inflammatory conditions of the bowel.

Smoking is also an important risk factor for stomach cancer.

Read our articles on how to stop smoking.

Eat properly to help your digestion

It's very easy to spend our working lives eating on the move or at our desks, gulping down food between meetings and then crashing out in front of the TV with a takeaway in the evenings. But eating this way can play havoc with our digestive system.

Follow some basic rules to prevent problems:

• Don't rush your food. Take the time to eat slowly. Try putting your fork down between bites and chew each mouthful well.
• Don't overeat. Reduce the size of your portions at mealtimes, or try eating four to five small meals instead of three large ones.
• Eat regularly and try not to skip meals.
• Avoid eating a big meal just before you go to bed. Eat your last meal at least two to three hours before lying down.
• Make sure you have plenty to drink.

Lose excess weight to beat heartburn

If you're overweight, your tummy fat puts pressure on your stomach and can cause heartburn. Shedding some pounds may relieve digestive symptoms such as heartburn and other acid-related stomach complaints.

Check your weight using this BMI self-assessment tool and read advice on losing weight.

Binge drinking causes acid-related digestive disorders

Moderate drinking won't hurt your digestive system, but binge drinking increases acid production in your stomach and can cause heartburn and aggravate other digestive disorders.

Binge drinking is defined as drinking eight or more units of alcohol in one session for men, and drinking more than six units in one session for women.

Read our articles on how to cut down on drinking.

Now, read how to get rid of bloating.

Common digestive problems - and how to treat them

Digestive complaints such as constipation, diarrhoea, heartburn and bloating are very common and usually treatable with lifestyle measures and over-the-counter remedies.

Self-help advice

Most digestive problems can be eased if you:

• improve your lifestyle
• eat the right diet

Around 40% of people have at least one digestive symptom at any one time, according to Dr Anton Emmanuel, consultant gastroenterologist at University College Hospital in London.

The most common are:

• abdominal pain
• changes in bowel habit (usually constipation or diarrhoea)
• indigestion
• heartburn

"Most digestive problems are to do with lifestyle, the foods we've eaten, or stress. Which means that taking steps to change your lifestyle can help, and often prevent, many of these problems," said Dr Emmanuel.

"There's a wide choice of pharmacy remedies for heartburn, indigestion and similar problems that are very good for the short-term relief of symptoms", he added.

Medicines that can upset your tummy

Certain medicines that your doctor may have prescribed for you for other health conditions can lead to side effects that may upset your tummy and cause indigestion, diarrhoea or constipation.

Avoid aspirin and medicines used to treat arthritis, known as non-steroidal anti-inflammatory drugs (NSAIDs), if you have an ulcer or you get indigestion. Consult your doctor if you rely on these medicines and are also prone to indigestion or ulcers. Paracetamol is a useful alternative.

Certain tranquillisers, painkillers, iron tablets and cough medicines can cause constipation and some people get diarrhoea while taking antibiotics or blood pressure pills.

Always tell your doctor if your prescribed medicines are upsetting your tummy.

When to see a doctor

Digestive symptoms are usually harmless and often settle down by themselves but sometimes they don't go away and can be a signal of serious illness.

Dr Emmanuel advised anyone who has taken a pharmacy remedy for a digestive problem for two weeks with no improvement to see their GP.

He also highlighted five symptoms, which mean you should see a doctor straight away. These symptoms may be an alarm warning of a serious digestive illness:

• a sudden, persistent change in the pattern of how your bowels work
• bleeding from the bottom
• worsening heartburn, indigestion or stomach pain
• losing weight unexpectedly
• difficulty swallowing

Beat the bloat

Get rid of bloating by cutting out fizzy drinks and foods that cause wind. Sit down to eat and take regular exercise.

Most of us have experienced the feeling of being bloated, when your tummy is stretched, puffy and uncomfortable. It often happens after a big weekend or over a festive season. But for some people, bloating is more than an occasional inconvenience.

If your stomach or tummy often feels bloated, it could be due to:

• excess wind
• constipation
• swallowing air (from talking while eating etc)
• Coeliac disease
• food intolerance
• irritable bowel syndrome

Excess wind and bloating

Cut down on foods known to cause wind and bloating, such as:

• beans
• onions
• broccoli
• cabbage
• sprouts
• cauliflower

But make sure you still eat five portions of fruit and vegetables a day.

Read how to keep up your fruit and veg intake while cutting down on bloating.

Constipation and bloating

If you get constipation, take steps to prevent it with a fibre-rich diet, drinking lots of fluids and taking regular exercise. Even a 20-30 minute brisk walk four times a week can improve your bowel function.

Read about how to eat more fibre.

Swallowing air and bloating

Try not to swallow too much air. Don't talk and eat at the same time, sit down to eat (sitting upright and not slumped over), reduce the amount of fizzy drinks you consume, stop chewing gum and chew with your mouth closed so that you're not taking in excess air.

Food intolerance and bloating

Food intolerance can lead to bloating when:

• your bowel doesn't empty properly
• the food causes gas to be trapped
• too much gas is produced as a reaction to the food

The main offenders are wheat or gluten and dairy products. The best approach if you have a food intolerance is to eat less of the culprit food or cut it out completely.

Keep a food diary for a couple of weeks, noting everything that you eat and drink and when bloating troubles you most. But don't get rid of food groups long-term without advice from your GP.

Find out whether you should cut out bread to stop bloating.

Read more about food intolerance.

Coeliac disease and bloating

Coeliac disease is a common digestive condition where your intestine can't absorb gluten found in wheat, barley and rye.

Apart from bloating, if you have Coeliac disease, eating foods containing gluten can also trigger diarrhoea, abdominal pain and fatigue.

See your GP for a blood test if you suspect you may have Coeliac disease.

There is no cure for Coeliac disease but, once the condition has been diagnosed, switching to a gluten-free diet should help.

Read more about Coeliac disease.

Irritable bowel syndrome and bloating

People with irritable bowel syndrome often complain of bloating, especially in the evening.

The bloating of IBS doesn't seem to be linked with excess wind. It's thought to be down to erratic propulsion of contents through the bowel.

Read more about IBS and its treatment.

When to see a doctor

If your bloating symptoms persist, consult your GP to rule out a more serious condition. Bloating, and a persistent feeling of fullness, are key symptoms of ovarian cancer.

Now read what to eat to help your digestion.