From fiber and diverticulitis to hemorrhoids and rectal bleeding, digestive health concerns are common, but it can be difficult to know when symptoms are normal and when they warrant medical attention. We turned to Dr. David Meyer, a board-certified general and colorectal surgeon with Georgia Colon & Rectal Surgical Associates, who shared practical guidance on diet, bowel habits, travel-related digestive issues and warning signs that should never be ignored. Here are his expert answers to common questions patients ask about keeping their digestive system healthy.
What foods improve colon health?
The strongest evidence supports high-fiber and Mediterranean-style diets. A diet rich in fruits, vegetables, whole grains, legumes and other fiber-rich foods supports regular bowel function and overall colon health.
What triggers diverticulitis attacks?
The exact cause is not fully understood, and our understanding has changed over the past decade. Risk factors include obesity, smoking, inactivity and low-fiber dietary patterns. Nuts, seeds and popcorn have not been shown to increase risk. No single food has been proven to trigger diverticulitis. Maintaining a healthy weight, regular exercise and a high-fiber diet may reduce risk.
Is this IBS or something more serious?
You may have typical symptoms of irritable bowel syndrome (IBS), but there are numerous alarm features that mean any abdominal pain symptoms or changes in stool frequency or consistency — even if present for months — should be properly evaluated by a professional. Symptoms such as rectal bleeding, unexplained weight loss, anemia, persistent diarrhea or constipation, new symptoms after age 50, or a family history of colon cancer should prompt medical evaluation. Don't assume new symptoms are simply IBS.
Why are hemorrhoids worse during the summer?
First of all, worsening of hemorrhoids during the summer is largely a plausible physiologic association rather than a proven phenomenon. Hot weather can lead to dehydration, which may cause harder stools and straining. Increased summer travel (reduced fiber, less predictable hydration, constipation and "holding it"), dietary changes (barbecues, alcohol, less fiber and vacation eating), and certain types of physical activity (long car rides, more cycling and heavy lifting on outdoor projects) can also worsen hemorrhoid symptoms. Practically speaking, summer doesn't directly cause hemorrhoids, but behaviors associated with summer may worsen symptoms.
Is my rectal bleeding just hemorrhoids?
Rectal bleeding is common and often comes from hemorrhoids, but you should never assume rectal bleeding is caused by hemorrhoids until it has been properly evaluated. Bright red blood on toilet paper can also come from proctitis, IBD, diverticular bleeding, polyps, colorectal cancer, radiation injury, ischemia or infection. Don't be embarrassed, and don't self-diagnose bleeding as hemorrhoids.
How can I manage constipation or diarrhea while traveling?
Traveler's constipation is extremely common. Stay hydrated, maintain a consistent fiber intake, stay active and avoid waiting too long to use the restroom. Consider bringing your usual fiber supplement when traveling. For diarrhea, prioritize oral rehydration and avoid excessive use of antidiarrheals if fever or bloody stools are present. Evidence supports fiber supplementation as one of the few interventions that can improve both constipation-predominant and diarrhea-predominant symptoms by normalizing stool consistency.
Are there specific high-fiber foods I should prioritize or avoid while on vacation?
Choose fruits, vegetables, beans, whole grains and nuts when possible. Limit excessive fast food, processed snacks and large amounts of alcohol, which can contribute to bowel irregularity.
How much water should I be drinking to avoid heat-related constipation?
Evidence is surprisingly limited. Hydration alone does not reliably treat constipation in adequately hydrated individuals. Most adults should drink enough fluids to keep urine pale yellow, usually 2 to 3 liters of fluid daily. In hot weather or during exercise, additional fluids are often needed.
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