Doctor Q&A: Am I eating my way to bad eye health? Doctor Renée answers your burning health questions

Hey doc, my gut is right out of sorts. I have to rush to the toilet three or four times a night. It doesn't appear to be connected to spicy foods either. What would you advise?

The answer to this question depends very much on how old you are; is it normal stool or diarrhoea; is it new or long-standing, and how long has it been going on for. I will try and give you some pointers though and as you mention food, I will assume you mean stools!

If your bowel habit has changed and persisted for more than four to six weeks, it always needs to be checked out because rarely it can be a sign of bowel cancer, so it is important for you to see a doctor if this applies to you. Additional signs of this may include blood in your stool (although this is not always serious), weight loss, and pain.

However, there are many more common and less serious reasons for your issue that might be at play.

If it is nocturnal diarrhoea you are experiencing, this may be caused by:

• Food
• Infection
• Allergies
• New medications
• Stress

If any of these factors are responsible, identifying the cause and treating/removing typically clears it up. If not, it is worth considering if you have an underlying health condition irritable bowel syndrome (IBS) - a common cause of changes to bowel habits and the most common symptoms are pain in your abdomen, often related to your bowel movements, and changes in your bowel movements.

These changes may be diarrhoea, constipation, or both. IBS can be very related to the food you eat and not just spicy, so it is important to keep a food diary and see if you can identify triggers.

It may be worth looking up the FODMAP diet to see if there are any foods on there that you are partial to and withdraw them for a couple of weeks to see if this helps.

It is important to think about recent stressors which have coincided with the onset of the problem. I have a VLOG on this here.

Coeliac disease - a chronic autoimmune disorder that occurs when the body's immune system attacks the small intestine after consuming glutena could be to blame.

A simple blood test carried out by your GP or withholding gluten from your diet will give you the answer and the treatment is avoiding gluten.

Colitis or inflammation of the colon (large bowel) can develop at any age and be caused by"

• Bacterial food poisoning
• Infections
• Crohn disease
• Ulcerative colitis

The treatment will depend totally on the cause and the best way of diagnosing this is initially with a simple stool test such as faecal calprotectin which shows inflammation and then a colonoscopy, a camera into the colon, to diagnosis the actual type of inflammation.

Hopefully that gives you some pointers but I must stress the need to see your GP if this has been going on for more than four to six weeks or if you have any of the other symptoms.

Meanwhile I would always add a probiotic and the one I like is Symprove, to improve gut health. Do this in conjunction with a clean fresh food diet, cooked at home and avoid processed foods.

Hey Doctor Renee, I recently read online that consuming pistachios daily may significantly improve eye health and it got me wondering: are there any foods that can cause your vision to deteriorate?

This is such an interesting question because people often have no idea that they can protect their eyes long-term with a good intake of certain nutrients/compounds. So, a good place to start is to confirm that pistachios do indeed offer one of these critical nutrients which is Lutein - one of two crucial nutrients for eyes that are often contained in specialist vitamins for eyes, a well-known one being Macushield. The other ingredient is zeaxanthin.

There are other nutrients that can be obtained from either a good varied, non-processed diet, or a multi-vitamin but diet is always best and research shows that diet can really influence eye health so be sure to include:

• Oily fish – plentiful omega 3
• Nuts, seeds and Legumes – vitamin E
• Leafy green veggies – vitamin C
• Citrus fruits – vitamins C and E
• Carrots – beta-carotene and vitamin A
• Eggs – Lutein, zeaxanthin, vitamins C, E and zinc

Now to turn to your question about foods which are bad for the eyes. The answer to this is really the same as the answer to any question about a healthy diet. It is the typically bad diets which can spell trouble for eye health in the long term. But in particular:

1. Sugary foods

Sugar is inflammatory and a high sugar diet puts you at risk of diabetes and diabetic retinopathy can threaten sight.

2. Processed meat

Heavy in salt and other chemicals which can increase blood pressure and damage the delicate and tiny blood vessels feeding the back of the eye.

3. Fried food

High in trans fats which raise cholesterol and affect circulation potentially denying the retina the oxygen-rich blood essential for eye health.

4. High sodium foods

Can raise blood pressure and this can manifest in the eye with hypertensive retinopathy and other eye problems.

5. Artificial sweeteners

Some research suggests that these affect blood sugar regulation and so indirectly can affect vision.

6. Refined carbohydrates

Pasta, white bread and pastries raise blood sugar quickly and repeated surges can cause insulin resistance and diabetes, bringing with it diabetic eye disease.

So, as often, it comes back to eating a varied, home-cooked, low sugar Mediterranean-style diet for general health and in this instance eye health!

Hey doc, what foods would you recommend avoiding if you have heartburn? It's causing me considerable grief and I am inspecting my diet. Thank you

Heartburn is the common term for indigestion caused by acid reflux from the stomach, through the sphincter (that should keep food and acid in the stomach) and back into the oesophagus towards the mouth.

There are several lifestyle changes that you can make to reverse this and these will always be better for you long-term than relying on the common medication for this - proton pump inhibitors (PPI), which suppress your stomach acid but don’t address the cause and have some worrying long term side effects such as bone thinning.

Diet is certainly a good place to start and the foods to avoid include:

• Tomatoes
• Spicy food
• Chocolate
• Alcohol
• Peppermint
• Caffeine

And don’t smoke!

Don’t hate me, but weight also plays a critical role in intra-abdominal pressure and each excess kilo pushes on the stomach and can cause reflux so getting your weight under BMI 25 will always help.

On a more positive note, there are foods that you can eat that claim to actually help. These include:

• Fibrous foods – these you feel full so you're less likely to overeat. Foods loaded with healthy fibre include whole grains and root veggies.
• Watery foods that can dilute stomach acid include celery, watermelon, herbal teas (decaffeinated) and cucumber.
• Alkaline foods are less likely to cause reflux. Those with higher pH are alkaline and can help offset strong stomach acid. Alkaline foods include nuts, bananas, melons and cauliflower.
• Finally, there are some home remedies that many swear by to help with the symptoms of heartburn and these include;
• Ginger: Is alkaline and anti-inflammatory so sipping a ginger tea when you feel heartburn developing can help.
• Milk: Long hailed as a buffer for the stomach.
• Apple cider vinegar: Make sure it is very dilute otherwise the strong acid can harm the stomach, but there are claims for a small amount diluted in water and drunk with meals.
• Lemon water and honey: Again, a very small amount of lemon juice in water can neutralize stomach acid and honey has natural anti-oxidants so this one is win-win.

I hope this helps you win the battle against this painful condition.